Bariatric surgery for obese children and adolescents: A review of the moral challenges

BMC Medical Ethics

Volumn 14, Issue 1, 2013, Pages

  Hofmann, Bjørn ^a,b  

^a NORWEGIAN UNIVERSITY OF SCIENCE AND TECHNOLOGY   (Norway)

^b UNIVERSITY OF OSLO   (Norway)

Author keywords

Adolescents; Bariatric surgery; Children; Ethics; Moral

Indexed keywords

ADOLESCENT; ATTITUDE TO HEALTH; BARIATRIC SURGERY; BENEFICENCE; BODY IMAGE; CHILD; COGNITION; COMORBIDITY; COMPREHENSION; EATING; ECONOMICS; ESTHETICS; ETHICS; FEMALE; FOOD; HEALTH CARE DELIVERY; HUMAN; INFORMED CONSENT; INTERPERSONAL COMMUNICATION; LIFESTYLE; MALE; MENTAL CAPACITY; MORALITY; OBESITY; PATIENT COMPLIANCE; PERSONAL AUTONOMY; REVIEW; SOCIAL JUSTICE; SOCIAL PSYCHOLOGY; STANDARD;

ADOLESCENT; BARIATRIC SURGERY; BEAUTY; BENEFICENCE; BODY IMAGE; CHILD; COMORBIDITY; COMPREHENSION; EATING; FEMALE; FOOD; HEALTH KNOWLEDGE, ATTITUDES, PRACTICE; HEALTH SERVICES ACCESSIBILITY; HUMANS; INFORMED CONSENT BY MINORS; LIFE STYLE; MALE; MENTAL COMPETENCY; MORALS; OBESITY; PATIENT COMPLIANCE; PERSONAL AUTONOMY; PREJUDICE; SOCIAL JUSTICE; TRUTH DISCLOSURE; VOLITION;

EID: 84876786142     PISSN: None     EISSN: 14726939     Source Type: Journal    
DOI: 10.1186/1472-6939-14-18     Document Type: Review

References (230)

1. WHO, Obesity and Overveight Geneva: World Health Organisation 2003
2. Pediatric obesity epidemiology. Orsi C, Hale D, Lynch J, Curr Opin Endocrinol Diabetes Obes 2011 18 1 14 22 10.1097/MED.0b013e3283423de1 21157323
3. Worldwide trends in childhood overweight and obesity. Wang Y, Lobstein T, Int J Pediatr Obes 2006 1 1 11 25 10.1080/17477160600586747 17902211
4. Adolescent bariatric surgery. Ibele AR, Mattar SG, Surg Clin North Am 2011 91 6 1339 1351 10.1016/j.suc.2011.08.005 22054157
5. The obesity epidemic: medical and ethical considerations. de Vries J, Sci Eng Ethics 2007 13 1 55 67 10.1007/s11948-007-9002-0 17703609
6. Childhood obesity: public-health crisis, common sense cure. Ebbeling CB, Pawlak DB, Ludwig DS, Lancet 2002 360 9331 473 482 10.1016/S0140-6736(02)09678-2 12241736 (Pubitemid 34880150)
7. Childhood obesity-the shape of things to come. Ludwig DS, N Engl J Med 2007 357 23 2325 2327 10.1056/NEJMp0706538 18057334 (Pubitemid 350223386)
8. Bariatric surgery and the social character of the obesity epidemic. Garrett JR, McNolty LA, Am J Bioeth 2010 10 12 20 22 10.1080/15265161.2010. 528512 21161835
9. Complications of obesity in children and adolescents. Daniels SR, Int J Obes (Lond) 2009 33 Suppl 1 60 S65
10. Interventions for preventing obesity in children. Waters E, de Silva-Sanigorski A, Hall BJ, Brown T, Campbell KJ, Gao Y, Armstrong R, Prosser L, Summerbell CD, Cochrane Database Syst Rev 2011 12 D001871 22161367
11. Interventions for preventing obesity in children. Summerbell CD, Waters E, Edmunds LD, Kelly S, Brown T, Campbell KJ, Cochrane Database Syst Rev 2005 3 D001871 16034868
12. Surgical treatment of obesity in adolescence. Livingston EH, JAMA 2010 303 6 559 560 10.1001/jama.2010.99 20145236
13. Methamphetamine use following bariatric surgery in an adolescent. Dutta S, Morton J, Shepanrd E, Peebles R, Farrales-Nguyen S, Hammer LD, Albanese CT, Obes Surg 2006 16 780 782 10.1381/096089206777346646 16756743 (Pubitemid 43874838)
14. Bariatric surgery for severely overweight adolescents: concerns and recommendations. Inge TH, Krebs NF, Garcia VF, Skelton JA, Guice KS, Strauss RS, Albanese CT, Brandt ML, Hammer LD, Harmon CM, Pediatrics 2004 114 1 217 223 10.1542/peds.114.1.217 15231931 (Pubitemid 38857589)
15. Managing obesity-from childhood and onwards. Lagerros Y, Rössner S, Int J Pediatr Obes 2011 6 Suppl 1 74 78 21905821
16. Best practice updates for pediatric/adolescent weight loss surgery. Pratt JS, Lenders CM, Dionne EA, Hoppin AG, Hsu GL, Inge TH, Lawlor DF, Marino MF, Meyers AF, Rosenblum JL, Obesity 2009 17 5 901 910 10.1038/oby.2008.577 19396070
17. Canadian clinical practice guidelines on the management and prevention of obesity in adults and children. Lau DCW, Douketis JD, Morrison KM, Hramiak Im SAMUE, CMAJ 2006 176 Suppl 8 1 117
18. Treatment of childhood obesity. Uli N, Sundararajan S, Cuttler L, Curr Opin Endocrinol Diabetes Obes 2008 15 1 37 47 10.1097/MED.0b013e3282f41d6a 18185061
19. Interventions for treating obesity in children. Oude Luttikhuis H, Baur L, Jansen H, Shrewsbury VA, O'Malley C, Stolk RP, Summerbell CD, Cochrane Database Syst Rev 2009 1 D001872 19160202
20. Childhood Obesity-2010: Progress and Challenges. Han JC, Lawlor DA, Kimm SY, Lancet 2010 375 9727 1737 1748 10.1016/S0140-6736(10)60171-7 20451244
21. Effectiveness of weight management programs in children and adolescents. Whitlock EA, O'Connor EP, Williams SB, Beil TL, Lutz KW, Evid Rep Technol Assess 2008 170 1 308
22. Obesity: Bariatric surgery in youth. Mitchell F, Nat Rev Endocrinol 2012 8 7 381 22585041
23. Bariatric surgery for morbidly obese adolescents: is there a rationale for early intervention? Inge TH, Growth Horm IGF Res 2006 16 Suppl A 15 S19 16714132
24. Bariatric surgery for pediatric extreme obesity: now or later? Inge TH, Xanthakos SA, Zeller MH, Int J Obes (Lond) 2007 31 1 1 14 10.1038/sj.ijo.0803525 (Pubitemid 46006009)
25. Bariatric surgery in obese adolescents. Keidar A, Hecht L, Weiss R, Curr Opin Clin Nutr Metab Care 2011 14 3 286 290 10.1097/MCO.0b013e3283453635 21358403
