HEALTH SERVICES AND PROGRAMS (R WELBOURN, SECTION EDITOR) Evidence Base for Multidisciplinary Care of Pediatric/Adolescent Bariatric Surgery Patients Mohamed O. Elahmedi 1 & Aayed R. Alqahtani 1 # Springer Science+Business Media, LLC 2017 Abstract Purpose of Review Severe childhood obesity, defined as having a body mass index (BMI) greater than the 99th percentile for age and gender, is rising in most countries and is associated with early morbidity and mortality. Optimal management of the health of the child with obe- sity requires a multidisciplinary approach that identifies and treats associated derangements. Recent Findings Lifestyle interventions such as diet, exer- cise, and behavioral therapy for the severely obese pedi- atric patient are generally not effective. Few centers worldwide offer bariatric surgery for adolescents in a mul- tidisciplinary setting, and we are the only center that of- fers a multidisciplinary approach that incorporates bariat- ric surgery for severely obese children and adolescents across all age groups. Summary In this paper, we review up-to-date evidence in this subject including ours, and provide details on the multidisci- plinary approach to pediatric obesity that accommodates bar- iatric surgery for children across all age groups. Keywords Pediatric . Children and adolescents . Bariatric surgery . Sleeve gastrectomy . Multidisciplinary . Obesity Introduction Overweight and obesity affect one in three children and ado- lescents in the USA, and an estimated one in 20 has extreme obesity. While recent studies suggest that the overall preva- lence of childhood obesity is plateauing, the number of chil- dren with extreme obesity is rising steadily [1]. Severe childhood obesity (defined as having a body mass index (BMI) that is greater than the 99th percentile for age and gender, or greater than 120% of the 95th percentile for age and gender) is associated with a host of diseases that are major risk factors for early morbidity and mortality [2–4]. The relation- ship between pediatric obesity and poor long-term outcomes has been well-documented in many longitudinal studies, such as the Bogalusa Heart Study and national data from several countries around the world [5–9]. Our studies suggest that more than 90% of children and adolescents with severe obe- sity have type 2 diabetes, hypertension, obstructive sleep ap- nea, or dyslipidemia, and that half of them have three or more of these comorbidities [10••]. The life of children with severe obesity is seriously impacted, and reports suggest that their quality of life is similar to that of those with cancer [11•]. However, recent evidence suggests that in young age groups, bariatric surgery safely induces significant weight loss and resolution of comorbidities [12••, 13••, 14••, 15••, 16••, 17••]. The Multidisciplinary Approach to Pediatric Obesity Pediatric obesity has a multitude of genetic, endocrine, behavior- al, nutritional, and psychological causes and consequences [ 18, 19]. The numerous medical and psychosocial complications of childhood obesity led to its recognition as a public health priority by many groups and experts [ 20–25]. Optimal health manage- ment of the child with obesity requires a multidisciplinary This article is part of the Topical Collection on Health Services and Programs * Aayed R. Alqahtani qahtani@yahoo.com 1 Department of Surgery, College of Medicine, King Saud University, 1 Baabda, Riyadh 11472, Saudi Arabia Curr Obes Rep DOI 10.1007/s13679-017-0278-3