Weight loss surgery is an effective tool in treating obesity in teens and young adults who have been unsuccessful with typical weight loss methods.
More than 85% of adolescents with severe obesity will become adults with obesity. Teens with obesity can achieve improvements in weight status by use of weight management programs that focus on diet, activity and behavior change. Many of these changes do not lead to the amount of weight loss they want.
Early intervention in obesity is important in preventing serious health problems as they age such as diabetes and heart disease.
Who Is a Good Candidate?
To be considered for weight loss surgery, a teen must meet the following criteria:
- Body mass index (BMI) greater than or equal to 35 (generally more than 120 pounds over ideal weight) with obesity-related health problems (obstructive sleep apnea, diabetes, high blood pressure, significant quality-of-life or mobility problems).
- BMI greater than or equal to 40 with less serious health problems.
- Inadequate weight loss with organized weight loss attempt.
Undergoing surgery is a serious decision that requires careful thought, family support, life-long follow-up and long-term personal commitment to a healthy lifestyle.
What Are the Surgical Options?
Decisions are made based on medical assessment and the patient / families input. The options are:
- Laparoscopic Roux en Y Gastric Bypass: Recognized by the National Institutes of Health as a safe, well-tolerated, and effective method for weight reduction. This procedure has been performed and perfected over a 30-year period.
- Laparoscopic Sleeve Gastrectomy: originally performed as a first stage prior to Roux en Y for adults with severe obesity who were too high of a surgical risk for the bypass surgery. The sleeve gastrectomy was found to be effective as a stand-alone procedure and has been done at Cincinnati Children’s since 2008.
What Are the Major Risks for Adolescents?
The sleeve gastrectomy has potentially serious complications including leakage of intestinal contents, bowel obstruction and bleeding, which are extremely rare. All patients require close follow up for monitoring of iron and vitamin deficiencies.
What Is Life Like after Weight Loss Surgery?
Ninety percent of patients who undergo this surgery lose 60-70% of their excess body weight within the first year of surgery. There is an initial period of rapid weight loss then it gradually stops.
The results from surgical weight loss procedures in teens are similar to or better than those seen in adults.
Weight loss surgery in teens has been found to be far more effective than conventional lifestyle modification in lowering BMI, improving co-morbidities, and raising quality of life.
Because part of the stomach and small intestine are bypassed, some nutrients are not adequately absorbed. Vitamin and mineral supplements and dietary changes must be followed throughout life to maintain overall health.
To assure long-term weight management success, motivation and family support are essential.