26. Best practice updates for pediatric/adolescent weight loss surgery. Pratt JSA, Lenders CM, Dionne EA, Hoppin AG, Hsu GLK, Inge TH, Lawlor DF, Marino MF, Meyers AF, Rosenblum JL, Sanchez VM, Obesity (Silver Spring) 2009 17 5 901 910 10.1038/oby.2008.577
27. Informed consent issues in the conduct of bariatric surgery. Raper SE, Sarwer DB, Surg Obes Relat Dis 2008 4 1 60 68 10.1016/j.soard.2007.09.002 17974497
28. Stuck in the Middle: The Many Moral Challenges With Bariatric Surgery. Hofmann B, Am J Bioeth 2010 10 12 3 11 10.1080/15265161.2010.528509 21161829
29. Hofmann B, Ethical aspects of bariatric treatment of adult obesity. In Institute of Health Economics: Alberta 2011
30. Ethical issues of obesity surgery-a health technology assessment. Saarni SI, Anttila H, Saarni SE, Mustajoki P, Koivukangas V, Ikonen TS, Malmivaara A, Obes Surg 2011 21 9 1469 1476 10.1007/s11695-011-0386-1 21479827
31. Toward a procedure for integrating moral issues in health technology assessment. Hofmann B, Int J Tech Assess Health Care 2005 21 3 312 318 (Pubitemid 41099211)
32. On value-judgements and ethics in health technology assessment. Hofmann B, Poiesis & Praxis 2005 3 4 277 295 10.1007/s10202-005-0073-1 22162960 (Pubitemid 43045812)
33. Hofmann B, Ethics in Health Technology Assessments (HTA), Volume 28 Oslo: Norwegian Knowledge Center for the Health Services 2008
34. HTA Core Model for Medical and Surgical Interventions. Kaila M, Mäkelä M, Helsinki: European Network for Health Technology Assessment EUnetHTA, EUnetHTA, 2008
35. Ethical analysis to improve decision-making on health technologies. Saarni S, Hofmann B, Lampe K, Luhmann D, Makela M, Velasco-Garrido M, Autti-Ramo I, Bull World Health Organ 2008 86 8 617 623 10.2471/BLT.08.051078 18797620
36. Tackling ethical issues in HTA: a proposed framework. Burls A, Caron L, de Langavant GC, Dondorp W, Harstall C, Pathak-Sen E, Hofmann B, Int J Tech Assess Health Care 2010 in press
37. The encompassing ethics of bariatric surgery. Hofmann B, Am J Bioeth w2 10 12 1 w2
38. Ethics of palliative surgery in patients with cancer. Hofmann B, Haaheim L, Søreide J, Br J Surg 2005 92 7 802 809 10.1002/bjs.5104 15962261 (Pubitemid 40961394)
39. Bariatric surgery in extremely obese children and adolescents. Bluher S, Till H, Kiess W, Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2011 54 5 577 583 10.1007/s00103-011-1268-3 21547649
40. Adolescent obesity and bariatric surgery. Levitsky LL, Misra M, Boepple PA, Hoppin AG, Curr Opin Endocrinol Diabetes Obes 2009 16 1 37 44 10.1097/MED.0b013e32832101ff 19104236
41. Systematic review and meta-analysis of bariatric surgery for pediatric obesity. Treadwell JR, Sun F, Schoelles K, Ann Surg 2008 248 5 763 776 10.1097/SLA.0b013e31818702f4 18948803
42. Laparoscopic adjustable gastric banding in severely obese adolescents: a randomized trial. O'Brien PE, Sawyer SM, Laurie C, Brown WA, Skinner S, Veit F, Paul E, Burton PR, McGrice M, Anderson M, JAMA 2010 303 6 519 526 10.1001/jama.2010.81 20145228
43. Devices for the treatment of obesity: will understanding the physiology of satiety unravel new targets for intervention? Weiss R, J Diabetes Sci Technol 2008 2 3 501 508 19885218
44. Adolescent bariatric surgery: treatment delayed, treatment denied, a crisis invited. Garcia VF, DeMaria EJ, Obes Surg 2006 16 1 1 4 10.1381/096089206775222195 16417748 (Pubitemid 43232230)
45. Bariatric surgery in adolescence. Is this the best age to operate? Capella JF, Capella RF, Obes Surg 2003 13 6 826 832 10.1381/096089203322618597 14738664 (Pubitemid 38010698)
46. Bariatric surgery in adolescents: A difficult issue. Dixon J, J Paediatr Child Health 2010 46 Suppl. 2 3
47. Medical versus surgical interventions for the metabolic complications of obesity in children. Dixon JB, Jones K, Dixon M, Semin Pediatr Surg 2009 18 3 168 175 10.1053/j.sempedsurg.2009.04.007 19573759
48. Incidence of perioperative adverse events in obese children undergoing elective general surgery. El-Metainy S, Ghoneim T, Aridae E, Abdel Wahab M, Br J Anaesth 2011 106 3 359 363 10.1093/bja/aeq368 21149286
49. Short-term psychological outcomes in severely obese adolescents after bariatric surgery. Jarvholm K, Olbers T, Marcus C, Marild S, Gronowitz E, Friberg P, Johnsson P, Flodmark CE, Obesity (Silver Spring) 2012 20 2 318 323 10.1038/oby.2011.310
50. Bariatric surgery in morbidly obese adolescents: a 4-year follow-up of ten patients. Widhalm K, Dietrich S, Prager G, Silberhummer G, Orth D, Kispal ZF, Int J Pediatr Obes 2008 3 Suppl 1 78 82 18278637 (Pubitemid 351285472)
51. My quality of life is worse compared to my earlier life: living with chronic problems after weight loss surgery. Groven KS, Raheim M, Engelsrud G, Int J Qual Stud Health Well-being 2010 5 4 http://www.ncbi.nlm.nih.gov/pmc/ articles/PMC2989899 (Accessed May 3, 2013) 10.3402/qhw.v5i4.5553
52. Health-related quality of life and depressive symptoms in adolescents with extreme obesity presenting for bariatric surgery. Zeller MH, Roehrig HR, Modi AC, Daniels SR, Inge TH, Pediatrics 2006 117 4 1155 1161 10.1542/peds.2005-1141 16585310 (Pubitemid 46071507)
53. King T, Wheeler M, Fernandez A, Schillinger D, Bindman A, Grumbach K, Villela T, Medical Management of Vulnerable & Underserved Patients: Principles, Practice, Population New York, NY, US: McGraw 2006 23644812
