Bariatric Surgery for Adolescents: Should it be an Option?

Bariatric Surgery For Adolescents: Should It Be An Option?
by Amanda McGowan, editor

March 3, 2010


I read an article this morning about a 16-year-old girl named Cassie Mills who is losing a battle with weight. Standing at 5’ 4” and 213 pounds, Cassie is considering bariatric surgery after several different diets and workout solutions have failed to help her succeed in losing weight.

The topic of bariatric surgery has been frequently covered in the news. Whether patients are over-using the procedure to shed their excess weight has been questioned, and some surgeons have even advocated bariatric surgery on non-obese patients to treat Type 2 diabetes.

Recently, a discussion of bariatric surgery for adolescents has been brought to the forefront. Is it right for some obese or severely overweight children and adolescents to undergo these surgeries, or is it too risky? It is a better option for obese teenagers than a strict regiment of diet and exercise?

According to the article, reported by Denver Channel 7 News, nearly one third of US children and adolescents are classified as obese or overweight, and more and more of them are considering drastic measures—such as surgery—to reverse it. In fact, a recent study showed teens that underwent gastric band surgery lost significantly more weight than teens that were simply on a diet.

Still, the argument against bariatric surgery in teens is two-fold. First, it’s a risky procedure. Research has looked at the safety and effectiveness of weight-loss surgery for adults, but the evidence for teens is not as strong. Plus, having a weight loss procedure is not a one-and-done type of experience. It involves a life-long commitment after surgery in order to be successful.

Second, some say having surgery to lose weight would send the wrong message to young people. Is bariatric surgery the “easy way out” over diet and exercise?

Some could argue the value of diet and exercise is often overlooked by Americans and too-quickly ruled out as a viable solution for losing a large amount of weight. Case in point, a headline that popped up on my homepage this morning reads, “2 Out of 3 People Don’t Exercise Enough.” I click on the article, and it goes on to inform me that only 12 percent of Americans eat what is considered to be a healthy diet. Further, in May 2008, the Bureau of Labor Statistics reported that only about 16 percent of Americans 15 years and older participated in sports and exercise activities on an average day.

Generally, bariatric surgery been seen as a last-resort option for people who have tried everything else and still cannot lose the weight. However, given these statistics, how do we know that absolutely every diet and exercise solution has been tried and failed, particularly when the patient is a mere 16 years old?

On the flip side, if it is not dealt with in adolescence, weight and obesity can doom a person for the rest of their life, leading to worsening health problems.

It can also have negative social consequences for a young person. For Cassie, her weight sparked cruel and frequent teasing on theschool bus, and forced her to quit activities that she loved such as dancing, due to her weight. At what point in an adolescent’s battle with obesity is it time for a doctor and the patient say, “enough is enough” and consider surgery as a solution?

In Denver, the Rose Medical Center has instituted the state’s first teen bariatric program and Cassie has joined. According to Dr. Michael Snyder, head of the program, before surgery is even put on the table as an option, every teen gets a team that includes a nutritionist, a psychologist, an exercise therapist and a surgeon. In order for surgery to be considered for the teen, it has to be viewed as reasonable by the team of professionals.

Either way, surgery or not, changing an overweight teen’s life is the ultimate goal of the program. And that means surgery—as controversial as it may be—is on the table. Perhaps in some cases, it is reasonable, and it may be the only option to successfully deal with a young person’s weight once and for all.