February 19, 2020

Studies Show Weight Loss Surgery Holds Promise for Children and Teens

Current statistics from the National Center for Health Statistics state that over 60 million adults and nine million children between the ages of six and nineteen are considered obese. Weight loss surgery has quickly gained popularity among overweight adults over the past few years, and the American Society for Bariatric Surgery estimated that more than 177,000 Americans had some type of weight loss surgery last year. Previously, the number of children having weight loss surgery has been very small, but due to the major increase in the number of overweight children and improvements in surgical techniques, many doctors and parents are now considering it as a viable option.

For many years, weight loss surgery for children was considered very risky as it carries a death rate of 1 in 50. According to federal statistics, only 350 children in the United States had the surgery in 2014. A large scale study will begin shortly to look at how children respond to various types of weight loss surgery. A study is currently under progress at the University of Illinois Medical Center in Chicago and at the Morgan Stanley Children’s Hospital of New York-Presbyterian. In addition, New York University recently completed a study examining the effectiveness of laparoscopic gastric banding (otherwise known as “gastric banding” or “lap band”) surgery in children.

The Cincinnati Children’s Hospital Medical Center is starting a study this spring to examine how children respond to different types of weight loss surgery including gastric bypass, where a pouch is stapled off from the rest of the stomach and connected to the small intestine. Three other hospitals received approval to investigate the effectiveness of gastric banding, where an elastic collar around the stomach limits a person’s food intake.

Results from the study conducted at NYU were reported in the Journal of Pediatric Surgery this month. A total of 53 girls and boys between the ages of 13 and 17 participated in the study. Results indicated that they were able to lose half of their weight over 18 months and did not suffer any major complications. Children were only considered as candidates for surgery after they spent six months trying to lose weight using under the supervision of the hospital or a physician.

Crystal Kasprowicz, 17, of St James, NY, said that she lost 100 pounds after having the surgery. Prior to the surgery, she took medication for rapid heartbeat, and was showing signs of developing diabetes. She made efforts to curtail her weight gain such as dieting and exercise, but all of them failed. She no longer needs medication and her blood sugar levels are normal.

“I’m a totally different person,” she said. “I’ve very outgoing now. I hike a lot and go to the beach in the summer now. I’m not as self conscious when I go shopping for clothing.”

Growing acceptance for weight loss surgery in children has also faced criticism, especially since the long term effects are unknown at this point. According to the federal Agency for Healthcare Research and Quality, four in ten adult weight loss surgery patients develop complications within six months. Common complications include: pouch stretching, band erosion, leakage of stomach contents into the abdomen, and nutritional deficiencies.

Evan Nadler, a pediatric surgeon and co-author of the NYU study, said nineteen of the patients who participated suffered some sort of complication within six months. Two of the patients needed additional surgery to adjust a slipping band; two developed hernias; five got an infection; five suffered mild hair loss, and four had iron deficiencies. One asked for the band to be removed due to discomfort.

Many overweight adults have come to view weight loss surgery as a “quick fix.” According to Thomas Wadden, an obesity expert at the University of Pennsylvania School of Medicine, many patients show up demanding weight loss surgery as a first step. When asked what they have done to lose weight, many will respond that they have done nothing. He said, “They are going right to a $25,000 operation for which they are ill prepared.”

Joanne Ikeda, a nutritionist emeritus at the University of California, Berkeley said, “I don’t think altering the human digestive tract is a solution to the problem of excess weight. It’s one of these quick fixes that isn’t a fix at all.”

According to Nadler, the potential medical complications related to surgery are minor when compared with the long term complications such as diabetes, coronary heart disease, and hypertension that are associated with being overweight. He believes that the surgery can be very beneficial to teens if careful screening is in place. He said, “These are people who have tried everything they could possibly try. Once they reach this level of morbid obesity, the vast majority go on to be obese adults.”