54. Pregnancy after gastric bypass surgery in adolescents. Roehrig HR, Xanthakos SA, Sweeney J, Zeller MH, Inge TH, Obes Surg 2007 17 7 873 877 10.1007/s11695-007-9162-7 17894144 (Pubitemid 350042913)
55. Health technology assessment in child health. Ungar W, Value Health 2012 16 4 206 A207
56. Bariatric surgery-stereotypes and paradigms. Zentralblatt für. Hell E, Miller K, Chirurgie 2002 127 12 1032 1034
57. The stigma of obesity: a review and update. Puhl RM, Heuer CA, Obesity 2009 17 5 941 964 10.1038/oby.2008.636 19165161
58. The impact of obesity surgery and the paradox of control: a qualiltative study. Ogden J, Clementi C, Aylwin S, Psychol Health 2006 21 2 273 293 10.1080/14768320500129064 21985121 (Pubitemid 43663670)
59. Obesity interventions and ethics. Holm S, Obes Rev 2007 8 Suppl 1 207 210 17316327
60. Don't let them eat cake! A view from across the pond. Mackenzie R, Am J Bioeth 2010 10 12 16 18 10.1080/15265161.2010.528716 21161833
61. Application of law to the childhood obesity epidemic. Alderman J, Smith JA, Fried EJ, Daynard RA, J Law Med Ethics 2007 35 1 90 112 10.1111/j.1748-720X. 2007.00115.x 17341219
62. The health of adolescent girls: does the law support it? English A, Curr Womens Health Rep 2002 2 6 442 449 12429078
63. Ethical issues in pediatric bariatric surgery. Caniano DA, Semin Pediatr Surg 2009 18 3 186 192 10.1053/j.sempedsurg.2009.04.009 19573761
64. Parental misperception of their child's weight status: Clinical implications for obesity prevention and control. Duncan DT, Obesity 2011 19 12 2293 10.1038/oby.2011.190 22108706
65. Childhood obesity and medical neglect. Varness T, Allen DB, Carrel AL, Fost N, Pediatrics 2009 123 1 399 406 10.1542/peds.2008-0712 19117907
66. Bariatric surgery for obese adolescents-'make assurance doubly sure'. Weiss R, Obes Facts 2009 2 5 277 280 20057193
67. Insurance-mandatd preoperative dietary counseling does not improve ouotcome and increases dropout rates in patients considering gastric bypass surgery for morbid obesity. Jamal MK, DeMaria EJ, Johnson JM, Carmody BJ, Wolfe LG, Kellum JM, Meador JG, Surg Obes Relat Dis 2006 2 2 122 127 10.1016/j.soard.2006.01.009 16925335
68. Best practice guidelines on informed consent for weight loss surgery patients. Sabin J, Fanelli R, Flaherty H, Istfan N, Mariner W, Barnes JN, Pratt JS, Rossi L, Samour P, Obes Res 2005 13 2 250 253 10.1038/oby.2005.34 15800281
69. Updates for informed consent and patient education in weight loss surgery. Wee CW, Pratt JS, Fanelli R, Samour PQ, Trainer LS, Paasche-Orlow MK, Obesity 2009 17 885 888 10.1038/oby.2008.567 19396067
70. Informed consent in children and adolescents: age, maturation and psychological state. Dorn LD, Susman EJ, Fletcher JC, J Adolesc Health 1995 16 3 185 190 10.1016/1054-139X(94)00063-K 7779827
71. What is the meaning of informed consent, weight loss surgery, and the pediatric patient? Gallagher SM, Bariatric Nursing and Surgical Patient Care 2010 5 3 231 234 10.1089/bar.2010.9912
72. Postoperative laparoscopic bariatric surgery patients do not remember potential complications. Madan AK, Tichansky DS, Taddeucci RJ, Obes Surg 2007 17 7 885 888 10.1007/s11695-007-9164-5 17894146 (Pubitemid 350042915)
73. Risk perception and decision processes underlying informed consent to research participation. Reynolds WW, Nelson RM, Soc Sci Med 2007 65 10 2105 2115 10.1016/j.socscimed.2007.06.021 17689846 (Pubitemid 47593039)
74. An evaluation of bariatric web sites for patient education and guidance. Nichols C, Oermann MH, Gastroenterol Nurs 2005 28 2 112 117 10.1097/00001610- 200503000-00005 15832111
75. Failure to report financial disclosure information in a study of gastric banding in adolescent obesity. O'Brien PE, JAMA 2010 303 23 2357 20460606
76. Oakley J, Ashcroft RE, Dawson A, Draper H, McMillan JR, Patients and disclosure of surgical risk. In: Principles of Health Care Ethics Chichester UK: John Wiley & Sons 2007
77. Psychiatric needs must be considered. James RJ, Morgan JF, BMJ 2010 341 5298 10.1136/bmj.c5298 20880914
78. Bariatric psychology, psychological aspects of weight loss surgery. van Hout G, van Heck G, Obes Facts 2009 2 1 10 15 20054199
79. Psychiatric diagnoses and psychiatric treatment among bariatric surgery candidates. Sarwer DB, Cohn NI, Gibbons LM, Magee L, Crerand CE, Raper SE, Rosato EF, Williams NN, Wadden TA, Obes Surg 2004 14 1148 1156 10.1381/0960892042386922 15527626 (Pubitemid 39458586)
80. Deficit in the discrimination of nonverbal emotions in children with obesity and their mothers. Baldaro B, Rossi N, Caterina R, Codispoti M, Balsamo A, Trombini G, Int J Obes 2003 27 2 191 195 10.1038/sj.ijo.802228 (Pubitemid 36255800)
81. Obesity and psychiatric disorders. Berdah C, Ann Med Psychol 2010 168 3 184 190
82. Overweight girls who internalize fat stereotypes report low psychosocial well-being. Davison KK, Schmalz DL, Young LM, Birch LL, Obesity (SilverSpring) 2008 16 Suppl 2 30 S38
83. Psychosocial causes and consequences of obesity in children. Grubic M, Paediatria Croatica Suppl 2008 52 1 57 60 (Pubitemid 351830952)
84. Obesity and depression: results from the longitudinal Northern Finland 1966 Birth Cohort Study. Herva A, Laitinen J, Miettunen J, Veijola J, Karvonen JT, Laksy K, Joukamaa M, Int J Obes (Lond) 2006 30 3 520 527 10.1038/sj.ijo.0803174
