Teen bariatric surgery rose 7.7-fold in a decade and still reached only 0.24 percent of eligible adolescents

Use of weight-loss surgery in US teenagers rose sharply over the past decade and is still rare. A study published September 4, 2026 in the Journal of Pediatric Surgery counted 5,430 adolescents aged 12 to 19 who had metabolic and bariatric surgery between 2016 and 2025. Over that period the rate rose 7.7-fold, from 31 to 239 operations per 100,000 eligible adolescents. Even at the peak, 0.24 percent of eligible teenagers had surgery.

The researchers used Epic Cosmos, a de-identified research database built from the electronic health records of health systems that use Epic software. That means the study counts what clinicians actually recorded during care across a large share of US hospitals and clinics, rather than answers to a survey or the case series of a single hospital.

Sleeve gastrectomy accounted for 89.1 percent of the operations

Nearly nine in ten teens had a sleeve gastrectomy, an operation that removes most of the stomach and leaves a narrow tube behind. Conversion to gastric bypass, which is a second and more complex operation, was rare, under 0.4 percent.

How often surgery was used tracked closely with how severe the obesity was. By 2025, adolescents with a body mass index of 50 or above had a sleeve gastrectomy roughly nine times as often as those in the lowest eligible BMI group, 605 versus 69 per 100,000. Average hospital stay fell over the decade from 2.0 days to 1.6 days.

Serious complications within 30 days stayed at or below 0.6 percent

In the first 30 days after surgery, surgical complications and infections each affected 0.6 percent of patients or fewer. Cardiovascular events and blood clots each affected 0.3 percent or fewer. Reoperation, conversion to bypass, and death were each recorded in under 0.4 percent of patients.

Those are rates of events recorded in the first month. They are not an account of long-term risk. A teenager who has this operation lives with an altered digestive system for decades, and a ten-year picture is not what this study set out to provide.

Nausea and gallbladder removal were the common problems afterward

The most frequent diagnoses after surgery were digestive and biliary. Nausea and vomiting were recorded in 12.5 percent of patients within one year. Cholecystectomy, meaning removal of the gallbladder, was recorded in 7.5 percent within three years.

As general background, gallstones are a recognized risk after rapid weight loss from any cause. This study counted the operations that happened and did not test what caused them, so the gallbladder figure should be read as a description of what families can expect to encounter rather than a measured effect of the surgery itself.

A records study can count operations but cannot say why so few teens have them

The authors conclude that access should be widened. That is their interpretation, and the data support only part of it. The study shows that use is low and that recorded early complications are low. It does not measure why families do not proceed, whether insurers denied coverage, how many eligible teenagers were even offered a referral, or what happened to the teenagers who did not have surgery.

The 0.24 percent figure also depends entirely on how the researchers defined an eligible adolescent, and the published abstract does not spell that out. The full paper is behind a paywall, so that denominator could not be checked for this brief. Rates expressed per 100,000 eligible adolescents move a great deal depending on where that line is drawn.

Finally, the record only covers what clinicians entered into Epic systems. Care delivered elsewhere, including an operation at a center that does not use Epic software, would not appear in these counts.