A growing number of children and teenagers are turning to weight loss surgery amid rising rates of childhood obesity, according to a new study published in JAMA Pediatrics.
Between 2020 and 2021, there is an increase of about 19% Weight loss surgery Researchers from the University of Texas, University of Miami Miller School of Medicine and the University at Buffalo School of Medicine and Biomedical Sciences found that among US youth between the ages of 10 and 19.
Researchers were particularly interested in seeing these trends after the American Academy of Pediatrics (AAP) released a statement in late 2019 endorsing increased access to bariatric surgery for teenagers, said lead study author Sarah Mesia, PhD, professor and pediatric obesity researcher. UTHhealth Houston School of Public Health.
The study draws on six years of data from the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program, which accredits bariatric surgery centers in the United States and Canada.
“Historically, research shows that pediatricians have hesitated to refer to them Patients with severe obesity for bariatric surgery,” Messia told Fox News Digital in an email.
“Our results show a steady increase in use in the two years following publication of this AAP statement.”
The increase was particularly high for racial and ethnic minority groups. This includes Hispanics/Latinos, non-Hispanic blacks/African Americans and others, possibly because they are “disproportionately affected by cardiometabolic disease risk factors versus non-Hispanic whites,” Messia said.
These risk factors include high blood pressure, lipids, insulin, glucose and waist circumference – all of which are risk factors. Type 2 diabetes and cardiovascular disease as well as some types of cancer, he adds.
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The new study had some limitations, Messia said.
“We’re always limited in the data we’re analyzing in that it doesn’t include the entire universe of all adolescents who underwent bariatric surgery in the United States during the analysis period,” he said.
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“However, this dataset includes All adolescent patients Those who have had their surgery done at a US-accredited center, which is the gold standard,” the doctor added.
The AAP’s recommendations for weight loss surgery
In January 2023, the AAP released its new pediatric obesity treatment guidelines, officially endorsing bariatric surgery and weight loss prescriptions for the first time.
“With teenagers ages 13 and up Severe obesity (BMI ≥120% of the 95th percentile for age and sex) should be evaluated for metabolic and bariatric surgery,” the guidelines said.
According to the Cleveland Clinic, there are four main types of bariatric surgery: gastric bypass, sleeve gastrectomy, gastric band, and duodenal switch.
There was a lot of resistance to the AAP’s recommendations, Messia noted.
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“However, our analysis would suggest that families are following their own path in deciding whether to proceed with surgery for their adolescent,” he said.
“It will be important that we help these families move forward to ensure optimal health outcomes for their adolescents as they move into adulthood.”
Guidelines vary across hospitals
at Children’s Mercy Hospital Kansas City, MissouriOffers a laparoscopic sleeve gastrectomy.
Billed as a minimally invasive procedure, it involves removing a large portion of the stomach to suppress appetite, according to its website.
“People see it as the ‘easy way out,’ but it’s really the only way out for 95% of people who are morbidly obese.”
The hospital recommends exploring weight loss surgery for children who are at least 5 years old, have a BMI of at least 40 (or above 35 with other medical conditions) and have at least six months of “supervised medical weight loss therapy.”
Cincinnati Children’s Hospital in Ohio also has a bariatric surgery program, but its website says it is for “severely obese adolescents who have not been successful with behavioral and nutritional approaches to weight loss.”
Nationwide Children’s Hospital In Columbus, OhioTwo types of bariatric surgery are offered: gastric bypass and gastric sleeve.
The website does not specify a minimum age requirement, but patients must be at least 100 pounds over their “ideal body weight.”
Opinions, experiences differ
Patients and doctors have gone online to share their experiences and opinions on pediatric weight loss surgery.
These range from success stories to cautionary tales.
A bariatric surgeon on Reddit expressed concern about the procedure’s misconceptions.
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“People see it as the ‘easy way out,’ but it’s really the only way out for 95% of people who are morbidly obese,” the doctor wrote.
“If you try to diet and lose weight, your metabolic rate will slow down significantly and your progress will slow down—and weight regain is almost inevitable. Bariatric surgery doesn’t, and something like gastric bypass hardware on malabsorptive material. Override that. won’t go.”
“All medical options need to be exhausted before considering surgery, as surgery is irreversible.”
“Do I think we should be doing bariatric surgery on teenagers? I wouldn’t do it anytime soon, but I think it’s appropriate in a controlled setting with IRB approval,” the surgeon continued, referring to the Institutional Review Board.
“We have an entire population of teenagers with type 2 diabetes, obstructive sleep apnea, and severe joint pain due to their weight,” the surgeon wrote. “It would be ignorant to ignore an obvious treatment for this condition.”
Another poster, however, shared that her friend opted for a bypass procedure at age 16 and didn’t have a good experience.
“She is now 26 years old and has gained all the weight back and more,” she wrote.
“Her brain was not fully developed and she was not mature enough to understand the consequences of such major surgery and to follow the guidelines and deal with it. random eating“
“With bariatric surgery, you’re changing the anatomy of the GI tract.”
Meanwhile, a surgery intern at a private hospital posted that the facility performed a “surprisingly high number of bariatric cases” and recalled seeing many complications—even when very skilled surgeons performed the procedures.
Weight loss doctors are cautious
Dr. Sue Decotis, is a triple board-certified weight loss physician in New York CityChildren and adolescents are warned of the potential dangers of these surgeries, given their “irreversible nature.”
He told Fox News Digital, “With bariatric surgery, you’re changing the anatomy of the GI tract, and that anatomy — if it’s a bypass — can never be put back. [to its original state]”
“This means the person will never be able to eat regular meals because the anatomy of the stomach has changed,” he added.
Another potential problem is that after the stomach’s anatomy changes, Decotis said, the person won’t be able to eat as many high-nutrient and high-fiber foods because they’ll feel full immediately.
“It can attract them to processed foods because they’re so much easier to get down,” he said.
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Before going on the surgical path for a child or teen, Decotis recommends making dietary changes first, such as cutting out soda and sugary foods, and gradually Introducing more nutritious fare.
And for teenagers with severe obesity, doctors have shown that if they start with some of the newer weight loss drugs available, surgery may not be necessary.
“All medical options need to be exhausted before considering surgery, because surgery is irreversible,” said Decotis.
The only exception, she said, is if the child or teen is “morbidly obese” (now known as Class III obesity, which is when a person has a BMI of 40 or higher, or 35 or higher and has obesity-related health conditions, according to the Cleveland Clinic. ).
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“Otherwise, it’s not worth it because they’ll probably gain the weight back—and because their anatomy is disrupted, it’ll be harder to get proper nutrition in the future.”
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