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Weight-loss surgery and children

Obesity in children and teens is a serious health problem. About 1 in 6 children in the United States are obese.

A child who is overweight or obese is more likely to be overweight or obese as an adult.

Children with obesity have health problems that used to be seen only in adults. When these problems begin in childhood, they often become worse in adulthood. A child who is overweight or obese is also more likely to have problems such as:

  • Low self-esteem
  • Poor grades in school
  • Depression

Weight-loss Surgery and Teenagers

Many adults who have weight-loss surgery are able to lose a large amount of weight. This weight loss can have health benefits such as:

  • Better control of diabetes
  • Lower cholesterol and blood pressure
  • Fewer sleep problems

In the United States, weight loss operations have been used with success in teenagers. After any weight-loss surgery, your child will:

  • Have a smaller stomach
  • Feel full or satisfied with less food
  • Not be able to eat as much as before

The most common operation now offered to teens is the vertical sleeve gastrectomy.

Adjustable gastric banding is another type of weight-loss surgery. However, this procedure has largely been replaced by sleeve gastrectomy.

All weight loss operations can be performed through 5 to 6 small cuts on the belly. This is known as laparoscopic surgery.

Is Weight-loss Surgery Right for Your Child?

Most children who have weight-loss surgery also have health problems that are related to the extra body weight.

The body mass index (BMI) measures below are used by many doctors to decide who can be helped the most by weight-loss surgery. But not all doctors agree about this. The general guidelines are:

A BMI of 35 or higher and a serious health condition related to obesity, such as:

  • Diabetes (high blood sugar)
  • Pseudotumor cerebri (increased pressure inside the skull)
  • Moderate or severe sleep apnea (symptoms include daytime sleepiness and loud snoring, gasping, and holding breath while asleep)
  • Severe inflammation of the liver that is caused by excess fat

A BMI of 40 or higher.

Other factors should also be considered before a child or teenager has weight-loss surgery.

  • The child has not been able to lose weight while on a diet and exercise program for at least 6 months, while under the care of a physician.
  • The teenager should be finished growing (most often 13-years-old or older for girls and 15-years-old or older for boys).
  • Parents and the teen must understand and be willing to follow the many lifestyle changes that are necessary after surgery.
  • The teen has not used any illegal substances (alcohol or drugs) during the 12 months before surgery.

Children who have weight-loss surgery should receive care at an adolescent bariatric surgery center. There, a team of experts will give them the special care they need.

Is Weight-loss Surgery Safe for Teens?

The studies that have been done on bariatric surgery in teens show these operations are as safe for this age group as for adults. However, not as much research has been done to show if there are any long-term effects on growth for teens that undergo weight loss surgery.

Teenagers' bodies are still changing and developing. They will need to be careful to get enough nutrients during the period of weight loss following surgery.

Gastric bypass surgery changes the way some nutrients are absorbed. Teens that have this kind of weight-loss surgery will need to take certain vitamins and minerals for the rest of their life. In most cases, a sleeve gastrectomy does not cause changes in how nutrients are absorbed. However, teens may still need to take vitamins and minerals.

References

Boyett D, Magnuson T, Schweitzer M. Metabolic changes following bariatric surgery. In: Cameron JL, Cameron AM, eds. Current Surgical Therapy. 12th ed. Philadelphia, PA: Elsevier; 2017:chap 802-806.

Gahagan S. Overweight and obesity. In: Kliegman RM, St. Geme JW, Schor NF, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 60.

Marcdante KJ, Kliegman RM. Obesity. In: Marcdante KJ, Kliegman RM, eds. Nelson Essentials of Pediatrics. 8th ed. Elsevier; 2019:chap 29.

Mechanick JI, Youdim A, Jones DB, et al. Clinical practice guidelines for the perioperative nutritional, metabolic, and nonsurgical support of the bariatric surgery patient--2013 update: cosponsored by American Association of Clinical Endocrinologists, the Obesity Society, and American Society for Metabolic and Bariatric Surgery. Endocr Pract. 2013;19(2):337-372. PMID: 23529351 www.ncbi.nlm.nih.gov/pubmed/23529351.

