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Erschienen in: Obesity Surgery 4/2017

17.10.2016 | Original Contributions

Initial Approach to Childhood Obesity in Spain. A Multisociety Expert Panel Assessment

verfasst von: Ramon Vilallonga, José Manuel Moreno Villares, Diego Yeste Fernández, Raquel Sánchez Santos, Felipe Casanueva Freijo, Francisco Santolaya Ochando, Nuria Leal Hernando, Albert Lecube Torelló, Luis Antonio Castaño González, Albert Feliu, Gontrand Lopez-Nava, Dolores Frutos, Antonio J. Torres Garcia, Juan Carlos Ruiz de Adana

Erschienen in: Obesity Surgery | Ausgabe 4/2017

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Abstract

Purpose

In recent years, the incidence of childhood obesity in Europe, and Spain in particular, has increased dramatically. Bariatric surgery could play a major role in treating of adolescents with severe obesity. However, no specific guidelines for bariatric surgery currently exist in Spain.

Methods

The Board of the Spanish Society for Obesity Surgery and Metabolic Diseases (SECO) proposed a study of childhood obesity by using the Delphi method. This prospective study involved 60 experts from nine national societies. Each society leader recruited experts from their society in obesity-related fields. Two online questionnaires were taken, and consensus on guidelines for various obesity treatments was reached according to the percentage of answers in favor or against inclusion of a given guideline. Based on these results, preoperative, surgical management and follow-up of childhood obesity management among others were analyzed.

Results

The survey results indicated significant concern among all societies regarding obesity. There was strong consensus with regard to adolescents and obesity, medical treatment, dietary recommendations, environmental and social factors, and goals for adolescents with obesity. Consensus on the use of intragastric balloons and other techniques was not reached. However, biliopancreatic diversion was rejected as a primary treatment, and mandatory psychological/psychiatric assessment was agreed upon. Inclusion criteria accepted were similar to those for adults with the exception of surgery in those with a body mass index <40.

