# Severe Obesity — GCMD Library living collection

Everything in the library about severe obesity — built automatically from dossiers that name it.

Updated: n/a · 3 episodes · 58 cited statements

## Episodes
### Medical Management
- [Pharmacology: Pediatric Obesity 2017](https://library.globalcastmd.com/watch/pharmacology-pediatric-obesity-2017-366) — video · 45:08 · [machine version](https://library.globalcastmd.com/watch/pharmacology-pediatric-obesity-2017-366.md)

### Surgical Management
- [Adolescent Bariatric Surgery: Pediatric Obesity 2017](https://library.globalcastmd.com/watch/adolescent-bariatric-surgery-pediatric-obesity-2017-371) — video · 32:47 · [machine version](https://library.globalcastmd.com/watch/adolescent-bariatric-surgery-pediatric-obesity-2017-371.md)
- [AAP Policy for Adolescent Bariatric Surgery: Pediatric Obesity 2017](https://library.globalcastmd.com/watch/aap-policy-for-adolescent-bariatric-surgery-pediatric-obesity-2017-372) — video · 27:22 · [machine version](https://library.globalcastmd.com/watch/aap-policy-for-adolescent-bariatric-surgery-pediatric-obesity-2017-372.md)

## Chapters
- [0:00](https://library.globalcastmd.com/watch/pharmacology-pediatric-obesity-2017-366?t=0) Introduction and Speaker Presentation (Ep 1)
- [2:09](https://library.globalcastmd.com/watch/pharmacology-pediatric-obesity-2017-366?t=129) Why Consider Pharmacotherapy for Pediatric Obesity (Ep 1)
- [11:20](https://library.globalcastmd.com/watch/pharmacology-pediatric-obesity-2017-366?t=680) Limitations of Lifestyle Modification Therapy (Ep 1)
- [18:00](https://library.globalcastmd.com/watch/pharmacology-pediatric-obesity-2017-366?t=1080) Biological Mechanisms of Obesity and Weight Regain (Ep 1)
- [25:00](https://library.globalcastmd.com/watch/pharmacology-pediatric-obesity-2017-366?t=1500) FDA-Approved Medications: Orlistat and Phentermine (Ep 1)
- [32:00](https://library.globalcastmd.com/watch/pharmacology-pediatric-obesity-2017-366?t=1920) Off-Label Medications and Future Directions (Ep 1)
- [37:50](https://library.globalcastmd.com/watch/pharmacology-pediatric-obesity-2017-366?t=2270) Q&A: Long-term Use, Insurance Coverage, and Clinical Practice (Ep 1)
- [0:00](https://library.globalcastmd.com/watch/adolescent-bariatric-surgery-pediatric-obesity-2017-371?t=0) Introduction and Study Overview (Ep 2)
- [4:00](https://library.globalcastmd.com/watch/adolescent-bariatric-surgery-pediatric-obesity-2017-371?t=240) Rationale for Aggressive Treatment and Mortality Risk (Ep 2)
- [8:00](https://library.globalcastmd.com/watch/adolescent-bariatric-surgery-pediatric-obesity-2017-371?t=480) Cincinnati FAS-5 Study Design and Retention (Ep 2)
- [13:00](https://library.globalcastmd.com/watch/adolescent-bariatric-surgery-pediatric-obesity-2017-371?t=780) FAS-5 Weight Loss Outcomes and BMI Trajectories (Ep 2)
- [17:00](https://library.globalcastmd.com/watch/adolescent-bariatric-surgery-pediatric-obesity-2017-371?t=1020) Comorbidity Remission and Incidence Rates (Ep 2)
- [20:00](https://library.globalcastmd.com/watch/adolescent-bariatric-surgery-pediatric-obesity-2017-371?t=1200) Residual BMI and Metabolic Harm (Ep 2)
- [23:00](https://library.globalcastmd.com/watch/adolescent-bariatric-surgery-pediatric-obesity-2017-371?t=1380) Micronutrient Deficiencies in FAS-5 (Ep 2)
- [24:00](https://library.globalcastmd.com/watch/adolescent-bariatric-surgery-pediatric-obesity-2017-371?t=1440) Swedish AMOS Study Design and Weight Outcomes (Ep 2)
- [28:00](https://library.globalcastmd.com/watch/adolescent-bariatric-surgery-pediatric-obesity-2017-371?t=1680) AMOS Comorbidity Resolution and Complications (Ep 2)
- [30:00](https://library.globalcastmd.com/watch/adolescent-bariatric-surgery-pediatric-obesity-2017-371?t=1800) Teen Labs Consortium: Current Status and Future Aims (Ep 2)
