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Weight-loss surgery and children

Description

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

A child who is overweight or has obesity is more likely to be overweight or have obesity 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 has obesity 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 However, this procedure has largely been replaced by sleeve gastrectomy.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 kilograms per square meter (kg/m2) 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 kg/m2 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

Cameron J. Endocrine glands. In: Cameron J, ed. Current Surgical Therapy. 14th ed. Philadelphia, PA: Elsevier; 2023:chap 13.

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, Schuh AM. Obesity. In: Marcdante KJ, Kliegman RM, Schuh AM, eds. Nelson Essentials of Pediatrics. 9th ed. Philadelphia, PA: Elsevier; 2023:chap 29.

Mechanick JI, Apovian C, Brethauer S, et al. Clinical Practice Guidelines for the Perioperative Nutrition, Metabolic, and Nonsurgical Support of Patients Undergoing Bariatric Procedures - 2019 Update: Cosponsored by American Association of Clinical Endocrinologists/American College of Endocrinology, The Obesity Society, American Society for Metabolic and Bariatric Surgery, Obesity Medicine Association, and American Society of Anesthesiologists. Obesity (Silver Spring). 2020;28(4):O1-O58. PMID: 32202076 pubmed.ncbi.nlm.nih.gov/32202076/.

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. 2018;14(3):413-422. PMID: 29248351 pubmed.ncbi.nlm.nih.gov/29248351/.

Review Date: 4/12/2023

Reviewed By: John E. Meilahn, MD, Bariatric Surgeon, Philadelphia, PA. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.