Conclusions

Spanish obesity-related societies are aware of the societal problem of childhood obesity. Multisociety development of national approaches may arise from consensus-building studies among specialists.
Literatur
1.
Zurück zum Zitat Pérez RC. Current mapping of obesity. Nutr Hosp. 2013;28(Suppl 5):21–31. Pérez RC. Current mapping of obesity. Nutr Hosp. 2013;28(Suppl 5):21–31.
2.
Zurück zum Zitat Singh GK, Kogan MD, van Dyck PC. Changes in state-specific childhood obesity and overweight prevalence in the United States from 2003 to 2007. Arch Pediatr Adolesc Med. 2010;164:598–607.PubMed Singh GK, Kogan MD, van Dyck PC. Changes in state-specific childhood obesity and overweight prevalence in the United States from 2003 to 2007. Arch Pediatr Adolesc Med. 2010;164:598–607.PubMed
3.
Zurück zum Zitat Cheung PC, Cunningham SA, Naryan KM, et al. Childhood obesity incidence in the United States: a systematic review. Child Obes. 2016;12(1):1–11.CrossRefPubMedPubMedCentral Cheung PC, Cunningham SA, Naryan KM, et al. Childhood obesity incidence in the United States: a systematic review. Child Obes. 2016;12(1):1–11.CrossRefPubMedPubMedCentral
4.
Zurück zum Zitat Carrascosa A, Fernandez JM, Fernandez C, et al. Estudio transversal español de crecimiento 2008. Parte II: valores de talla, peso e índice de masa corporal desde el nacimiento a la talla adulta. An Pediatr (Barc). 2008;68:552–69.CrossRef Carrascosa A, Fernandez JM, Fernandez C, et al. Estudio transversal español de crecimiento 2008. Parte II: valores de talla, peso e índice de masa corporal desde el nacimiento a la talla adulta. An Pediatr (Barc). 2008;68:552–69.CrossRef
6.
Zurück zum Zitat Nobili V, Vajro P, Dezsofi A, et al. Indications and limitations of bariatric intervention in severely obese children and adolescents with and without nonalcoholic steatohepatitis: ESPGHAN hepatology committee position statement. J Pediatr Gastroenterol Nutr. 2015 Apr;60(4):550–61. Nobili V, Vajro P, Dezsofi A, et al. Indications and limitations of bariatric intervention in severely obese children and adolescents with and without nonalcoholic steatohepatitis: ESPGHAN hepatology committee position statement. J Pediatr Gastroenterol Nutr. 2015 Apr;60(4):550–61.
7.
Zurück zum Zitat Michalsky MP, Inge TH, Simmons M, et al. Cardiovascular risk factors in severely obese adolescents: the teen longitudinal assessment of bariatric surgery (teen-LABS) study. JAMA Pediatr. 2015;169(5):438–44. Michalsky MP, Inge TH, Simmons M, et al. Cardiovascular risk factors in severely obese adolescents: the teen longitudinal assessment of bariatric surgery (teen-LABS) study. JAMA Pediatr. 2015;169(5):438–44.
8.
Zurück zum Zitat Franks PW, Hanson RL, Knowler WC, et al. Childhood obesity, other cardiovascular risk factors, and premature death. N Engl J Med. 2010;362:485–93. Franks PW, Hanson RL, Knowler WC, et al. Childhood obesity, other cardiovascular risk factors, and premature death. N Engl J Med. 2010;362:485–93.
9.
Zurück zum Zitat Yeste D, Carrascosa A. Obesity-related metabolic disorders in childhood and adolescence. An Pediatr (Barc). 2011;75:135 .e1-9CrossRef Yeste D, Carrascosa A. Obesity-related metabolic disorders in childhood and adolescence. An Pediatr (Barc). 2011;75:135 .e1-9CrossRef
10.
Zurück zum Zitat Cole TJ, Bellizzi MC, Flegal KM, et al. Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ. 2000;320:1240–3. Cole TJ, Bellizzi MC, Flegal KM, et al. Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ. 2000;320:1240–3.
11.
