Is Bariatric Surgery the Solution for Obese Teens?
While headlines abound lamenting the consequences of childhood obesity in the United States, the number of adolescents who have undergone bariatric surgery has been steadily increasing, having tripled in recent years. According to new research, many teenagers are now considering surgery as a viable way to combat obesity and the physical, emotional, and social problems it can cause.
Public Spotlight on Childhood Obesity
In the last decade, a growing number of surveys, clinical studies, and daytime television slots have been devoted to exploring the consequences of Americas’ ever-expanding waistline, and the public is becoming increasingly aware of the major health risks associated with obesity. Terms like “body mass index,” “type 2 diabetes,” and “triglyceride levels“ are quickly making their way into the national vocabulary, and the people using them aren’t just doctors and middle-aged patients-they’re children and teens who, in rising numbers, suffer from obesity-related health problems.
According to data made available by the Center for Diseases Control and Prevention, the prevalence of overweight is currently 13.9 percent for children aged two to five; 18.8 percent for those aged six to 11; and 17.4 percent for those aged 12 to 19. These numbers have risen significantly since the late seventies and eighties, raising widespread concern over the future health of America’s children.
A number of measures have been taken by the public and private sectors alike to counteract childhood obesity. Most recently, the Robert Wood Johnson Foundation announced that it would spend $500 million over the next five years to help combat the problem by increasing access to healthy food, developing safe outdoor play places, and contributing to obesity research, among other initiatives. The US government has also backed efforts to implement more frequent physical education and decrease the amount of junk food available in public schools.
Most health professionals and obesity clinics still promote changes in diet and exercise as the best way for children and adolescents to lose weight. However, for teens who are severely obese, bariatric surgery is becoming a popular choice. A recent study published in the Archives of Pediatrics and Adolescent Medicine reveals that the number of American adolescents who have undergone bariatric surgery tripled between 2000 and 2003, with 771 adolescents electing to have surgery in 2003 alone. The study, conducted by researchers at the Robert Wood Johnson Medical School in New Brunswick, New Jersey and the Cincinnati Children’s Hospital Medical Center, tracked the number of people aged 10 to 19 who have undergone the surgical weight loss treatment.
In previous decades, the number of children who underwent bariatric weight loss surgery was negligible. Pediatricians were tentative about subjecting young people whose bodies were still developing to such a risky surgical procedure. However, as surgical techniques improve and the number of obese children continues to grow, many doctors are reconsidering their stance.
“It’s not at all unexpected that drastic times call for drastic measures—and it’s not that surgery is such a drastic measure,” says Dr. Thomas Inge, one of the researchers involved the Archives study. “If there are two million teens who have morbid obesity, it’s not at all unexpected that a certain percentage of them would have reason to undergo surgical weight loss treatment.”
Such treatment can range from gastric bypass surgery, in which the surgeon staples off a small pouch from the rest of the stomach and connects it directly to the small intestine, to the LAP-BAND® System procedure, in which a silicon band is strapped around the top of the stomach, dramatically decreasing the amount of food the patient can consume at one time. The LAP-BAND® System procedure is currently approved only for adults, but is available off-label for teens.
Currently, the Alfred I. duPont Hospital for children is, along with three other U.S. hospitals, conducting a Food and Drug Administration study to evaluate the safety and effectiveness of the LAP-BAND® System procedure. Meanwhile, Cincinnati Children’s Hospital Medical Center is conducting a more comprehensive study to observe how young patients respond to a range of weight loss surgeries, including gastric bypass.
The Cultural Climate
Some critics have been swift to brush off bariatric surgery as a “quick fix” or a “lazy” solution to adolescent obesity. The implication is that overweight teens lack the willpower and initiative to lose weight through diet and exercise.
What these critics fail to take into account is the barrage of mixed messages today’s teenagers face when it comes to weight, body image, and nutrition. On the one hand, Hollywood promotes an ideal body type that fails to reflect the national average. Women are expected to adhere to a svelte, size-zero “norm,” while men are expected to appear increasingly muscular and lean. On the other hand, television commercials promote junk food that is high in sugar and fat but offers little nutritional value. Product placement for soft drinks, candy, energy drinks, and fast food is a standard practice in many films, and prominent athletes can be found promoting sports beverages so laden with sugar that they would likely never consume them themselves. In the midst of this, many adolescents watch their parents struggle through the Adkins, South Beach, or Zone diets, or overhear their fellow classmates talking about weight loss pills, fasting techniques, and even steroids.
It isn’t any wonder that, in the face of such contradictory messages, teenagers find it difficult to stick to balanced, healthy eating patterns. And for teens who are 100 pounds or more overweight, it becomes much more difficult to lose weight without surgical intervention.
“These kids are not fat, lazy, stupid slobs. They are kids trapped by their biology and by some extent our society,” says Dr. Allen Browne, who is participating in the FDA study of gastric banding in obese teens. “These kids don’t do it to themselves. Why would anybody do this to themselves?”
Adding It Up
As with any statistics, those regarding teen bariatric surgery can be blown out of proportion. In reality, people under the age of 19 still represent less than one percent of all patients electing to have weight loss surgery. While the number of teens undergoing surgery is on the rise, it is still quite small and is comprised exclusively of patients whose weight poses a serious, immediate health risk.
Although the risks of bariatric surgery should not be downplayed, they are often outweighed by the benefits. Complications of obesity such as sleep apnea, heart diseases, diabetes, and joint pain are all alleviated by weight loss, and the emotional gains that teen patients experience can be immeasurable. However, since no long-term studies have yet been carried out concerning the medical and psychological results of teen bariatric surgery, only doctor and patient testimonials can currently provide dependable insight.
Dr. Inge offers his observations of the positive effects surgery can have on patients’ lives: ”They become healthier, they become happier, and they become really much more at peace with themselves. It really is a dramatic turnaround that you see.”
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