Bariatric Surgery For Children?

Last year, we had a series of posts about bariatric (weight-loss) surgery, including two that took opposing positions on the procedure. But as one would expect for such a controversial topic, bariatric surgery is back in the news again, this time in a discussion about its appropriateness for children.

In an article published on the Web site of the journal The Lancet, three researchers examine the causes and potential solutions to the growing epidemic of childhood obesity. They conclude that far too little is known about how to successfully prevent and treat this problem, and that multicenter clinical trials to test and compare solutions are needed. In the meantime, they say, calorie-intake and physical activity guidelines should be reviewed, and doctors should prescribe weight-loss drugs or bariatric surgery only under severe circumstances — defined as a body-mass index over 50, or over 40 if the child has a related risk factor such as high blood pressure or diabetes — and even then not necessarily. According to an article from Reuters on the report, an estimated 40% of children in North America are overweight or obese.

The main reasons for the recommended conservative approach to both drugs and surgery, according to the Reuters article, are the relative lack of data and the known possibility of side effects and, in the case of surgery, complications. However, based on a study of gastric banding surgery in teenagers that was published in February in the Journal of the American Medical Association, the results seem to be mostly positive. According to an article published in the Wall Street Journal, the 24 teens in the study who underwent the operation lost an average of 76.3 pounds, compared with an average of 6.6 pounds in the study’s diet-and-exercise group. The surgery group also had closer-to-normal blood glucose levels and better cardiovascular health.

More anecdotally, The New York Times recently profiled a teen who underwent bariatric surgery, dropping from 404 pounds before the procedure to 175 pounds six years later.

What do you think — are children a special case when it comes to bariatric surgery, given that it may irreversibly alter the digestive system? How should the risks of the surgery be balanced against its benefits? How would you, as a parent, try to deal with obesity in a child of yours? Do you have real experience in this area? Leave a comment below!