Zurück zum Zitat Calañas-Continente A, Arrizabalaga J, Caixàs A, et al. Grupo de Trabajo sobre Obesidad de la Sociedad Española de Endocrinología y Nutrición. Med Clin (Barc). 2010;135:265–73. Calañas-Continente A, Arrizabalaga J, Caixàs A, et al. Grupo de Trabajo sobre Obesidad de la Sociedad Española de Endocrinología y Nutrición. Med Clin (Barc). 2010;135:265–73.
14.
Zurück zum Zitat Koebnick C, Smith N, Coleman KJ, et al. Prevalence of extreme obesity in a multiethnic cohort of children and adolescents. J Pediatr. 2010;157:26–31. Koebnick C, Smith N, Coleman KJ, et al. Prevalence of extreme obesity in a multiethnic cohort of children and adolescents. J Pediatr. 2010;157:26–31.
15.
Zurück zum Zitat Skinner AC, Steiner MJ, Henderson FW, et al. Multiple markers of inflammation and weight status: cross-sectional analyses throughout childhood. Pediatrics. 2010;125:e801–9. Skinner AC, Steiner MJ, Henderson FW, et al. Multiple markers of inflammation and weight status: cross-sectional analyses throughout childhood. Pediatrics. 2010;125:e801–9.
16.
Zurück zum Zitat Xanthakos SA, Jenkins TM, Kleiner DE, et al. High prevalence of nonalcoholic fatty liver disease in adolescents undergoing bariatric surgery. Gastroenterology. 2015;149(3):623–34 e8. Xanthakos SA, Jenkins TM, Kleiner DE, et al. High prevalence of nonalcoholic fatty liver disease in adolescents undergoing bariatric surgery. Gastroenterology. 2015;149(3):623–34 e8.
17.
Zurück zum Zitat Bout-Tabaku S, Michalsky MP, Jenkins TM, et al. Musculoskeletal pain, self-reported physical function, and quality of life in the teen-longitudinal assessment of bariatric surgery (teen-LABS) cohort. JAMA Pediatr. 2015 Jun;169(6):552–9. Bout-Tabaku S, Michalsky MP, Jenkins TM, et al. Musculoskeletal pain, self-reported physical function, and quality of life in the teen-longitudinal assessment of bariatric surgery (teen-LABS) cohort. JAMA Pediatr. 2015 Jun;169(6):552–9.
18.
Zurück zum Zitat Speiser PW, Rudolf M, Anhalt H, et al. Consensus statement: childhood obesity. J Clin Endocrinol Metab. 2005;90:1871–87. Speiser PW, Rudolf M, Anhalt H, et al. Consensus statement: childhood obesity. J Clin Endocrinol Metab. 2005;90:1871–87.
19.
Zurück zum Zitat Collins J, Qureshi F, Warman J, et al. Initial outcomes of laparoscopic roux-en-Y gastric bypass in morbidly obese adolescents. Surg Obes Relat Dis. 2007b;3:147–52. Collins J, Qureshi F, Warman J, et al. Initial outcomes of laparoscopic roux-en-Y gastric bypass in morbidly obese adolescents. Surg Obes Relat Dis. 2007b;3:147–52.
20.
Zurück zum Zitat Sinha A, Kling S. A review of adolescent obesity: prevalence, etiology, and treatment. Obes Surg. 2009;19:113–20.CrossRefPubMed Sinha A, Kling S. A review of adolescent obesity: prevalence, etiology, and treatment. Obes Surg. 2009;19:113–20.CrossRefPubMed
21.
Zurück zum Zitat Daniels SR, Arnett DK, Eckel RH, et al. Overweight in children and adolescents: pathophysiology, consequences, prevention, and treatment. Circulation. 2005;19(111):1999–2012. Daniels SR, Arnett DK, Eckel RH, et al. Overweight in children and adolescents: pathophysiology, consequences, prevention, and treatment. Circulation. 2005;19(111):1999–2012.
22.
Zurück zum Zitat Jen HC, Rickard DG, Shew SB, et al. Trends and outcomes of adolescent bariatric surgery in California, 2005-2007. Pediatrics. 2010;126:e746–53. Jen HC, Rickard DG, Shew SB, et al. Trends and outcomes of adolescent bariatric surgery in California, 2005-2007. Pediatrics. 2010;126:e746–53.
23.
