The spiraling obesity epidemic has become a top concern not only for doctors and weight loss centers, but for the government, schools, and even the food industry. The options to treat obesity are fairly uncomplicated: a healthy diet and more physical activity. Yet these deceptively simple steps remain a formidable challenge, leading increasing numbers of people to choose weight loss surgery to help them regain their health.
According to Marc Bessler, MD, Director of the Center for Metabolic and Weight Loss Surgery, it has been widely proven that a severely overweight adult person, someone who is 100 pounds or more over their ideal weight, may benefit greatly from weight loss surgery. Overall, length of life and quality of life improve greatly. Direct benefits of weight loss include significant reduction or elimination of cardiovascular disease, asthma, obstructive sleep apnea, non-alcoholic fatty liver disease, gastro-esophageal reflux disease (GERD), and other serious health problems. Moreover, gastric bypass surgery, the most popular weight loss procedure in adults, provides an additional benefit: rapid elimination of type 2 diabetes. “Patients who undergo gastric bypass surgery experience significant improvement or elimination of type 2 diabetes within a month after surgery, before significant weight loss even occurs,” says Dr. Bessler. Interestingly, a woman who has had weight loss surgery between pregnancies will provide her second child with a better chance of having a healthier weight, says Dr. Bessler. Yet, with all these benefits, should weight loss surgery be an option for obese teenagers and adolescents?
According to a University of Michigan study of general practitioners and family doctors that was published in May of this year, the verdict as decided by these clinicians is mixed. Forty-eight percent stated that they would never refer an obese adolescent for weight loss surgery, and 46 percent stated that the minimum age at which they refer a patient for weight loss surgery would be 18 years. 1
During the past 15 years, Dr. Bessler has helped many patients to achieve a healthy weight. He explains, “Without a very significant change in lifestyle, a 200 pound 15-year-old will be a 300 pound 18-year-old, and then a 375 pound 21-year-old. By this time, he or she may already be experiencing serious health issues because of the excess weight.” Dr. Bessler has pioneered continuous advancements in minimally invasive surgical techniques, which translate to exceedingly safe procedures and very successful outcomes.
Jeffrey Zitsman, MD, Director of the Adolescent Bariatric Surgery program at NewYork-Presbyterian Morgan Stanley Children’s Hospital/Columbia University Medical Center has been studying laparoscopic gastric banding in teens since for several years now. Although adults may choose among several surgical options for weight loss (gastric bypass, laparoscopic gastric banding, and sleeve gastrectomy), Columbia performs only laparoscopic gastric banding in patients under 18, because it is the least invasive and best studied procedure in teens to date.
Gastric banding involves placing an adjustable, removable silicone band around the upper portion of the stomach. This creates a small upper pocket in the stomach that fills rapidly, creating a feeling of fullness, and causing the patient to eat less. Because it does not surgically alter the intestinal tract, the procedure is less likely to cause nutrient absorption problems than other types of weight loss surgery, and it is fully reversible.
Although gastric bands are not approved for those who are under 18 years of age, doctors at Columbia have been granted approval by the FDA to test the procedure in selected patients, who are then followed for at least five years. Outcomes among adolescents have been excellent, according to Dr. Zitsman, with weight loss in teens comparable to that in adults who undergo gastric banding.
Not every teen will qualify for weight loss surgery, since other factors in addition to obesity, such as compliance to a healthy diet, physical activity and family support, are important factors in weight loss success. Risk of complications of weight loss surgery must be carefully weighed in the context of health risks associated with obesity. Careful screening by Columbia’s multidisciplinary team is essential to provide a patient with the best opportunity for a successful outcome after weight loss surgery. The decision for a teen to undergo weight loss surgery is a personal one. What would you do if this was you or your adolescent family member?
Additional Articles:
Gastric Banding Gives Good Results in Obese Teens
Teen Takes Drastic Measures To Battle Weight
Weight-Loss Surgery for Obese Teens Backed by Study
1 “Bariatric Surgery in Severely Obese Adolescents Debated” on Medscape Today [web site]; available from www.medscape.com/viewarticle/721446 retrieved 18 May 2010.
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