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, complete family support, life-long follow-up, and long-term personal commitment to a healthy lifestyle.
What Are the Surgical Options?
Decisions are made on an individual basis and based on medical assessment and patient / family 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 considered to be 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 percent to 70 percent of their excess body weight within the first year of surgery. This initial period of rapid weight loss then gradually reaches a plateau.
The results from surgical weight loss procedures in adolescents are similar to or better than those seen in adults in terms of safety, efficacy and resolution of comorbidities.
Weight loss surgery in adolescents has been found to be far more effective than conventional lifestyle modification in reducing 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 adherence to dietary changes must be followed throughout life in order to maintain overall health.
To assure long-term weight management success, motivation and family support are essential.