Zurück zum Zitat Longitudinal Assessment of Bariatric Surgery (LABS) Consortium, Flum DR, Belle SH, King WC, Wahed AS, Berk P, et al. Perioperative safety in the longitudinal assessment of bariatric surgery. N Engl J Med. 2009;361:445–54.CrossRef Longitudinal Assessment of Bariatric Surgery (LABS) Consortium, Flum DR, Belle SH, King WC, Wahed AS, Berk P, et al. Perioperative safety in the longitudinal assessment of bariatric surgery. N Engl J Med. 2009;361:445–54.CrossRef
24.
Zurück zum Zitat Vilallonga R, Valverde S, Caubet E. Intestinal occlusion as unusual complication of new intragastric balloon Spatz Adjustable Balloon system for treatment of morbid obesity. Surg Obes Relat Dis. 2011 Dec 22. Vilallonga R, Valverde S, Caubet E. Intestinal occlusion as unusual complication of new intragastric balloon Spatz Adjustable Balloon system for treatment of morbid obesity. Surg Obes Relat Dis. 2011 Dec 22.
25.
Zurück zum Zitat Pratt JS, Lenders CM, Dionne EA, et al. Best practice updates for pediatric/adolescent weight loss surgery. Obesity (Silver Spring). 2009;17:901–10. Pratt JS, Lenders CM, Dionne EA, et al. Best practice updates for pediatric/adolescent weight loss surgery. Obesity (Silver Spring). 2009;17:901–10.
26.
Zurück zum Zitat Mion F, Napoléon B, Roman S, et al. Effects of intragastric balloon on gastric emptying and plasma ghrelin levels in nonmorbid obese patients. Obes Surg. 2005;15:510–6. Mion F, Napoléon B, Roman S, et al. Effects of intragastric balloon on gastric emptying and plasma ghrelin levels in nonmorbid obese patients. Obes Surg. 2005;15:510–6.
27.
Zurück zum Zitat Imaz I, Martínez-Cervell C, García-Alvarez EE, et al. Safety and effectiveness of the intragastric balloon for obesity. A Meta-analysis Obes Surg. 2008;18:841–6. Imaz I, Martínez-Cervell C, García-Alvarez EE, et al. Safety and effectiveness of the intragastric balloon for obesity. A Meta-analysis Obes Surg. 2008;18:841–6.
28.
Zurück zum Zitat Iqbal CW, Kumar S, Iqbal AD, et al. Perspectives on pediatric bariatric surgery: identifying barriers to referral. Surg Obes Relat Dis. 2009;5:88–93. Iqbal CW, Kumar S, Iqbal AD, et al. Perspectives on pediatric bariatric surgery: identifying barriers to referral. Surg Obes Relat Dis. 2009;5:88–93.
29.
Zurück zum Zitat Barlow SE. Expert committee and treatment of child and adolescent overweight and obesity: expert committee recommendations regarding the prevention. Assess, Rep Pediatr. 2007;120:S164–92. Barlow SE. Expert committee and treatment of child and adolescent overweight and obesity: expert committee recommendations regarding the prevention. Assess, Rep Pediatr. 2007;120:S164–92.
30.
Zurück zum Zitat Xanthakos SA, Daniels SR, Inge TH. Bariatric surgery in adolescents: an update. Adolesc Med Clin. 2006;17:589–612.PubMed Xanthakos SA, Daniels SR, Inge TH. Bariatric surgery in adolescents: an update. Adolesc Med Clin. 2006;17:589–612.PubMed
31.
Zurück zum Zitat Inge TH, Krebs NF, Garcia VF, et al. Bariatric surgery for severely overweight adolescents: concerns and recommendations. Pediatrics. 2004;114:217–23 Review. Inge TH, Krebs NF, Garcia VF, et al. Bariatric surgery for severely overweight adolescents: concerns and recommendations. Pediatrics. 2004;114:217–23 Review.
32.
Zurück zum Zitat Whitlock EA, O’Connor EP, Williams SB, et al. Effectiveness of weight management programs in children and adolescents. Evid Rep Technol Assess (Full Rep). 2008;170:1–308. Whitlock EA, O’Connor EP, Williams SB, et al. Effectiveness of weight management programs in children and adolescents. Evid Rep Technol Assess (Full Rep). 2008;170:1–308.
33.
Zurück zum Zitat August GP, Caprio S, Fennoy I, et al. Prevention and treatment of pediatric obesity: an endocrine society clinical practice guideline based on expert opinion. J Clin Endocrinol Metab. 2008;93:4576–99. August GP, Caprio S, Fennoy I, et al. Prevention and treatment of pediatric obesity: an endocrine society clinical practice guideline based on expert opinion. J Clin Endocrinol Metab. 2008;93:4576–99.