85. Obesity and mental disorders in childhood. Tadiello P, Salvatoni A, Alberti G, Bosetti G, Gambarini G, Marni E, Pediatria Medica e Chirurgica 1990 12 6 647 654 2093887
86. Social, psychological and physical correlates of eating problems. A study of the general adolescent population in Norway. Wichstrom L, Psychol Med 1995 25 3 567 579 10.1017/S0033291700033481 7480437
87. Academic performance in urban schoolchildren with Metabolic Syndrome. Alejandra B, Roxana VR, Patricia TS, Jaimes-Aviles MG, Cynthia MC, Juan FR, Annarzhvaelig GA, FASEB J 2009 23 Meeting Abstract Supplement 914 918 Conference: Experimental Biology (EB 2009)
88. Overweight is associated with decreased cognitive functioning among school-age children and adolescents. Li Y, Dai Q, Jackson JC, Zhang J, Obesity 2008 16 8 1809 1815 10.1038/oby.2008.296 18551126
89. Obesity and skill attainment in early childhood. Cawley J, Spiess CK, Econ Hum Biol 2008 6 3 388 397 10.1016/j.ehb.2008.06.003 18678531
90. Adolescent bariatric surgery: ANZ guidance and recommendations. Dixon JB, Fitzgerald DA, Kow L, Bailey D, Baur LA, ANZ J Surg 2011 81 12 854 855 10.1111/j.1445-2197.2011.05897.x 22507405
91. Psychological profile of the morbidly obese. van Hout GC, van Oudheusden I, van Heck GL, Obes Surg 2004 14 579 588 10.1381/096089204323093336 15186623 (Pubitemid 38716576)
92. The influence of weight on sense of self among college women. Aibel CE, Dissertation Abstr Int B Sci Eng 2003 64 4-B 1890
93. Body satisfaction and body weight: Gender differences and sociodemographic determinants. Austin SB, Haines J, Veugelers PJ, BMC Public Health 2009 9 rticle Number: 313
94. Childhood obesity stigma: association with television, videogame, and magazine exposure. Latner JD, Rosewall JK, Simmonds MB, Body Image 2007 4 2 147 155 10.1016/j.bodyim.2007.03.002 18089260
95. Weight Bias in a Child's World. Latner JD, Schwartz MB, Weight bias: Nature, consequences, and remedies New York, NY, US: Guilford Publications, Brownell KD, Puhl RM, Schwartz MB, Rudd L, 2005 54 67
96. Psychological complications of pediatric obesity. Vander Wal JS, Mitchell ER, Pediatr Clin North Am 2011 58 6 1393 1401 10.1016/j.pcl.2011.09.008 22093858
97. Childhood maltreatment in extremely obese male and female bariatric surgery candidates. Grilo CM, Masheb RM, Brody M, Toth C, Burke-Martindale CH, Rothschild BS, Obes Res 2005 13 123 130 10.1038/oby.2005.16 15761171
98. Extreme obesity: a new medical crisis in the United States. Hensrud DD, Klein S, Mayo Clinical Proceedings 2006 81 Suppl 10 5 S10
99. Treating severe obesity: morbid weights and morbid waits. Padwal RS, Sharma AM, CMAJ 2009 181 11 777 778 10.1503/cmaj.081508 19687104
100. It's OK to ask about past abuse. Edwards VJ, Dube SR, Felitti VJ, Anda RF, Am Psychol 2007 62 4 327 328 17516786
101. Presurgical psychiatric evaluations of candidates for bariatric surgery, part 1: reliability and reasons for and frequency of exclusion. Zimmerman M, Francione-Witt C, Chelminski I, Young D, Boerescu D, Attiullah N, Pohl D, Roye GD, Harrington DT, J Clin Psychiatry 2007 68 10 1557 1562 10.4088/JCP.v68n1014 17960972 (Pubitemid 350073405)
102. Childhood obesity; parents fail to Recognise. General practitioners fail to act. White A, O'Brien B, Houlihan T, Darker C, Shea BO, Ir Med J 2012 105 1 10 13 22397205
103. Is family-based behavioral weight control appropriate for severe pediatric obesity? Levine MD, Ringham RM, Kalarchian MA, Wisniewski L, Marcus MD, Int J Eat Disord 2001 30 318 328 10.1002/eat.1091 11746293 (Pubitemid 32843649)
104. Health-related quality of life in overweight and nonoverweight black and while adolescents. Fallon EM, Tanofsky-Kraff M, Norman AC, McDuffe JR, Taylor ED, Cohen ML, Young-Hyman D, Keil M, Kolotkin RL, Yanovski JA, J Pediatr 2005 147 443 450
105. Predictors of health-related quality of life in obese youth. Zeller MH, Modi AC, Obesity 2006 14 122 130 10.1038/oby.2006.15 16493130 (Pubitemid 46214782)
106. Caregivers' inability to identify childhood adiposity: A cross-sectional survey of rural children and their caregivers' attitudes. Fisher L, Fraser J, Alexander C, Aust J Rural Health 2006 14 2 56 61 10.1111/j.1440-1584.2006.00764. x 16512790 (Pubitemid 43337350)
107. The weight of opinion on childhood obesity: recognizing complexity and supporting collaborative action. Pagnini D, King L, Booth S, Wilkenfeld R, Booth M, Int J Pediatr Obes 2009 4 4 233 241 10.3109/17477160902763333 19922037
108. Bioethical and legal implications of pediatric gastric bypass. Wilde ML, Willamette Law Review 2004 40 3 575 625 16273705
109. A historical analysis of public health, the law, and stigmatized social groups: the need for both obesity and weight bias legislation. Pomeranz JL, Obesity 2008 16 Suppl 2 93 S103 18978770
110. The integrative prejudice framework and different forms of weight prejudice: An analysis and expansion. Brochu PM, Gawronski B, Esses VM, Group Processes & Intergroup Relations 2011 14 3 429 444 10.1177/1368430210396520 23671896
111. Bias, discrimination and obesity. Puhl R, Brownell KD, Obes Res 2001 9 12 788 805 10.1038/oby.2001.108 11743063
