Abstract

Riquin E; Malka J; Schmitt F; Beaumesnil M; Curt F; Robin M; Corcos M; Coutant R; Duverger P
University Hospital Of Angers; Pediatric Re-education And Functional Rehabilitation Center, Angers; Institut Mutualiste Montsouris, Paris

Childhood obesity is a growing importance phenomenon in France and around the world. An obese child often remains so in adulthood and epidemiological studies connect obesity and premature mortality in adults by 50 to 80%. The care of obese subjects, from the first signs, improves both short and long term results by preventing the development of comorbidities and therefore constitutes a priority. However, the results of medical treatment of childhood obesity are disappointing. Given this situation, surgical treatment, which has become a treatment of choice for severe obesity in adults, is now contemplated for severe and resistant obesity in adolescents.
In the United States, the first young patients were operated in 1993. In France, this approach is still new and innovative in this age group. However, under specific indications and in the context of a multidisciplinary monitoring involving dieticians, surgeons, child psychiatrists, bariatric surgery adolescent appears justified in the literature.
Since 2009, pediatrics and child psychiatrics team of the University Hospital of Angers offer a multidisciplinary innovative support in addition to the conventional medical approach leading to the possibility of bariatric surgery by gastric banding under specific indications. The authors retrospectively studied the epidemiology and psychopathology of these obese adolescents candidate to surgery in the University Center since the beginning of the "obesity network". The network organisation and the study results will be presented. We will discuss the management of these young patients in their psychic and somatic healthcare circuit before and after surgery, questioning firstly the place and development of obesity related to the presence of environmental predisposing factors. Secondly we will talk about the psychic effects of weight loss and / or disappearance of alimentary symptoms such as binge eating disorder after a gastric banding surgery.

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