34.
Zurück zum Zitat Scheimann AO, Butler MG, Gourash L, et al. Critical analysis of bariatric procedures in Prader-Willi syndrome. J Pediatr Gastroenterol Nutr. 2008;46:80–3. Scheimann AO, Butler MG, Gourash L, et al. Critical analysis of bariatric procedures in Prader-Willi syndrome. J Pediatr Gastroenterol Nutr. 2008;46:80–3.
35.
Zurück zum Zitat Yitzhak A, Mizrahi S, Avinoach E. Laparoscopic gastric banding in adolescents. Obes Surg. 2006;16:1318–22.CrossRefPubMed Yitzhak A, Mizrahi S, Avinoach E. Laparoscopic gastric banding in adolescents. Obes Surg. 2006;16:1318–22.CrossRefPubMed
36.
Zurück zum Zitat DeMaria EJ, Pate V, Warthen M, et al. Baseline data from American Society for Metabolic and Bariatric Surgery-Designated bariatric surgery centers of excellence using the bariatric outcomes longitudinal database. Surg Obes Relat Dis. 2012;6:347–55. DeMaria EJ, Pate V, Warthen M, et al. Baseline data from American Society for Metabolic and Bariatric Surgery-Designated bariatric surgery centers of excellence using the bariatric outcomes longitudinal database. Surg Obes Relat Dis. 2012;6:347–55.
37.
Zurück zum Zitat Dolan L, Creighton G, Hopkins, et al. Laparoscopic gastric banding in morbidly obese adolescents. Obes Surg. 2003;13:101–4. Dolan L, Creighton G, Hopkins, et al. Laparoscopic gastric banding in morbidly obese adolescents. Obes Surg. 2003;13:101–4.
38.
Zurück zum Zitat Fielding GA, Duncombe JE. Laparoscopic adjustable gastric banding in severely obese adolescents. Surg Obes Relat Dis. 2005;1:399–405.CrossRefPubMed Fielding GA, Duncombe JE. Laparoscopic adjustable gastric banding in severely obese adolescents. Surg Obes Relat Dis. 2005;1:399–405.CrossRefPubMed
39.
Zurück zum Zitat Silberhumer GR, Miller K, Kriwanek S, et al. Laparoscopic adjustable gastric banding in adolescents: the Austrian experience. Obes Surg. 2006;16:1062–7. Silberhumer GR, Miller K, Kriwanek S, et al. Laparoscopic adjustable gastric banding in adolescents: the Austrian experience. Obes Surg. 2006;16:1062–7.
40.
Zurück zum Zitat Angrisani L, Favretti F, Furbetta F, et al. Obese teenagers treated by lap-band system: the Italian experience. Surgery. 2005;138:877–81. Angrisani L, Favretti F, Furbetta F, et al. Obese teenagers treated by lap-band system: the Italian experience. Surgery. 2005;138:877–81.
41.
Zurück zum Zitat Horgan S, Holterman MJ, Jacobsen GR, et al. Laparoscopic adjustable gastric banding for the treatment of adolescent morbid obesity in the United States: a safe alternative to gastric bypass. J Pediatr Surg. 2005;40:86–90 discussion 90–91. Horgan S, Holterman MJ, Jacobsen GR, et al. Laparoscopic adjustable gastric banding for the treatment of adolescent morbid obesity in the United States: a safe alternative to gastric bypass. J Pediatr Surg. 2005;40:86–90 discussion 90–91.
42.
Zurück zum Zitat Alqahtani AR, Elahmedi MO. Pediatric bariatric surgery: the clinical pathway. Obes Surg. 2015 May;25(5):910–21.CrossRefPubMed Alqahtani AR, Elahmedi MO. Pediatric bariatric surgery: the clinical pathway. Obes Surg. 2015 May;25(5):910–21.CrossRefPubMed
43.
Zurück zum Zitat Nadler EP, Brotman LM, Miyoshi T, et al. Morbidity in obese adolescents who meet the adult National Institutes of Health criteria for bariatric surgery. J Pediatr Surg. 2009;44:1869–76. Nadler EP, Brotman LM, Miyoshi T, et al. Morbidity in obese adolescents who meet the adult National Institutes of Health criteria for bariatric surgery. J Pediatr Surg. 2009;44:1869–76.