- [34:00](https://library.globalcastmd.com/watch/adolescent-bariatric-surgery-pediatric-obesity-2017-371?t=2040) Summary and Window of Opportunity (Ep 2)
- [0:00](https://library.globalcastmd.com/watch/aap-policy-for-adolescent-bariatric-surgery-pediatric-obesity-2017-372?t=0) Introduction of Speaker and Topic (Ep 3)
- [0:50](https://library.globalcastmd.com/watch/aap-policy-for-adolescent-bariatric-surgery-pediatric-obesity-2017-372?t=50) Rationale for Policy Development and Obesity Prevalence (Ep 3)
- [7:00](https://library.globalcastmd.com/watch/aap-policy-for-adolescent-bariatric-surgery-pediatric-obesity-2017-372?t=420) Evolution of Evidence Base (Ep 3)
- [10:40](https://library.globalcastmd.com/watch/aap-policy-for-adolescent-bariatric-surgery-pediatric-obesity-2017-372?t=640) Consensus Guidelines Development History (Ep 3)
- [15:00](https://library.globalcastmd.com/watch/aap-policy-for-adolescent-bariatric-surgery-pediatric-obesity-2017-372?t=900) National Accreditation Standards (Ep 3)
- [18:20](https://library.globalcastmd.com/watch/aap-policy-for-adolescent-bariatric-surgery-pediatric-obesity-2017-372?t=1100) Insurance Authorization Barriers (Ep 3)
- [22:30](https://library.globalcastmd.com/watch/aap-policy-for-adolescent-bariatric-surgery-pediatric-obesity-2017-372?t=1350) Physician Attitudes and Procedural Prevalence (Ep 3)
- [24:30](https://library.globalcastmd.com/watch/aap-policy-for-adolescent-bariatric-surgery-pediatric-obesity-2017-372?t=1470) AAP Policy Statement Development Timeline (Ep 3)
- [25:33](https://library.globalcastmd.com/watch/aap-policy-for-adolescent-bariatric-surgery-pediatric-obesity-2017-372?t=1533) Closing Discussion and Current Status (Ep 3)

## Statements
Every statement is attributed, typed, and timestamped; the link is the citation.
- "Of 12-year-olds with BMI at 99th percentile, all will grow up to have BMIs greater than 30, 88% will have BMIs greater than 35, and 2/3 will have class 3 obesity, according to the Bogalusa Heart Study." — Claudia Fox (epidemiological) [Ep 1 · 9:30](https://library.globalcastmd.com/watch/pharmacology-pediatric-obesity-2017-366?t=570)
- "Severe obesity is defined as BMI greater than 1.2 times the 95th percentile." — Claudia Fox (guideline) [Ep 1 · 13:00](https://library.globalcastmd.com/watch/pharmacology-pediatric-obesity-2017-366?t=780)
- "Only 2% of teenagers with severe obesity demonstrated clinically significant BMI reduction with lifestyle modification therapy." — Claudia Fox (clinical) [Ep 1 · 15:30](https://library.globalcastmd.com/watch/pharmacology-pediatric-obesity-2017-366?t=930)
- "In a study comparing inpatient (6 months) versus outpatient lifestyle modification therapy followed for 2 years, there was no statistically significant difference in outcomes at 2 years despite better response during inpatient treatment." — Claudia Fox (clinical) [Ep 1 · 17:00](https://library.globalcastmd.com/watch/pharmacology-pediatric-obesity-2017-366?t=1020)
- "Mutations in the melanocortin 4 receptor (MC4R) account for the most common single gene mutation causing early onset severe obesity in pediatrics." — Claudia Fox (clinical) [Ep 1 · 21:00](https://library.globalcastmd.com/watch/pharmacology-pediatric-obesity-2017-366?t=1260)
- "Bupropion-naltrexone combination works by bupropion stimulating POMC cells to secrete alpha-MSH (which stimulates MC4 receptors to decrease hunger), while naltrexone blocks the auto-inhibitory feedback from beta-endorphin, allowing relatively more alpha-MSH activity." — Claudia Fox (clinical) [Ep 1 · 22:00](https://library.globalcastmd.com/watch/pharmacology-pediatric-obesity-2017-366?t=1320)
