Are eating disorders an exclusion criterion for adolescent bariatric surgery?

• A. No, treat and stabilize before surgery
• B. Yes, they immediately exclude
• C. Only if severe
• D. Only if current symptoms persist.

Answer: (C)

In adolescents, deciding about bariatric surgery hinges on readiness to adopt lasting lifestyle changes and to engage in ongoing psychological support. An eating disorder influences this readiness because active, uncontrolled symptoms can derail postoperative adherence, nutrition, and weight outcomes. Importantly, it isn’t treated as an automatic disqualification. If the eating disorder is severe and persists despite appropriate treatment, delaying surgery to focus on stabilization is the safer path. But if the disorder is mild, in remission, or well-controlled with continuous therapeutic support, surgery can proceed with a solid plan for ongoing mental health care and monitoring. This nuance makes the best choice that eating disorders matter only if they are severe, rather than serving as an automatic exclusion or being irrelevant.