Bariatric Surgery Offers Teen Hope for a Healthy Adulthood
Weight-Loss Surgery for Teens
Are teenagers good candidates for bariatric surgery — and how young is too young to undergo this procedure?
By Krisha McCoy
Medically Reviewed by Pat F. Bass III, MD, MPH
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For teenagers who are extremely obese, bariatric surgery may be a treatment option that can help, especially when traditional treatments (for example, diet, exercise, or weight-loss medications) have failed. In fact, there has been an increase in bariatric weight-loss surgeries (WLS) among children in recent years.
"There is a growing — near exploding — epidemic of adolescent and childhood obesity," says Scott Shikora, MD, chief of bariatric surgery and director of the weight and wellness center at Tufts Medical Center in Boston. "There are no better treatments for intractable morbid obesity than surgery," he says.
WLS: When Teens May Need Bariatric Surgery
Dr. Shikora says that children can become candidates for bariatric surgery when their body mass index (BMI, a measure of weight relative to height) is 35 or greater and they have obesity-related conditions, such as diabetes, high blood pressure, or sleep apnea. Bariatric surgery may also be an option for kids whose BMI is 40 or greater, even when they appear to be otherwise healthy.
"For those kids and adolescents, at least the option of considering surgery is reasonable," says Shikora.
Though there are no universally accepted guidelines regarding how young is too young to have bariatric surgery, Shikora says that some programs consider children as young as 13 or 14 years old, and most require that children have reached a certain level of maturity (for example, their bone maturity has been demonstrated on X-ray).
According to Shikora, the two particular types of surgery for weight loss that have been the most extensively studied in children are gastric bypass and adjustable gastric banding (Lap-Band). "It is reasonable to discuss the pros and cons of both procedures with the child and the child's parents," Shikora says.
Surgery for Weight Loss: Other Factors to Consider
When deciding if bariatric surgery is an option for your child, your child's medical team will want to investigate many different factors, including:
- Risks vs. benefits.Medical professionals and parents must always weigh the risks of the procedure against the risks of the excess weight when considering bariatric surgery in children. Today, bariatric surgery is considered to be a safe procedure, but there are potential risks (for example, blood clots, bleeding, leakages, and death) associated with the various weight-loss surgeries. "The operative risks and the psychosocial risks [of bariatric surgery] are the same [in children] as for adults," says Shikora.
- Your child's motivation.Bariatric surgery is only successful in patients who are willing to commit to long-term lifestyle changes (diet and exercise) after the operation. According to Shikora, a surgeon will consider whether the teen understands her obligations, and if she is emotionally mature enough to make the necessary behavior changes after bariatric surgery.
- Network of support."There has to be evidence of strong parental support or pediatrician support, or even behavioral therapist support — somebody who can help guide the adolescent through the process," says Shikora.
If your child does have bariatric surgery, he should be able to resume activities soon after surgery. "I would think that kids could return to school [and] full activities within a couple of weeks," says Shikora.
Studies have shown that bariatric surgery is much more effective in helping severely obese children lose weight than diet and behavioral interventions alone. And researchers believe that bariatric surgery may improve obesity-related health problems in children even better than it does in adults. In addition, a recent study found that extremely obese children show significant improvements in quality of life and depressive symptoms during the first year after having a gastric bypass operation.
Video: Pediatrics: Weight Loss Surgery for Teens
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