With the increasing rates of severe obesity, the use of bariatric surgery in increasingly younger years is rising. This has led programs to have to consider the long term management of adolescents in their care and begin to develop pathways and protocols to manage clinical care situations previously believed to just be needed in adult centers. Currently, no research exists on the management of adolescents who require an escalation of therapy either through medication management or surgical revision following bariatric surgery. This abstract attempts to identify the key decision making steps in order to standardize care and be able to compare outcomes among programs.


A group of pediatric psychologists and surgeons involved in Stage 4 clinical and research activities came to consensus on key areas needing to be examined in order to consider escalation of therapy based on the literature and clinical case experience.


Pattern of weight loss, behavior change, comorbid mental health and compliance to program standards were identified as important areas to assess.


The use of adolescent bariatric surgery is rising and many questions still remain in the standardization of protocols in adolescent programs. This abstract attempts to provide guidance, and a call for research, about when to escalate therapy for weight loss following adolescent bariatric surgery.