112. Changes in perceived weight discrimination among Americans: 199501996 through 2004-2006. Andreyeva T, Puhp R, Brownell KD, Obesity 2008 16 1129 1134 10.1038/oby.2008.35 18356847 (Pubitemid 351620477)
113. Brownell KD, Puhl RM, Schewartz MB, Rudd L, Weight bias: nature, consequences, and remedies New York: The Guilford Press 2005
114. Weight bias in the media: A review of recent research. Ata RN, Thompson JK, Obes Facts 2010 3 1 41 46 10.1159/000276547 20215794
115. Citing intolerance, obese people take steps to press cause. Goldberg C, Understanding prejudice and discrimination New York, NY, US: McGraw-Hill, Plous S, 2003 93 97
116. Prejudice against obesity among 10-year-olds: a nationwide population-based study. Hansson LM, Karnehed N, Tynelius P, Rasmussen F, Acta Paediatr 2009 98 7 1176 1182 10.1111/j.1651-2227.2009.01305.x 19397543
117. The stigmatization of obesity in children. A survey in Greek elementary schools. Koroni M, Garagouni-Areou F, Roussi-Vergou CJ, Zafiropoulou M, Piperakis SM, Appetite 2009 52 1 241 244 10.1016/j.appet.2008.09.006 18835307
118. Weight-based stigmatization in children. Kraig KA, Keel PK, Int J Obes 2001 25 11 1661 1666 10.1038/sj.ijo.0801813 (Pubitemid 33052077)
119. Body size stigmatization: an examination of attitudes of african american preschool-age children attending head start. Margulies AS, Floyd RG, Hojnoski RL, J Pediatr Psychol 2008 33 5 487 496 17905802
120. Disparities by ethnicity and socioeconomic status in the use of weight loss treatments. Tsai AG, Wadden TA, Pillitteri JL, Sembower MA, Gerlach KK, Kyle TK, Burroughs VJ, J Natl Med Assoc 2009 101 1 62 70 19245074
121. Criteria for selection of patients for bariatric surgery. Cowan GS Jr, Hiler ML, Buffington C, Eur J Gastroenterol Hepatol 1999 11 2 69 75 10.1097/00042737-199902000-00003 10102213 (Pubitemid 29103563)
122. Weight stereotypes and behavioral intentions toward thin and fat peers among White and Hispanic adolescents. Greenleaf C, Chambliss H, Rhea DJ, Martin SB, Morrow JR Jr, J Adolesc Health 2006 39 4 546 552 10.1016/j.jadohealth.2006. 01.013 16982390 (Pubitemid 44375026)
123. Predictors of 10-year-olds' obesity stereotypes: A population-based study. Hansson LM, Rasmussen F, Int J Pediatr Obes 2010 5 1 25 33 10.3109/17477160902957141 19437242
124. Perceptions of obesity across the lifespan. Hebl MR, Ruggs EN, Singletary SL, Beal DJ, Obesity (Silver Spring) 2008 16 Suppl 2 46 S52
125. Mexican physicians' bias towards the obese child. Jimenez-Cruz A, Bacardi-Gascon M, Armendariz-Anguiano A, Marquez IB, Sepulveda-Romo M, Revelles Rojas IC, Nutr Hosp 2008 23 1 77 78 18372951 (Pubitemid 351872278)
126. Australian GPs' perceptions about child and adolescent overweight and obesity: The weight of opinion study. King LA, Loss JHM, Wilkenfeld RL, Pagnini DL, Booth ML, Booth SL, Br J Gen Pract 2007 57 535 124 129 17263929 (Pubitemid 46242537)
127. Questionnaire survey looking at current practice, satisfaction and barriers faced by primary and secondary care health professionals involved in managing children with obesity. Thornton W, Dhorajiwala T, Bose-Haider B, Puttha R, Conference: Royal College of Paediatrics and Child Health Annual Conference, RCPCH 2010 Coventry United Kingdom. Conference Start: 20100420 Conference End: 20100422. Conference Publication:(var.pagings) Archives of Disease in Childhood. 2010 51
128. A study of discrimination within the medical community as viewed by obese patients. Kaminsky J, Gadaleta D, Obes Surg 2002 12 1 14 18 10.1381/096089202321144513 11868290 (Pubitemid 34155255)
129. Etik og kommunikation i behandlingen af svært overvægtige patienter. Bøgedal G, Plambech L, Ergoterapeuten 2008 69 9 26 29
130. What do patients, families and society expect from the bariatric surgeon? Cowan GS Jr, Obes Surg 1998 8 1 77 85 10.1381/096089298765555105 9562492 (Pubitemid 28143550)
131. The politics of pathology: how obesity became an epidemic disease. Oliver JE, Perspect Biol Med 2006 49 4 611 627 10.1353/pbm.2006.0062 17146144 (Pubitemid 44623370)
132. News Media Framing of Childhood Obesity in the United States From 2000 to 2009. Barry CL, Jarlenski M, Grob R, Schlesinger M, Gollust SE, Pediatrics 2011 128 1 132 145 10.1542/peds.2010-3924 21690111
133. Natural ways are better: adolescents and the anti-obesity gene. Levitt M, Sci Eng Ethics 1997 3 3 305 315 10.1007/s11948-997-0037-z 11657964 (Pubitemid 127554200)
134. ABC of obesity. Obesity-can we turn the tide? Lean M, Gruer L, Alberti G, Sattar N, BMJ 2006 333 7581 1261 1264 10.1136/bmj.39049.626076.68 17170418 (Pubitemid 46032358)
135. 'I've put weight on cos I've been inactive, cos I've 'ad me knee done': moral work in the obesity clinic. Webb H, Sociol Health Illn 2009 31 6 854 871 10.1111/j.1467-9566.2009.01188.x 19843271
136. Why should obesity be managed? The obese individual's perspective. Evans E, Int J Obes (Lond) 1999 23 Suppl 4 3 S5
137. Perspectives on pediatric bariatric surgery: identifying barriers to referral. Iqbal CW, Kumar S, Iqbal AD, Ishitani MB, Surg Obes Relat Dis 2009 5 1 88 93 10.1016/j.soard.2008.08.023 18996760
138. To cut or not to cut: physicians' perspectives on referring adolescents for bariatric surgery. Woolford SJ, Clark SJ, Gebremariam A, Davis MM, Freed GL, Obes Surg 2010 20 7 937 942 10.1007/s11695-010-0152-9 20401742