- "When people lose weight, they experience increased hunger, decreased satiety, increased preference for highly palatable foods, and increased metabolic efficiency—all promoting weight regain." — Claudia Fox (clinical) [Ep 1 · 28:00](https://library.globalcastmd.com/watch/pharmacology-pediatric-obesity-2017-366?t=1680)
- "Bariatric surgery is currently the most effective and durable treatment for severe obesity in adolescents." — Claudia Fox (clinical) [Ep 1 · 29:00](https://library.globalcastmd.com/watch/pharmacology-pediatric-obesity-2017-366?t=1740)
- "Orlistat is a lipase inhibitor that blocks absorption of about 30% of fat, is FDA approved for children 12 and older, and in the largest RCT of about 500 patients showed placebo-subtracted BMI difference of about 0.8 units at one year." — Claudia Fox (clinical) [Ep 1 · 30:00](https://library.globalcastmd.com/watch/pharmacology-pediatric-obesity-2017-366?t=1800)
- "Phentermine is FDA approved for age 16 and older (from 1950s approval), but there have been no RCTs in adolescents longer than 1 month duration." — Claudia Fox (clinical) [Ep 1 · 31:00](https://library.globalcastmd.com/watch/pharmacology-pediatric-obesity-2017-366?t=1860)
- "Among adults, phentermine produces mean weight loss of about 3.5 kg." — Claudia Fox (clinical) [Ep 1 · 31:30](https://library.globalcastmd.com/watch/pharmacology-pediatric-obesity-2017-366?t=1890)
- "In studies of adults on phentermine, there have been no withdrawal symptoms upon abruptly stopping and no reports of increased blood pressure, probably because patients are losing weight." — Claudia Fox (clinical) [Ep 1 · 32:00](https://library.globalcastmd.com/watch/pharmacology-pediatric-obesity-2017-366?t=1920)
- "In a chart review of 25 patients on phentermine only for 6 months plus lifestyle modification, compared to 274 receiving only lifestyle modification, there was about a 4% decrease in BMI favoring the phentermine group." — Claudia Fox (clinical) [Ep 1 · 33:00](https://library.globalcastmd.com/watch/pharmacology-pediatric-obesity-2017-366?t=1980)
- "After many studies of metformin, we can expect about a one unit decrease in BMI." — Claudia Fox (clinical) [Ep 1 · 34:10](https://library.globalcastmd.com/watch/pharmacology-pediatric-obesity-2017-366?t=2050)
- "Liraglutide, a GLP-1 agonist, has recently been FDA approved for obesity in adults." — Claudia Fox (clinical) [Ep 1 · 34:40](https://library.globalcastmd.com/watch/pharmacology-pediatric-obesity-2017-366?t=2080)
- "In a pilot study of exenatide (GLP-1 agonist) with about 25 patients, during the first 3 months double-blinded portion, there was a placebo-subtracted effect of about 3% in BMI favoring the exenatide group." — Claudia Fox (clinical) [Ep 1 · 35:20](https://library.globalcastmd.com/watch/pharmacology-pediatric-obesity-2017-366?t=2120)
- "In a chart review of patients taking topiramate only (no other medications) with lifestyle modification therapy, there was about a 6% decrease in BMI at 6 months." — Claudia Fox (clinical) [Ep 1 · 36:30](https://library.globalcastmd.com/watch/pharmacology-pediatric-obesity-2017-366?t=2190)
- "In an RCT of topiramate 75mg/day after meal replacement induction phase, there was no statistically significant effect between topiramate and placebo groups by study end." — Claudia Fox (clinical) [Ep 1 · 37:10](https://library.globalcastmd.com/watch/pharmacology-pediatric-obesity-2017-366?t=2230)
- "Topiramate at 75mg/day was safe in adolescents, with extensive neurocognitive testing showing no signal of cognitive deficits." — Claudia Fox (clinical) [Ep 1 · 39:00](https://library.globalcastmd.com/watch/pharmacology-pediatric-obesity-2017-366?t=2340)
- "Topiramate is FDA approved down to age 2 for seizures and has been used in pediatrics for decades." — Claudia Fox (clinical) [Ep 1 · 38:50](https://library.globalcastmd.com/watch/pharmacology-pediatric-obesity-2017-366?t=2330)
