Weight Loss Surgery May be an Effective Treatment for Severely Obese Teens

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It’s hard to deny her happiness when you see Chelsea Hale smile into the camera.  She holds a picture of herself three years ago at the age 17 when she weighed in at 314 pounds.  After years of failed attempts at changing her diet, trying medication, and exercising more, Chelsea Hale opted to have obesity surgery.  She now weighs about 170 pounds, almost half her previous size, and relates that she can now physically do anything.  What causes a young teen to take such drastic measures?

In a recent study published by JAMA Pediatrics, researchers found that most teens opting to get weight loss surgery have a staggering number of health problems that used to be seen in adults only. Fifty perceont of the teens had a minimum of four major illnesses linked to their excess weight to include high cholesterol, sleep apnea, back and joint pain, high blood pressure and fatty liver disease. The study also demonstrated that weight loss surgery could be an effective and safe treatment for severely obese teens. 

Surgery Qualifications for Teens

Obesity surgery should be a final last-ditch option for teens.  Physicians and proponents for weight loss surgery emphasize that all patients are screened to ensure they are appropriate candidates for the procedure.  These institutions place very strict guidelines on what adolescents are eligible to undergo this type of surgery. 

To qualify, the teenage patient must be categorized as “severely obese”.  The group’s threshold for severe obesity is a body mass index (BMI) of at least 35.  The average BMI in the study was 51. They also take into account obesity related illnesses, age, psychological maturity, and previous attempts at weight-loss without surgery.

Dr. Thomas Inge, the study’s lead researcher and a surgeon at Cincinnati Children’s Hospital Medical Center, explains that the kids involved in the study weighed three times more than what is considered healthy.  They were not a bunch of teens that just wanted to fit into their cheerleading outfit better. In a cruel world, where being a severely obese teenager is difficult, weight loss surgery could be a light at the end of a dark tunnel.

Surgery Safety

242 teens underwent weight loss surgery at five U.S. centers from 2007 through 2011. Average age for the teens was 17.  Results for the first month post surgery helped bolster evidence that surgery is generally safe for obese teens.  Data showed that 92% of the 242 severely obese teens that had weight loss surgery did it without major complications.   The American Heart Association released a scientific statement stating obesity surgery may be the most effect treatment for what is called “severe obesity” in teens.  This condition affects around 5% of U.S. children and continues to increase nationwide. 

All initial anecdotal reports from the teens are positive.  Chelsea Hale dropped half her weight and no longer suffers from hormonal problems, heart blockage, or sleep apnea - all conditions linked to her obesity. She opted to do gastric sleeve surgery.  28 percent of the teens studied also underwent the same procedure.  Gastric sleeve surgery involves removing part of the stomach and creating a smaller tube or sleeve-shaped stomach.  Post operation, they must be careful about eating small portions of foods to avoid getting sick.

66 percent of the teens had gastric bypass or stomach stapling where a small pouch is created in the stomach and attached to the intestines. A small group had gastric band operations.  In this procedure, surgeons position an adjustable band around the top of the stomach and inflate it to shrink the stomach.  Currently this operation has not been approved for U.S. teens.

Complications Minimal

No deaths were reported during the initial hospitalization or within 30 days of the operation. Moreover, Inge and colleagues demonstrated that although minor and some major complications did occur in the early postoperative period after weight-loss surgery, the morbidity was treatable and similar to that in adults. 

The researchers suggest that more long-term studies are needed to assess accurate outcomes for adolescents undergoing weight loss surgery.  There are many unknowns as to the long-term effects of weight loss surgery on a child’s future growth and development.  Surgery does not guarantee that an adolescent will lose all of his or her excess weight and keep it off long-term.  Remember, weight loss surgery does not replace the long-term need for a healthy diet and regular physical activity. 


JAMA Pediatrics

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