139. Ethics and prevention of overweight and obesity: an inventory. Ten Have M, De Beaufort ID, Mackenbach JP, Van der Heide A, Obes Rev 2011 12 9 669 679 21545391
140. Stearns PN, Fat history. Bodies and beauty in the Modern West New York NY: New York University Press 1997
141. Genomics, obesity and enhancement: moral issues regarding aesthetics and health. Schermer M, Genomics, Society, and Policy 2012 4 2 36 52
142. The ethics of evaluating obesity intervention studies on children. Wickins-Drazilova D, Williams G, Consortium I, Int J Obes (Lond) 2011 35 Suppl1 24 29
143. Currents in contemporary ethics-Pediatric obesity: Ethical dilemmas in treatment and prevention. Hinds HL, J Law Med Ethics 2005 33 3 599 602 10.1111/j.1748-720X.2005.tb00522.x 16240739 (Pubitemid 41546093)
144. Pediatric obesity: ethical dilemmas in treatment and prevention. Hinds HL, J Law Med Ethics 2005 33 3 599 602 10.1111/j.1748-720X.2005.tb00522.x 16240739 (Pubitemid 41546093)
145. Acs ZJ, Lyles A, Obesity, business and public policy Northampton, MA, US: Edward Elgar Publishing 2007 267
146. Gilman S, Fat: A cultural history of obesity by Sander Gilman Cambridge: Polity 2008
147. Theorizing the obesity epidemic: Health crisis, moral panic and emerging hybrids. Patterson M, Johnston J, Soc Theor Health 2012 10 3 265 291 10.1057/sth.2012.4
148. Is a weight-centred health framework salutogenic? Some thoughts on unhinging certain dietary ideologies. Aphramor L, Soc Theor Health 2005 3 315 340 10.1057/palgrave.sth.8700059
149. Campos P, The obesity myth: why American's obsession with weight is hazardous to your health New York: Gotham Books 2004
150. The epidemiology of overweight and obesity: public health crisis or moral panic. Campos P, Saguy A, Ernsberger P, Oliver E, Gaesser G, Int J Epidemiol 2006 35 55 60 16339599 (Pubitemid 43205443)
151. Gard M, Wright J, The obesity epidemic: science, morality and ideology London Eng: Routledge 2005
152. Collateral damage from friendly fire? Race, nationality, class and the war against obesity Herndon A, Soc Semiotic 2005 15 2 127 141 10.1080/10350330500154634
153. Big handsome men, bears and others: virtual constructions of fat male embodiment Monaghan LF, Body Soc 2005 11 2 81 111 10.1177/1357034X05052463
154. Discussion piece: A critical take on the obesity debate. Monaghan LF, Soc Theor Health 2005 3 302 314 10.1057/palgrave.sth.8700058
155. How could you let yourself go like that? Stories of the origins of obesity in accounts of weight loss surgery. Throsby K, Soc Sci Med 2007 65 8 1561 1571 10.1016/j.socscimed.2007.06.005 17651875 (Pubitemid 47410349)
156. The government of girth. Coveney J, Health Sociol Rev 2008 17 2 199 213 10.5172/hesr.451.17.2.199
157. Obesity metaphors: how beliefs about the causes of obesity affect support for public policy. Barry CL, Brescoll VL, Brownell KD, Schlesinger M, Milbank Q 2009 87 1 7 47 10.1111/j.1468-0009.2009.00546.x 19298414
158. Obesity, fast food manufacture, and regulation: revisiting opportunities for reform. Ahmed HM, Food Drug Law J 2009 64 3 565 575 19999644
159. The perils of ignoring history: Big Tobacco played dirty and millions died. How similar is Big Food? Brownell KD, Warner KE, Milbank Q 2009 87 1 259 294 10.1111/j.1468-0009.2009.00555.x 19298423
160. The right to food and freedom from obesity. Damman S, Eide WB, TidsskrNor Laegeforen 2007 127 17 2263 2265
161. Prevention of overweight and obesity-the role of government, the food industry and the individual. Eichhorn C, Nagel E, Gesundheitswesen 2010 72 1 10 16 10.1055/s-0029-1237737 19795343
162. Just where does corporate responsibility end and consumer responsibility begin? The case of marketing food to kids around the globe. Mueller B, Int J Advert 2007 26 4
163. Ethical concerns regarding interventions to prevent and control childhood obesity. Govea J, Prev Chronic Dis 2011 8 5 91 21843421
164. Internet marketing of bariatric surgery: contemporary trends in themedicalization of obesity. Salant T, Santry HP, Soc Sci Med 2006 62 10 2445 2457 10.1016/j.socscimed.2005.10.021 16289735
165. Social inequalities in childhood obesity. Simonton SZ, Obesity in childhood and adolescence, Volume 1 Westport, CT, US: Praeger Publishers/Greenwood Publishing Group, Davies HD, Fitzgerald HE, Medical, biological, and social issues. 2008 61 91
166. Childhood overweight and obesity prevalences levelling off in Stockholm but socioeconomic differences persist. Sundblom E, Petzold M, Rasmussen F, Callmer E, Lissner L, Int J Obes (Lond) 2008 32 10 1525 1530 10.1038/ijo.2008.104
167. New perspectives on health disparities and obesity interventions in youth. Wilson DK, J Pediatr Psychol 2009 34 3 231 244 19223277
168. Prevalence of obesity and trends in body mass index among US children and adolescents, 1999-2010. Ogden C, Carroll M, Kit B, Flegal K, JAMA 2012 307 5 483 490 10.1001/jama.2012.40 22253364
169. Socio-demographic disparities in distribution shifts over time in various adiposity measures among American children and adolescents: What changes in prevalence rates could not reveal. Beydoun MA, Wang Y, Int J Pediatr Obes 2011 6 1 21 35 10.3109/17477166.2010.488693 21905812
170. The obesity epidemic: are minority individuals equally affected? Calzada PJ, Anderson-Worts P, Prim Care Clin Office Pract 2009 36 2 307 317 10.1016/j.pop.2009.01.007
