Is Bariatric Surgery Safe for My Teenager?

Posted on July 3, 2014 at 12:00 AM by Todd Eibes, MD

The subject of bariatric surgery for teenagers is not a simple one, though it’s gaining in both popularity and medical acceptance.

As advances in weight loss surgery for adults have led to reduced complications and mortality rates, more doctors have begun considering surgery as a valid treatment option for severe or morbid obesity in teens.

Among the easiest medical conditions to recognize, obesity is the most difficult to treat. Unhealthy weight gain due to poor diet and lack of exercise is responsible for over 300,000 deaths each year.

The annual cost to society for obesity is estimated at nearly $100 billion.

The problem of childhood obesity in the United States has grown considerably in recent years. Between 16 and 33 percent of children and adolescents in the United States are obese.

According to the Surgeon General, overweight adolescents have a 70% chance of becoming overweight or obese adults. The likelihood increases to 80% if one or both parents are overweight or obese.

Childhood obesity has both immediate and long-term effects on health and wellbeing. Obese adolescents are more likely to have risk factors for cardiovascular disease, such as high cholesterol or high blood pressure. They are also are more likely to have a high risk for development of diabetes.

Children who are obese are at greater risk for bone and joint problems, sleep apnea, and social and psychological problems such as low self-esteem and depression.

Bariatric surgery is still a relatively new procedure in adolescents, and it is important that particular consideration is given to the special needs of young patients. Only when other methods for weight loss have been exhausted should weight loss surgery considered to help teens to reach a healthier weight.

There are physical and physiological differences as well as behavioral and psychological factors that influence adolescent health, compared to their adult counterparts. However, studies have shown that these operations are as safe for this age group as for adults.

There is an added concern with teenage weight loss surgery because their bodies are still changing and developing. They will need to be careful to get enough nutrients during the period of weight loss following surgery. The surgery will change the way some nutrients are absorbed and because of this the teen may need to take vitamins and minerals for the rest of their life.

While opinions among surgeons vary, general guidelines for teen to be approved for bariatric surgery include:

A BMI of 35 or higher and a serious health condition related to obesity, such as:

Diabetes (high blood sugar)
Pseudotumor cerebri (increased pressure inside the skull)
Moderate or severe sleep apnea (symptoms include daytime sleepiness and loud snoring, gasping, and holding breath while asleep)
Severe inflammation of the liver that is caused by excess fat

A BMI of 40 or higher and a less serious health condition related to obesity, such as:

High blood pressure
High cholesterol
Mild sleep apnea
Depression

Other factors should also be considered before teenager has weight loss surgery.

The child has not been able to lose weight while on a diet and exercise program for at least 6 months, while under the care of a physician.
The teenager should be finished growing (usually 13-years-old or older for girls and 15-years-old or older for boys).
Parents and the teen must understand and be willing to follow the many lifestyle changes that are necessary after surgery.
The teen has not used any illegal substances (alcohol or drugs) during the 12 months before surgery.

At Iowa Weight Loss Specialists, Dr. Eibes believes that teen patients should be at least 18 years old before bariatric surgery should be considered. This is to ensure that not only is the body fully developed, but also to make sure that the teen is able to fully understand and participate in their own healthcare and weight loss journey.

Because the long-term effect of bariatric surgery for adolescents are unclear, the decision to have the surgery should be carefully considered and must include the entire family. It’s important that the teen, as well as the parent/guardian understand what causes both weight gain and weight loss, including what foods are nutritious and which are not.

Any challenges to the success of the teen should be identified and dealt with. In order for the teen to be successful and not regain the weight, everyone involved in the teen’s life must be supportive of the surgery and willing to do everything they can to help the teen be successful.

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