- "Obesity is a chronic disease requiring indefinite medication treatment; stopping the medication results in weight regain, similar to stopping antihypertensive medication causing blood pressure to rise." — Claudia Fox (opinion) [Ep 1 · 40:50](https://library.globalcastmd.com/watch/pharmacology-pediatric-obesity-2017-366?t=2450)
- "Recently FDA-approved medications for adult obesity (age 18+) include topiramate-phentermine combination, liraglutide, naltrexone-bupropion combination, and lorcaserin, approved for BMI >30 or >27 with weight-related comorbidities." — Claudia Fox (clinical) [Ep 1 · 41:40](https://library.globalcastmd.com/watch/pharmacology-pediatric-obesity-2017-366?t=2500)
- "Early success in weight management predicts long-term weight loss success, according to adult literature." — Claudia Fox (clinical) [Ep 1 · 40:20](https://library.globalcastmd.com/watch/pharmacology-pediatric-obesity-2017-366?t=2420)
- "Bariatric surgery is seen as more acceptable than pharmacotherapy for pediatric obesity, despite being arguably riskier and irreversible." — Claudia Fox (opinion) [Ep 1 · 41:40](https://library.globalcastmd.com/watch/pharmacology-pediatric-obesity-2017-366?t=2500)
- "Cardiovascular mortality begins to climb in the overweight range and increases definitively for adolescents at or above the 95th percentile BMI, leading to early cardiovascular death." — Tom Inge (host_summary) [Ep 2 · 4:00](https://library.globalcastmd.com/watch/adolescent-bariatric-surgery-pediatric-obesity-2017-371?t=240)
- "FAS-5 study achieved 81% participation (58 of 74 eligible) at 8-year follow-up, mostly with in-person research visits." — Tom Inge (clinical) [Ep 2 · 8:00](https://library.globalcastmd.com/watch/adolescent-bariatric-surgery-pediatric-obesity-2017-371?t=480)
- "At 8-year mean follow-up, gastric bypass patients had a mean BMI decline of 29%." — Tom Inge (clinical) [Ep 2 · 13:00](https://library.globalcastmd.com/watch/adolescent-bariatric-surgery-pediatric-obesity-2017-371?t=780)
- "Baseline BMI strongly correlates (R=0.75) with follow-up BMI: patients starting with BMI in the 60s end above 40, while those starting in the 40s reach near-normal BMI." — Tom Inge (clinical) [Ep 2 · 15:00](https://library.globalcastmd.com/watch/adolescent-bariatric-surgery-pediatric-obesity-2017-371?t=900)
- "Remission rates at 8 years: 88% for diabetes, 64% for dyslipidemia, 75% for hypertension." — Tom Inge (clinical) [Ep 2 · 17:00](https://library.globalcastmd.com/watch/adolescent-bariatric-surgery-pediatric-obesity-2017-371?t=1020)
- "Among those without baseline comorbidities, incidence rates were 0% for diabetes, 50% for dyslipidemia (small denominator), and 3 of 29 developed hypertension." — Tom Inge (clinical) [Ep 2 · 18:00](https://library.globalcastmd.com/watch/adolescent-bariatric-surgery-pediatric-obesity-2017-371?t=1080)
- "Follow-up BMI predicts probability of hypertension, dyslipidemia, high CRP, high insulin, insulin resistance, and low HDL; higher residual BMI is metabolically harmful." — Tom Inge (clinical) [Ep 2 · 20:00](https://library.globalcastmd.com/watch/adolescent-bariatric-surgery-pediatric-obesity-2017-371?t=1200)
- "At 8 years, FAS-5 cohort showed low iron stores with anemia, elevated PTH, and low vitamin D in substantial numbers." — Tom Inge (clinical) [Ep 2 · 23:00](https://library.globalcastmd.com/watch/adolescent-bariatric-surgery-pediatric-obesity-2017-371?t=1380)
- "In AMOS study, non-surgical controls with severe obesity gained weight over 5 years (BMI 42→45)." — Tom Inge (host_summary) [Ep 2 · 25:00](https://library.globalcastmd.com/watch/adolescent-bariatric-surgery-pediatric-obesity-2017-371?t=1500)