171. Lifecourse approach to racial/ethnic disparities in childhood obesity. Dixon B, Pena MM, Taveras EM, Adv Nutr 2012 3 1 73 82 10.3945/an.111.000919 22332105
172. Measuring health disparities: Trends in racial-ethnic and socioeconomic disparities in obesity among 2- to 18-year old youth in the United States, 2001-2010. Rossen LM, Schoendorf KC, Ann Epidemiol 2012 22 10 698 704 10.1016/j.annepidem.2012.07.005 22884768
173. Racial and ethnic health disparities among fifth-graders in three cities. Schuster MA, Elliott MN, Kanouse DE, Wallander JL, Tortolero SR, Ratner JA, Klein DJ, Cuccaro PM, Davies SL, Banspach SW, N Engl J Med 2012 367 8 735 745 10.1056/NEJMsa1114353 22913683
174. Ethnic group differences in overweight and obese children and young people in England: cross sectional survey. Saxena S, Ambler G, Cole TJ, Majeed A, Arch Dis Child 2004 89 30 36 14709498 (Pubitemid 38122004)
175. Being overweight and obese: Black children ages 2-5 years. Hudson CE, ABNF J 2008 19 3 89 91 18717206
176. Chronic malnutrition among overweight Hispanic children: Understanding health disparities. Iriart C, Handal AJ, Boursaw B, Rodrigues G, J Immigr Minor Health 2011 13 6 1069 1075 10.1007/s10903-011-9464-7 21416269
177. Race/ethnic and nativity disparities in child overweight in the United States and England. Martinson ML, McLanahan S, Brooks-Gunn J, Ann Am Acad Pol Soc Sci 2012 643 1 219 238 10.1177/0002716212445750 23633705
178. Children's health inequalities: ethical and political challenges to seeking social justice. Blacksher E, Hastings Cent Rep 2008 38 4 28 35 10.1353/hcr.0.0035 19192713
179. Toward and rational and equiable use of bariatric surgery. Flum DR, Khan TV, Dellinger EP, JAMA 2007 298 1442 1444 10.1001/jama.298.12.1442 17895461 (Pubitemid 47481611)
180. Ethical evaluations of childhood obesity interventions: equity and social justice. Public Health Nutr 2012 15 8A 1557 22932578
181. Adolescent bariatric surgery. Hsia DS, Fallon SC, Brandt ML, Arch Pediatr Adolesc Med 2012 166 8 757 766 10.1001/archpediatrics.2012.1011 22869408
182. Shell RE, The hungry gene. The inside story of the obesity industry New York, NY: Grove 2002
183. Extreme Childhood Obesity. Cox-White B, Connolly P, Hinman L, Keller DR, Ladenson R, Leever M, Ethics Education Library 2002 1
184. Garbarino J, Sigman G, A child's right to a healthy environment New York, NY, US: Springer Science + Business Media 2010 254 23671909
185. A child's right to an environment that prevents obesity: Ethical considerations. Sigman G, A child's right to a healthy environment New York, NY, US: Springer Science + Business Media, Garbarino J, Sigman G, 2010 163 181 23671909
186. Childhood obesity: bringing children's rights discourse to public health policy. Greenway J, Community Pract 2008 81 5 17 21 18549118
187. Doctors: 'Put obese children into care'. Goodchild S, The Independent June 10 2007
188. State intervention in life-threatening childhood obesity. Murtagh L, Ludwig DS, JAMA 2011 306 2 206 207 10.1001/jama.2011.903 21750301
189. Ethical family interventions for childhood obesity. Perryman ML, Prev Chronic Dis 2011 8 5 99 21843429
190. Life-threatening childhood obesity and legal intervention. Siegel RM, Inge TH, JAMA 2011 306 16 1763 10.1001/jama.2011.1521 22028351
191. Does Pediatric Obesity Indicate Child Neglect? Varness T, Virtual Mentor 2010 12 4 263 267 23148829
192. When does severe childhood obesity become a child protection issue? Alexander SM, Baur LA, Magnusson R, Tobin B, Med J Aust 2009 190 3 136 139 19203311
193. Personal responsibility among adolescents. McGuire A, Zhang J, Health Aff 2010 29 7 1418
194. From the womb to the tomb: Obesity and maternal responsibility. McNaughton D, Crit Publ Health 2011 21 2 179 190 10.1080/09581596.2010.523680
195. Childhood obesity and parental responsibilities. Schmidt H, Hastings Cent Rep 2008 38 4 3 19192702
196. The role of parents in pre-adolescent and adolescent overweight and obesity treatment: a systematic review of clinical recommendations. Shrewsbury VA, Steinbeck KS, Torvaldsen S, Baur LA, Obes Rev 2011 12 10 759 769 10.1111/j.1467-789X.2011.00882.x 21535361
197. Responsibility in health care-a liberal egalitarian approach. Cappelen A, Norheim OF, J Med Ethics 2005 31 476 480 10.1136/jme.2004.010421 16076974 (Pubitemid 41131628)
198. The parent versus the state: Responsibility in childhood obesity. Nicholls SG, Williams D, Conference: 18th European Congress on Obesity, ECO 2011 Istanbul Turkey. Conference Start: 20110525 Conference End: 20110528. Conference Publication:(var.pagings) Obesity Reviews. 2011 38
199. Parental Responsibility and Obesity in Children. Holm S, Public Health Ethics 2008 1 1 21 29 10.1093/phe/phn007
200. Debating parental responsibility for childhood obesity: Ethical and legal considerations. Pratt KJ, Greer AG, Bariatric Nursing and Surgical Patient Care 2012 7 3 146 149 10.1089/bar.2012.9973
201. Raising healthy children: Moral and political responsibility for childhood obesity. Purcell M, J Public Health Policy 2010 31 4 433 446 10.1057/jphp.2010.28 21119650
202. Childhood obesity: a framework for policy approaches and ethical considerations. Kersh R, Stroup DF, Taylor WC, Prev Chronic Dis 2011 8 5 93 21843423
