Overweight and obesity affect not only adults, but also children and adolescent populations. Among them, NAFLD is a typical disease brought about by metabolic syndrome, which progresses over a long period of time, with some patients requiring liver transplantation even in their 20s. Conservative treatments, such as exercise and changes in dietary habits, usually lead to poor long-term outcomes due to the patient’s own inability to adhere to them. Studies have explored bariatric surgery in early childhood and adolescence, and there is definitive evidence that bariatric surgery can significantly improve adult obesity and related complications. However, unlike the well-defined indications for bariatric surgery in adults, the indications for surgery in minors have been controversial. With reference to adult criteria, the following indications for bariatric surgery in adolescent patients are available: 1. BMI greater than 40 kg/m2 with severe comorbidities, e.g., moderate to severe apnea in type 2 diabetes, pseudotumor cerebri, nonalcoholic fatty liver with significant fibrosis; 2. BMI greater than 50 kg/m2 with milder comorbidities, e.g., hypertension, insulin resistance, glucose intolerance, decreased quality of life, Decreased quality of life. Additional additional requirements are: 1. previous attempts at dieting or lifestyle modification for weight loss; 2. Tanner stage 4 or higher; 3. DEXA scan suggesting 95% or more skeletal maturity; 4. ability to comply with lifestyle changes and a stable psychological environment. Routine tests that should be performed before surgery include routine blood liver function, lipids, thyroid function, blood glucose, glycosylated hemoglobin, urine routine, vitamin D, parathyroid hormone, and H. pylori determination. It is important to note that although weight loss surgery can improve NAFLD in morbidly obese adolescents as well as reduce body weight, the surgery can also bring about serious complications. Therefore, postoperative follow-up needs to be adhered to to maintain a good mindset and a stable lifestyle. Currently Roux-en-Y gastric diversion and laparoscopic adjustable gastric banding are more widely used in pediatric obese patients. Since the latter has not been approved by the US Food and Drug Administration, it is only recommended for experimental use. In addition, other weight reduction procedures, including sleeve gastrectomy