- "AMOS gastric bypass patients had dramatic BMI reduction from 45 to 30, stable at 5 years, similar to adult controls and SOS cohort." — Tom Inge (host_summary) [Ep 2 · 26:00](https://library.globalcastmd.com/watch/adolescent-bariatric-surgery-pediatric-obesity-2017-371?t=1560)
- "AMOS showed 83% dyslipidemia remission, 12 of 12 hypertension cases resolved, and 75% inflammation (CRP) resolved." — Tom Inge (host_summary) [Ep 2 · 28:00](https://library.globalcastmd.com/watch/adolescent-bariatric-surgery-pediatric-obesity-2017-371?t=1680)
- "AMOS had high internal hernia rates due to unclosed mesenteric defects at laparoscopic gastric bypass; closing defects prevents this complication." — Tom Inge (clinical) [Ep 2 · 29:00](https://library.globalcastmd.com/watch/adolescent-bariatric-surgery-pediatric-obesity-2017-371?t=1740)
- "In AMOS, low vitamin D was found in >50% of gastric bypass patients and also in controls; low B12 and iron deficiency anemia were noted." — Tom Inge (host_summary) [Ep 2 · 30:00](https://library.globalcastmd.com/watch/adolescent-bariatric-surgery-pediatric-obesity-2017-371?t=1800)
- "Teen Labs enrolled 242 adolescents (161 bypass, 67 sleeve, 14 band) at 5 centers; median age now 24, with 203 completing 5-year visits (72% in-clinic, 17% field)." — Tom Inge (clinical) [Ep 2 · 31:00](https://library.globalcastmd.com/watch/adolescent-bariatric-surgery-pediatric-obesity-2017-371?t=1860)
- "Adding 33 sleeve gastrectomy patients to Teen Labs will provide 80% power to compare bypass vs. sleeve for outcomes including blood pressure, PTH, HDL, and BMI." — Tom Inge (clinical) [Ep 2 · 32:00](https://library.globalcastmd.com/watch/adolescent-bariatric-surgery-pediatric-obesity-2017-371?t=1920)
- "Severely obese patients have greater bone mineral density due to loading; rapid weight loss after bariatric surgery drops bone mass, raising the question of whether it stabilizes or continues to decline (bariatric bone disease)." — Tom Inge (clinical) [Ep 2 · 34:00](https://library.globalcastmd.com/watch/adolescent-bariatric-surgery-pediatric-obesity-2017-371?t=2040)
- "Operating earlier after diagnosis of severe obesity may yield lower residual BMI and better long-term metabolic outcomes." — Tom Inge (opinion) [Ep 2 · 32:47](https://library.globalcastmd.com/watch/adolescent-bariatric-surgery-pediatric-obesity-2017-371?t=1967)
- "FAS-5 study had a residual mean BMI of 38 at 8 years, with many patients remaining severely obese; this residual obesity is metabolically harmful." — Tom Inge (clinical) [Ep 2 · 32:47](https://library.globalcastmd.com/watch/adolescent-bariatric-surgery-pediatric-obesity-2017-371?t=1967)
- "The 33 new sleeve patients can be enrolled within a year from consortium sites with ongoing clinical follow-up, enabling long-term comparisons." — Tom Inge (clinical) [Ep 2 · 32:17](https://library.globalcastmd.com/watch/adolescent-bariatric-surgery-pediatric-obesity-2017-371?t=1937)
- "Severe obesity estimates in the adolescent population range up to approximately 2 million patients who have physiologic or anthropomorphic qualifications to consider bariatric surgery." — Mark (epidemiological) [Ep 3 · 3:30](https://library.globalcastmd.com/watch/aap-policy-for-adolescent-bariatric-surgery-pediatric-obesity-2017-372?t=210)
- "Extremely obese children and teens have a very high propensity of carrying obesity into their adult years, supported by large cross-sectional studies." — Mark (host_summary) [Ep 3 · 4:00](https://library.globalcastmd.com/watch/aap-policy-for-adolescent-bariatric-surgery-pediatric-obesity-2017-372?t=240)
- "Non-surgical weight loss paradigms show very disappointing results in the literature for severely obese adolescents." — Mark (host_summary) [Ep 3 · 4:30](https://library.globalcastmd.com/watch/aap-policy-for-adolescent-bariatric-surgery-pediatric-obesity-2017-372?t=270)