Pedroso FE, Angriman F, Endo A, Dasenbrock H, et al. Weight loss after bariatric surgery in obese adolescents: a systematic review and meta-analysis. Surg Obes Relat Dis. 201;14(3):413-422. PMID: 29248351 www.ncbi.nlm.nih.gov/pubmed/29248351.

  • Childhood obesity

    Childhood obesity

    Animation

  •  

    Childhood obesity - Animation

    You may have heard of the childhood obesity epidemic. But is it real? And if it is real, how important is it? And the answer is yes, it's very real. Up until about 1988, kids' weights in the United States were pretty constant over the years. But since 1988, they've been skyrocketing. And that's important for a few reasons. One of them is that what ever our weight is today, people tend to gain weight gradually over time. So if you're already overweight as a child that sets you up to be really overweight as an adult. And all the more so as a child because when kids, before puberty especially, are putting on extra weight, they tend to make new fat cells. Where as adults, when they're getting overweight, tend to have the fat cells they already have get larger. People who make more fat cells during childhood find it easier to gain even more weight as an adult and harder to lose weight. So kids are setting habits in their metabolism and even the structure of their bodies as a child. Childhood obesity is a big problem. But it's not just because of the way fat looks. It's a health problem as well. In fact a ticking time bomb. When I started in pediatrics not that long ago, it was rare to see some of the common conditions of middle age in children. Things like high blood pressure, or abnormal blood sugar, waist size over 40 inches, abnormal cholesterol. Those things were really rare in kids. But in a recent study, about two-thirds of American high schools students already had at least one of those. Two-thirds. They use to call something juvenile diabetes and there was adult onset diabetes, the kind that you get often from being overweight. Well now, what use to be adult onset diabetes, type 2 diabetes, is more common by age 9 because of the obesity epidemic. It is a ticking time bomb. The good news is that it's never easier than today to start to make a difference in a child's life.

  • Childhood obesity

    Animation

  •  

    Childhood obesity - Animation

    You may have heard of the childhood obesity epidemic. But is it real? And if it is real, how important is it? And the answer is yes, it's very real. Up until about 1988, kids' weights in the United States were pretty constant over the years. But since 1988, they've been skyrocketing. And that's important for a few reasons. One of them is that what ever our weight is today, people tend to gain weight gradually over time. So if you're already overweight as a child that sets you up to be really overweight as an adult. And all the more so as a child because when kids, before puberty especially, are putting on extra weight, they tend to make new fat cells. Where as adults, when they're getting overweight, tend to have the fat cells they already have get larger. People who make more fat cells during childhood find it easier to gain even more weight as an adult and harder to lose weight. So kids are setting habits in their metabolism and even the structure of their bodies as a child. Childhood obesity is a big problem. But it's not just because of the way fat looks. It's a health problem as well. In fact a ticking time bomb. When I started in pediatrics not that long ago, it was rare to see some of the common conditions of middle age in children. Things like high blood pressure, or abnormal blood sugar, waist size over 40 inches, abnormal cholesterol. Those things were really rare in kids. But in a recent study, about two-thirds of American high schools students already had at least one of those. Two-thirds. They use to call something juvenile diabetes and there was adult onset diabetes, the kind that you get often from being overweight. Well now, what use to be adult onset diabetes, type 2 diabetes, is more common by age 9 because of the obesity epidemic. It is a ticking time bomb. The good news is that it's never easier than today to start to make a difference in a child's life.

    A Closer Look

     

    Talking to your MD

     

    Self Care

     

    Tests for Weight-loss surgery and children

     

     

    Review Date: 3/22/2019

    Reviewed By: Ann Rogers, MD, Associate Professor of Surgery; Director, Penn State Surgical Weight Loss Program, Penn State Milton S. Hershey Medical Center, Hershey, PA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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