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Bariatric surgery for obesity: what is it and is it for my teen?

Posted Oct 23 2009 10:03pm

We hear a lot these days about options for weight management -- nutrition, diets, exercise and activity, magical pills, and surgery.  Many times parents feel that they have tried 'everything' and are at their wits' end, concerned for their child's health and wellbeing.  They head for the internet, desperate to find a solution for their child and fast.... surgery, bariatric surgery seems like the next and final answer to it all.  Or is it?

Before heading down this route so quickly, even in this article, let's talk about some basics... 

  • What is Bariatric Medicine?   As defined on the  American Society of Bariatric Physicians (ASBP)  it is very simply stated as " the art and science of medical weight management and associated co-morbidities."   In other words, bariatric physicians are specially trained in dealing with those who are overweight and obese, the medical and health issues associated with being overweight or obese, and and such, they are trained to help lose weight safely, effectively, and efficiently.
  • What is Bariatric Surgery?  Simply stated, weight loss surgery.  Trained surgeons perform specific surgeries for those dangerously and life-threateningly obese for the purpose of losing weight and other added health benefits (many co-morbidities or associated health issues are resolved once weight is lost).  For more information visit the American Society for Metabolic and Bariatric Surgery ( ASMBS ).
  • Who qualifies for Bariatric Surgery?   The basic criteria involves at minimum a vigorous 6-month trial of a non-surgical weight loss program; typically under the supervision of a bariatric medicine physician specialist or a primary care physician.  If no significant weight loss has occurred after this time period with a Body Mass Index of > 40 or >35 with associated health issues such as diabetes, high blood pressure, etc., there is then consideration for referral to a  Bariatric Surgery Center of Excellence  for determination of possible candidacy and further evaluation by their specialized team of multidisciplinary specialists.  Some Bariatric Surgery Centers may have different eligibility criteria, but this gives you a starting point.
  • Is the criteria for eligibility for bariatric surgery the same for adults or teens?   Bariatric surgery is reported to have been performed on teenagers as young as 14 years of age.  There are more stringent criteria for teens.  Careful consideration of many factors must be taken seriously and the decision to proceed with the surgery should not be taken lightly.  Often times teenagers have not fully matured physically or psychologically and they may not fully comprehend the lifelong consequences of such a surgery.  A recent study done at Cincinatti Children's Hospital is the first of its kind to report that teens should not be referred until they are morbidly obese, but before then; it appears that a  narrow window of opportunity exists to perform bariatric surgery in teens  to achieve maximum benefits.
  • What types of surgeries are available?   At this time, there are 2 major types of bariatric surgery -- Gastric ByPass and Gastric LapBand.  Gastric byPass involves major surgery and a part of your intestine is removed; lifelong nutrient replacement supplements must be taken. The LapBand technique is less invasive and involves placing a special band over the middle-upper part of your stomach creating a small pouch; it significantly  limits the amount of food that one is able to consume at one meal or any one point in time.  Determination of which one may qualify for is determined by an experienced team of specialists at a Center of Excellence usually comprised of bariatric physician surgeon, psychologist, dietician, and coordinator.
  • Are the weight loss and health benefits after surgery permanent?   In many cases they absolutely are and the results are an amazingly increased quality of life and lengthening of longevity.  However, it is highly dependent on each person -- the medical and psychological issues leading to the obesity before surgery must be dealt with openly and honestly by both surgical team and patient and resolved -- if not, you can count on the weight returning and going back to square one.  In addition, the patient must be fully aware that the decision to have bariatric surgery is life-altering forever and must be willing to adhere to the recommendations provided by  the surgical medical teams.  Click here to view the potential  health benefits of bariatric surgery.

For more information regarding  Teen Bariatric Surgery,  click here to view a superb article regarding a teenager in Pittsburgh and her story. 

Picture by Stephan Morrosch, PhotoXpress

For more info: my training zone - bariatric medical weight management for children and adolescents

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