- "Data from a decade ago consisted mostly of single institutional, relatively small cohort, retrospective, non-uniform studies." — Mark (clinical) [Ep 3 · 5:50](https://library.globalcastmd.com/watch/aap-policy-for-adolescent-bariatric-surgery-pediatric-obesity-2017-372?t=350)
- "Recent studies (Teen Labs, FAS-5, AMOS) are high-level prospective studies using uniform data reporting methodology, which is the type of data needed to develop paradigm shifts and widespread clinical application." — Mark (clinical) [Ep 3 · 7:00](https://library.globalcastmd.com/watch/aap-policy-for-adolescent-bariatric-surgery-pediatric-obesity-2017-372?t=420)
- "These prospective studies serve as the foundation for making best practice guidelines and widely accepted recommendations on treatment paradigms." — Mark (opinion) [Ep 3 · 8:00](https://library.globalcastmd.com/watch/aap-policy-for-adolescent-bariatric-surgery-pediatric-obesity-2017-372?t=480)
- "The 2004 consensus paper in Pediatrics continues to hold significant influence in the insurance industry regarding access to care for adolescent bariatric surgery." — Mark (clinical) [Ep 3 · 10:40](https://library.globalcastmd.com/watch/aap-policy-for-adolescent-bariatric-surgery-pediatric-obesity-2017-372?t=640)
- "BMI recommendations for eligibility were higher in the 2004 paper than in current recommendations." — Mark (guideline) [Ep 3 · 11:10](https://library.globalcastmd.com/watch/aap-policy-for-adolescent-bariatric-surgery-pediatric-obesity-2017-372?t=670)
- "Current BMI eligibility guidelines target around 40 kg/m² or higher, though in certain individual cases below 40 is considered reasonable." — Mark (guideline) [Ep 3 · 13:00](https://library.globalcastmd.com/watch/aap-policy-for-adolescent-bariatric-surgery-pediatric-obesity-2017-372?t=780)
- "Updated guidelines from ASMBS pediatric committee are expected within the next 12 to 18 months." — Mark (clinical) [Ep 3 · 14:00](https://library.globalcastmd.com/watch/aap-policy-for-adolescent-bariatric-surgery-pediatric-obesity-2017-372?t=840)
- "Prior to 2014, ASMBS had no specific pediatric standards in their centers of excellence designation." — Mark (clinical) [Ep 3 · 15:20](https://library.globalcastmd.com/watch/aap-policy-for-adolescent-bariatric-surgery-pediatric-obesity-2017-372?t=920)
- "MBSAQIP (Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program) was formed around 2012, combining ASMBS and American College of Surgeons accreditation, and included for the first time a separate designation for centers offering bariatric surgery to individuals under age 18." — Mark (clinical) [Ep 3 · 16:00](https://library.globalcastmd.com/watch/aap-policy-for-adolescent-bariatric-surgery-pediatric-obesity-2017-372?t=960)
- "The first MBSAQIP pediatric standards were rolled out in 2014 and updated in 2016." — Mark (clinical) [Ep 3 · 17:00](https://library.globalcastmd.com/watch/aap-policy-for-adolescent-bariatric-surgery-pediatric-obesity-2017-372?t=1020)
- "In a 2014 study of Teen Labs centers, 47% of adolescents achieved initial insurance authorization at original request for surgery, compared to approximately 85% in the adult population." — Mark (epidemiological) [Ep 3 · 19:10](https://library.globalcastmd.com/watch/aap-policy-for-adolescent-bariatric-surgery-pediatric-obesity-2017-372?t=1150)
- "80% of insurance denials were approved after appeals, but required as many as 5 appeals." — Mark (epidemiological) [Ep 3 · 19:50](https://library.globalcastmd.com/watch/aap-policy-for-adolescent-bariatric-surgery-pediatric-obesity-2017-372?t=1190)
- "11% of adolescents in the Teen Labs centers study were ultimately unable to obtain insurance authorization for bariatric surgery." — Mark (epidemiological) [Ep 3 · 20:40](https://library.globalcastmd.com/watch/aap-policy-for-adolescent-bariatric-surgery-pediatric-obesity-2017-372?t=1240)
