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The first line of treatment is to identify the things in your lifestyle that are promoting weight gain and do something about these behaviors. We use the term “behavioral modification” to indicate that those things that someone is doing that are leading to obesity have to be changed. This usually means that we aim to decrease intake of calories. This doesn’t mean we starve people. But there is so much that the typical family does not understand about nutrition and about reading food labels and how to make better food choices. Sometimes, a “quick fix” is to cut way back on sugared drinks. Sometimes it is looking for the other major sources of calories that can be cut. Sometimes it is simply getting someone to eat breakfast, which research has shown to be helpful for reversing a weight problem. We also like to get people to think about ways they can increase their activity throughout the day.
In some adolescents and adults, drugs for weight loss have been tried. Some of the drugs decrease appetite. Some of them let fat that has been eaten pass through the body instead of entering the body.
Unfortunately, long-term studies have not shown major weight loss using dieting or drugs for the majority of obese adults or teenagers. The best non-surgical treatments for pediatric obesity have high drop-out rates and typically result in less than 5 percent weight loss.
Yes. Our research has shown significant treatment results for diabetics. We knew that surgical weight loss resulted in significant improvement in diabetes in adults. We carefully evaluated 11 teenagers with type 2 diabetes before and one year after they underwent Roux en Y gastric bypass. We looked at their weights, blood pressures, blood chemistries and diabetes medication usage. All but one of the teenagers who underwent gastric bypass had remission of diabetes (normal sugar levels without need for diabetic medications). Significant improvements in weight (loss of 34 percent), fasting blood glucose (41 percent improvement), fasting insulin concentrations (81 percent improvement) and hemoglobin A1C levels (7.3 percent to 5.6 percent) were also seen. There were also significant improvements in serum lipids (cholesterol) and blood pressure.
In comparison, we know that teens with type 2 diabetes, who do not undergo surgery, are highly likely to remain severely obese and are likely to see progression of their diabetes. We do feel as though extremely obese diabetic teens stand to benefit greatly from gastric bypass and can see significant weight loss and remission of type 2 diabetes due to the surgery.
To be considered for bariatric surgery, a teen must meet the following criteria (meeting these criteria does NOT necessarily mean that weight loss surgery is right for you):
First we need your primary healthcare provider to complete the Bariatric Fast Track Referral form referring you for bariatric surgery, which includes:
These records are reviewed by our clinical team to help determine if weight loss surgery may be an option for you.
It can take as little as three months or as long as one year, depending on the time it takes to obtain insurance authorization, diagnostic testing, team evaluation and surgical scheduling. Each case is handled on an individual basis. Please contact us with questions specific to your child.
It is important that you learn all you can about obesity, nutrition and optimal weight management options. It is also very important for us to learn as much about your family’s specific situation to help guide you. It is our sincere hope that by following the Surgical Weight Loss Program for Teens Preoperative Timeline, a careful and informed decision can be made.