203. Personal responsibility and obesity: a constructive approach to a controversial issue. Brownell KD, Kersh R, Ludwig DS, Post RC, Puhl RM, Schwartz MB, Willett WC, Health Aff 2010 29 3 379 387 10.1377/hlthaff.2009.0739
204. Policy tools for the childhood obesity epidemic. Dietz WH, Bland MG, Gortmaker SL, Molloy M, Schmid TL, J Law Med Ethics 2002 30 3 Suppl 83 87 12508508 (Pubitemid 39277881)
205. Public policy versus individual rights in childhood obesity interventions: perspectives from the Arkansas experience with Act 1220 of 2003. Phillips MM, Ryan K, Raczynski JM, Prev Chronic Dis 2011 8 5 96 21843426
206. Moral aspects of bariatric surgery for obese children and adolescents: the urgent need for empirical-ethical research. van Geelen SM, Bolt LL, van Summeren MJ, Am J Bioethics 2010 10 12 30 32 10.1080/15265161.2010.528514
207. Moral aspects of bariatric surgery for obese children and adolescents: the urgent need for empirical-ethical research. van Geelen SM, Bolt LL, van Summeren MJ, Am J Bioeth 2010 10 12 30 32 10.1080/15265161.2010.528514 21161840
208. Adolescent Obesity and Bariatric Surgery. Helmrath MA, Brandt ML, Inge TH, Surg Clin North Am 2006 86 2 441 454 10.1016/j.suc.2005.12.015 16580933
209. Sample size in obesity trials: patient perspective versus current practice. Allison DB, Elobeid MA, Cope MB, Brock DW, Faith MS, Vander VS, Berkowitz R, Cutter G, McVie T, Gadde KM, Medical Decision Making 2010 30 1 68 75 10.1177/0272989X09340583 19675318
210. Participation in biomedical research: the consent process as viewed by children, adolescents, young adults, and physicians. Susman EJ, Dorn LD, Fletcher JC, J Pediatr 1992 121 4 547 552 10.1016/S0022-3476(05)81142-4 1403387
211. Methodological and ethical challenges in evaluations of family-based approaches. Baker J, Conference: 19th European Congress on Obesity, ECO2012 Lyon France. Conference Start: 20120509 Conference End: 20120512. Conference Publication:(var.pagings) Obesity Facts. 2012 10
212. Children as research subjects: moral disputes, regulatory guidance, and recent court decisions. Kopelman LM, Mt Sinai J Med 2006 73 3 596 604 16758097 (Pubitemid 43834194)
213. Ethical and public policy aspects of childhood obesity: opinions of scientists working on an intervention study. Wickins-Drazilova D, Williams G, Obes Rev 2010 11 8 620 626 10.1111/j.1467-789X.2010.00752.x 20546143
214. Obesity. Lowry KW, Dulcan's textbook of child and adolescent psychiatry Arlington, VA, US: American Psychiatric Publishing, Inc, Dulcan MK, 2010 383 395 23026953
215. Theoretical considerations related to cutoff points. Pelletier D, Food Nutr Bull 2006 27 4:Suppl:Growth:Standard uppl-36
216. Childood obesity: current definitions and recommendations for their use. Rolland-Cachera M, Int J Pediatr Obes 2011 6 5-6 325 331 21916784
217. Measurement matters. Horlick M, Hediger ML, J Pediatr 2010 156 2 178 179 10.1016/j.jpeds.2009.09.055 20105636
218. The technological invention of disease. Hofmann B, J Med Eth 2001 27 10 19 (Pubitemid 32605710)
219. General practitioners' and patients' models of obesity: whose problem is it? Ogden J, Bandara I, Cohen H, Farmer D, Hardie J, Minas H, Moore J, Qureshi S, Walter F, Whitehead MA, Patient Educ Couns 2001 44 3 227 233 10.1016/S0738-3991(00)00192-0 11553423 (Pubitemid 32842863)
220. Beliefs about the causes and solutions to obesity: a comparison of GPs and lay people. Ogden J, Flanagan Z, Patient Educ Counsel 2008 71 1 72 78 10.1016/j.pec.2007.11.022
221. The overweight adolescent: clinical and ethical issues in intensive treatments for pediatric obesity. Cuttler L, Whittaker JL, Kodish ED, J Pediatr 2005 146 4 559 564 10.1016/j.jpeds.2004.12.013 15812467 (Pubitemid 40469724)
222. Absolving a deadly sin: a medical and legal argument for including obesity as a disability under the Americans with Disabilities Act. Kuss CL, J Contemp Health Law Policy 1996 12 2 563 605 8666735
223. Obesity as a disease: a white paper on evidence and arguments commissioned by the Council of the Obesity Society. Allison DB, Downey M, Atkinson RL, Billington CJ, Bray GA, Eckel RH, Finkelstein EA, Jensen MD, Tremblay A, Obesity 2008 16 6 1161 1177 10.1038/oby.2008.231 18464753 (Pubitemid 351770522)
224. Big questions remain unanswered. Pinkney J, BMJ 2010 341 5304 10.1136/bmj.c5304 20880917
225. Obesity in the United States: is there a quick fix? Pros and cons of bariatric surgery from the pediatric perspective. Wulkan ML, Durham MM, Curr Gastroenterol Rep 2005 7 6 445 450 10.1007/s11894-005-0074-1 16313873 (Pubitemid 43009335)
226. Moral expertise: a problem in the professional ethics of professional ethicists. Crosthwaite J, Bioethics 1995 9 5 361 379 11653255
227. Debating ethical expertise. Steinkamp NL, Gordijn B, ten Have HA, Kennedy Inst Ethics J 2008 18 2 173 192 10.1353/ken.0.0010 18610784
228. Why moral philosophers are not and should not be moral experts. Archard D, Bioethics 2011 25 119 127 10.1111/j.1467-8519.2009.01748.x 19659852
229. Baseline BMI is a strong predictor of nadir BMI after adolescent gastric bypass. Inge TH, Jenkins TM, Zeller M, Dolan L, Daniels SR, Garcia VF, Brandt ML, Bean J, Gamm K, Xanthakos SA, J Pediatr 2010 156 1 103 108 10.1016/j.jpeds.2009.07.028 19775700
230. A stitch in time versus a life in misery. Kral JG, Surg Obes Relat Dis 2007 3 1 2 5 10.1016/j.soard.2006.11.013 17241931 (Pubitemid 46112417)