Comparison Between Gastric Band, Laparoscopic Sleeve Gastrectomy, Gastric Bypass Surgeries

Inclusion Criteria: Youth 14-19yrs * 6 months of attempts at weight management by primary care physician or Pediatric Endocrinologist * Approval by the Adolescent Bariatric Surgery clinic to undergo surgery * Physically or nearly physically mature * BMI \>= 35kg/m2 with one obesity related comorbidities or BMI \>= 40 kg/m2 * Commitment to avoid pregnancy for at least 1 year postoperatively * Capability and willingness to adhere to nutritional guidelines postoperatively * Informed consent to surgical treatment * Demonstration of decisional capacity * Supportive family environment Exclusion Criteria: * Inability to be approved by Yale Adolescent Bariatric Surgery clinic to undergo surgery * Uncontrolled psychosis * Uncontrolled depression * Drug or alcohol abuse * History of congenital or acquired anomalies of gastrointestinal tract * Esophageal anatomical abnormality or dysmotility * Inflammatory bowel disease * Severe cardiopulmonary disease * Severe coagulopathy * Hepatic insufficiency or cirrhosis * Presence of localized or systemic infection at time of surgery * Obesity related to central causes: Prader Willi and hypothalamic abnormalities * Non-compliance to nutrition plan, exercise, and behavioral counseling/treatment * Pregnant, breast-feeding or planning of becoming pregnant within 1-2 years of surgery