OBJECTIVE: Cardiopulmonary exercise testing (CPET) is used prior to bariatric surgery in adolescents with obesity to assess surgical risk factors. Lack of normative equations for peak oxygen consumption (pVO2) for this population limits CPET interpretation. We aimed to use lean body weight (LBW) to predict pVO ₂ and developed novel predictive equations for use in this population. METHODS: 446 participants with obesity ages 9-20 underwent CPET prior to bariatric surgery from January 1, 2006 to December 31, 2019. Bioelectrical impedance analysis helped calculate LBW. Achieving peak heart rate > 90% predicted and RER of >1.1 were considered satisfactory effort. RESULTS: 107 CPET studies (29%) were satisfactory. Mean weight was 127 ± 21 kg, and BF% 49.7 ± 6.8, and LBW 63 ± 10, kg. Mean pVO ₂ was 22.2 ± 3.2 mL/kg/min. The mean pVO ₂ using LBW was 44.8 ± 8.7 mL/kg/min. Total body weight (TBW) estimated pVO ₂ to be 50.7 ± 7.0 % predicted[(1)](#ref-0001), while LBW estimated it at 102.3 ± 17.6 % predicted. Linear regression yielded reference equations pVO ₂=1571.6+12.2*TBW (males) and pVO2=1301.8+10.6*TBW (females). CONCLUSION: When pVO ₂ is corrected for LBW, adolescents with obesity demonstrate normal pVO ₂. A novel set of equations were developed to predict absolute pVO ₂ using TBW.