44.
Zurück zum Zitat O’Brien PE, Sawyer SM, Laurie C, et al. Laparoscopic adjustable gastric banding in severely obese adolescents: a randomized trial. JAMA. 2010;303:519–26. O’Brien PE, Sawyer SM, Laurie C, et al. Laparoscopic adjustable gastric banding in severely obese adolescents: a randomized trial. JAMA. 2010;303:519–26.
45.
Zurück zum Zitat Papadia FS, Adami GF, Marinari GM, et al. Bariatric surgery in a dolescents: a long-term follow-up study. Surg Obes Relat Dis. 2007;3:465–8. Papadia FS, Adami GF, Marinari GM, et al. Bariatric surgery in a dolescents: a long-term follow-up study. Surg Obes Relat Dis. 2007;3:465–8.
46.
Zurück zum Zitat Buchwald H, Avidor Y, Braunwald E, et al. Bariatric surgery: a systematic review and meta-analysis. JAMA. 2004;13(292):1724–37. Buchwald H, Avidor Y, Braunwald E, et al. Bariatric surgery: a systematic review and meta-analysis. JAMA. 2004;13(292):1724–37.
47.
Zurück zum Zitat Aikenhead A, Lobstein T, Knai C. Review of current guidelines on adolescente bariatric surgery. Clin Obes. 2011;1:3–11.CrossRefPubMed Aikenhead A, Lobstein T, Knai C. Review of current guidelines on adolescente bariatric surgery. Clin Obes. 2011;1:3–11.CrossRefPubMed
48.
Zurück zum Zitat Paulus GF, de Vaan LE, Verdam FJ, et al. Bariatric surgery in morbidly obese adolescents: a systematic review and meta-analysis. Obes Surg. 2015 May;25(5):860–78. Paulus GF, de Vaan LE, Verdam FJ, et al. Bariatric surgery in morbidly obese adolescents: a systematic review and meta-analysis. Obes Surg. 2015 May;25(5):860–78.
49.
Zurück zum Zitat Maggard MA, Shugarman LR, Suttorp M, et al. Meta-analysis: surgical treatment of obesity. Ann Intern Med. 2005;142:547–59. Maggard MA, Shugarman LR, Suttorp M, et al. Meta-analysis: surgical treatment of obesity. Ann Intern Med. 2005;142:547–59.
50.
Zurück zum Zitat Barnett SJ, Stanley C, Hanlon M, et al. Long-term follow-up and the role of surgery in adolescents with morbid obesity. Surg Obes Relat Dis. 2005;1:394–8. Barnett SJ, Stanley C, Hanlon M, et al. Long-term follow-up and the role of surgery in adolescents with morbid obesity. Surg Obes Relat Dis. 2005;1:394–8.
51.
Zurück zum Zitat Collins J, Mattar S, Qureshi F, et al. Initial outcomes of laparoscopic roux-en-Y gastric bypass in morbidly obese adolescents. Surg Obes Relat Dis. 2007a;3:147–52. Collins J, Mattar S, Qureshi F, et al. Initial outcomes of laparoscopic roux-en-Y gastric bypass in morbidly obese adolescents. Surg Obes Relat Dis. 2007a;3:147–52.
52.
Zurück zum Zitat Lawson ML, Kirk S, Mitchell T, et al. One-year outcomes of roux-en-Y gastric bypass for morbidly obese adolescents: a multicenter study from the pediatric bariatric study group. J Pediatr Surg. 2006;41:137–43 discussion 137–143. Lawson ML, Kirk S, Mitchell T, et al. One-year outcomes of roux-en-Y gastric bypass for morbidly obese adolescents: a multicenter study from the pediatric bariatric study group. J Pediatr Surg. 2006;41:137–43 discussion 137–143.
53.
Zurück zum Zitat Boza C, Viscido G, Salinas J, et al. Laparoscopic sleeve gastrectomy in obese adolescents: results in 51 patients. Surg Obes Relat Dis. 2012;8:133–7 discussion 137-9. Boza C, Viscido G, Salinas J, et al. Laparoscopic sleeve gastrectomy in obese adolescents: results in 51 patients. Surg Obes Relat Dis. 2012;8:133–7 discussion 137-9.
54.
