FRIDAY, Oct. 8 (HealthDay News) -- Weight-loss surgery may be
gaining traction as a viable treatment for obese teenagers,
particularly those who are beginning to show the detrimental health
effects of morbid obesity.
Teen obesity has become a serious public health concern in the
United States, with recent research finding that nearly one in
every four teenagers is obese, according to the U.S. Centers for
Disease Control and Prevention. Despite this, doctors have been
loath to perform weight-loss surgery -- also called gastric bypass
and bariatric surgery -- on teenagers, though it's become a common
and effective method of weight loss in adults.
But new studies evaluating the merits of weight-loss surgery for
teenagers have provided fresh evidence that such a drastic step may
be needed to head off a lifetime of obesity and illness.
"There's certainly a feeling among health-care providers and families that little Johnny is really getting heavier and heavier, but all he needs to do is put his mind to it and he can reverse this," said Dr. Thomas Inge, director of the Center for Bariatric Research and Innovation at the Cincinnati Children's Hospital Medical Center. "But that is clearly not working for some kids. Until you bring up the option of bariatric surgery for those patients, you haven't done your job as a doctor."
Inge served as lead author on a study that argued for the use of
weight-loss surgery earlier rather than later in children who are
becoming "super obese." The study of 61 teens found that kids with
an incredibly high body mass index (BMI) lost more than one-third
of their weight after gastric bypass but were still heavy enough to
be considered morbidly obese. BMI is a measurement that takes into
account weight and height.
"We are seeing patients still in 2010 who are coming to us routinely with a BMI of the high 50s and 60s and 70s," Inge said. "When we can get to these kids with BMIs in the 40s, we can have a decent chance of turning around their morbid obesity. When BMIs are higher than that, very often we can get their weight down, but they're still going to remain morbidly obese even after treatment. Once they get into the high 50s and beyond, I think we've done the kid a disservice."
Another small study, involving 50 severely obese Australian
teenagers, found that those who underwent gastric banding surgery
were much more successful in losing weight. The target goal of
losing more than half their excess weight was achieved by 84
percent of the teens who went through weight-loss surgery, but only
12 percent of the kids who tried dieting and exercise.
Bariatric surgery for children is currently recommended
primarily for those who either have a BMI of 35 or above and have
major health problems related to their obesity, and for children
with a BMI of 40 or above who are showing early signs of
obesity-related health problems, Inge said.
Not every child meeting those criteria would be a good candidate
for weight-loss surgery, however.
Because bariatric surgery can deplete the body of key nutrients
needed for healthy development, children should have already
undergone the majority of their linear growth, said Dr. Lori
Laffel, chief of the pediatric, adolescent and young adult section
at the Joslin Diabetes Center and an associate professor of
pediatrics at Harvard Medical School.
"Their bones need to be as close as possible to what they will possess in adulthood," Laffel said. "You don't want to compromise opportunities to attain maximum bone density and maximum bone mass."
That would limit weight-loss surgery for the most part to girls
older than 13 and boys older than 15, Laffel said.
The teenager also should display a certain level of emotional
maturity and have a supportive family, Laffel and Inge said.
Weight-loss surgery places very strict dietary requirements on
people. Certain foods are restricted or completely banned, and
dietary supplements become essential to make sure the person
receives sufficient nutrients, vitamins and minerals. If the kids
aren't capable of meeting these requirements or do not have parents
to help them by buying the right foods and making sure they eat
them, then the surgery should not be undertaken, they said.
Laffel stressed that prevention and lifestyle choices should
properly remain the first line of treatment when it comes to teen
"You want maintaining a healthy weight to become an effort for life," Laffel said, noting that kids who undergo bariatric surgery might not understand the amount of healthy eating and exercise that will be needed to keep off the weight they shed.
At the same time, there's no denying that weight-loss surgery
can help kids who are otherwise doomed to a lifetime of obesity and
chronic illness, she said.
"There's no question this gives you a remarkable jump-start," Laffel said. "As the procedures get simple and safer, I think this will be more often considered."
The Nemours Foundation offers more on
weight-loss surgery for teens.
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
Copyright © EBSCO Publishing. All rights reserved.