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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 U.S. 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. But it is not yet approved for teenagers in the United States.

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 and a less serious health condition related to obesity, such as:

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 (usually 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, too little 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.

References

Marcdante KJ, Kliegman RM. Obesity. In: Marcdante KJ, Kliegman RM, eds. Nelson Essentials of Pediatrics. 7th ed. Philadelphia, PA: Elsevier Saunders; 2015: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. PMID: 23529351 www.ncbi.nlm.nih.gov/pubmed/23529351.

Update Date 3/31/2015

Updated 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, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.