- "The most cited reason for insurance denial was age less than 18 years." — Mark (epidemiological) [Ep 3 · 21:00](https://library.globalcastmd.com/watch/aap-policy-for-adolescent-bariatric-surgery-pediatric-obesity-2017-372?t=1260)
- "In Susan Woolford's survey of 375 pediatricians and equal number of family physicians, almost half declared they would never refer an adolescent patient for weight loss surgery." — Mark (host_summary) [Ep 3 · 22:30](https://library.globalcastmd.com/watch/aap-policy-for-adolescent-bariatric-surgery-pediatric-obesity-2017-372?t=1350)
- "About half of surveyed physicians endorsed a minimal age of 18 for bariatric surgery referral." — Mark (host_summary) [Ep 3 · 23:10](https://library.globalcastmd.com/watch/aap-policy-for-adolescent-bariatric-surgery-pediatric-obesity-2017-372?t=1390)
- "99% of surveyed physicians endorsed participation in a monitored weight management program prior to referral for weight loss surgery." — Mark (host_summary) [Ep 3 · 23:30](https://library.globalcastmd.com/watch/aap-policy-for-adolescent-bariatric-surgery-pediatric-obesity-2017-372?t=1410)
- "Kelleher's 2012 study using the Kids Inpatient Database showed a significant increase in adolescent bariatric surgery from 2000 to 2003, but essentially no statistically significant change from 2003 to 2009, suggesting a plateau." — Mark (host_summary) [Ep 3 · 24:10](https://library.globalcastmd.com/watch/aap-policy-for-adolescent-bariatric-surgery-pediatric-obesity-2017-372?t=1450)
- "A 2013 Children's Hospital Association survey of 188 hospitals (54% response rate) found that 49 centers had stage 4 obesity treatment (including drug therapy protocols and/or bariatric surgery), with 88% of those 49 centers stating they had some access to bariatric surgery." — Mark (host_summary) [Ep 3 · 25:10](https://library.globalcastmd.com/watch/aap-policy-for-adolescent-bariatric-surgery-pediatric-obesity-2017-372?t=1510)
- "The most recent AHRQ report developed by Kaiser on management for obese and severely obese children makes only scant reference to bariatric surgery and largely ignores it as a consideration for this population." — Mark (clinical) [Ep 3 · 26:20](https://library.globalcastmd.com/watch/aap-policy-for-adolescent-bariatric-surgery-pediatric-obesity-2017-372?t=1580)
- "In 2016, the AAP Section on Obesity and Section on Surgery executive committees agreed to sponsor joint policy statements on adolescent bariatric surgery." — Mark (clinical) [Ep 3 · 28:00](https://library.globalcastmd.com/watch/aap-policy-for-adolescent-bariatric-surgery-pediatric-obesity-2017-372?t=1680)
- "The AAP policy statement is currently in draft in committee as of first quarter 2017, with peer review planned for Q1 2017 and proposed publication by end of 2017 or early 2018." — Mark (clinical) [Ep 3 · 27:22](https://library.globalcastmd.com/watch/aap-policy-for-adolescent-bariatric-surgery-pediatric-obesity-2017-372?t=1642)
- "The AAP policy statement will be released around the same time as revised ASMBS best practice guidelines." — Mark (clinical) [Ep 3 · 27:22](https://library.globalcastmd.com/watch/aap-policy-for-adolescent-bariatric-surgery-pediatric-obesity-2017-372?t=1642)
- "Procedural prevalence for adolescent bariatric surgery remains stable despite favorable outcomes and standardization of care." — Mark (clinical) [Ep 3 · 27:22](https://library.globalcastmd.com/watch/aap-policy-for-adolescent-bariatric-surgery-pediatric-obesity-2017-372?t=1642)

## Changelog
- Sep 15: 3 items added automatically

---
Educational content from recorded physician discussions — not medical advice. Cite the canonical URL or the ?t= deep link. Policy: https://library.globalcastmd.com/ai