Zurück zum Zitat Pedroso FE, Gander J, Oh PS, et al. Laparoscopic vertical sleeve gastrectomy significantly improves short term weight loss as compared to laparoscopic adjustable gastric band placement in morbidly obese adolescent patients. J Pediatr Surg. 2015;50:115–22. Pedroso FE, Gander J, Oh PS, et al. Laparoscopic vertical sleeve gastrectomy significantly improves short term weight loss as compared to laparoscopic adjustable gastric band placement in morbidly obese adolescent patients. J Pediatr Surg. 2015;50:115–22.
55.
Zurück zum Zitat Oberbach A, von Bergen M, Blüher S, et al. Combined serum proteomic and metabonomic profiling after laparoscopic sleeve gastrectomy in children and adolescents. J Laparoendosc Adv Surg Tech A. 2012;22:184–8. Oberbach A, von Bergen M, Blüher S, et al. Combined serum proteomic and metabonomic profiling after laparoscopic sleeve gastrectomy in children and adolescents. J Laparoendosc Adv Surg Tech A. 2012;22:184–8.
56.
Zurück zum Zitat Inge TH, Xanthakos S. Sleeve gastrectomy for childhood morbid obesity: why not? Obes Surg. 2010;20:118–20.CrossRefPubMed Inge TH, Xanthakos S. Sleeve gastrectomy for childhood morbid obesity: why not? Obes Surg. 2010;20:118–20.CrossRefPubMed
57.
Zurück zum Zitat Alqahtani AR, Antonisamy B, Alamri H, et al. Laparoscopic sleeve gastrectomy in 108 obese children and adolescents aged 5 to 21 years. Ann Surg. 2012 Apr 16. Alqahtani AR, Antonisamy B, Alamri H, et al. Laparoscopic sleeve gastrectomy in 108 obese children and adolescents aged 5 to 21 years. Ann Surg. 2012 Apr 16.
58.
Zurück zum Zitat Inge TH, Corucoulas AP, Jenkins TM, et al. Weight loss and health status 3 years after bariatric surgery in adolescents. N Engl J Med. 2016;374:113–23. Inge TH, Corucoulas AP, Jenkins TM, et al. Weight loss and health status 3 years after bariatric surgery in adolescents. N Engl J Med. 2016;374:113–23.
59.
Zurück zum Zitat Arman GA, Himpens J, Dhaenens J, et al. Long-term (11 + years) outcomes in weight, patient satisfaction, comorbidities, and gastroesophageal reflux treatment after laparoscopic sleeve gastrectomy. Surg Obes Relat Dis. 2016 19. Arman GA, Himpens J, Dhaenens J, et al. Long-term (11 + years) outcomes in weight, patient satisfaction, comorbidities, and gastroesophageal reflux treatment after laparoscopic sleeve gastrectomy. Surg Obes Relat Dis. 2016 19.
60.
Zurück zum Zitat Gussinyer S, García-Reyna NI, Carrascosa A, et al. Cambios antropométricos, dietéticos y psicológicos tras la aplicación del programa Niñ@s en movimiento en la obesidad infantil. Med Clin (Barc). 2008;131:245–9. Gussinyer S, García-Reyna NI, Carrascosa A, et al. Cambios antropométricos, dietéticos y psicológicos tras la aplicación del programa Niñ@s en movimiento en la obesidad infantil. Med Clin (Barc). 2008;131:245–9.
61.
Zurück zum Zitat Inge TH. Reversal of type 2 diabetes mellitus and improvements in cardiovascular risk factors after surgical weight loss in adolescents. Pediatrics. 2009;123:214–22. Inge TH. Reversal of type 2 diabetes mellitus and improvements in cardiovascular risk factors after surgical weight loss in adolescents. Pediatrics. 2009;123:214–22.
Metadaten
Titel
Initial Approach to Childhood Obesity in Spain. A Multisociety Expert Panel Assessment
verfasst von
Ramon Vilallonga
José Manuel Moreno Villares
Diego Yeste Fernández
Raquel Sánchez Santos
Felipe Casanueva Freijo
Francisco Santolaya Ochando
Nuria Leal Hernando
Albert Lecube Torelló
Luis Antonio Castaño González
Albert Feliu
Gontrand Lopez-Nava
Dolores Frutos
Antonio J. Torres Garcia
Juan Carlos Ruiz de Adana
Publikationsdatum
17.10.2016
Verlag
Springer US
Erschienen in
Obesity Surgery / Ausgabe 4/2017
Print ISSN: 0960-8923
Elektronische ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-016-2413-8

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