Bariatric surgery is OK for some teens with obesity

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Bariatric surgery can be a justifiable treatment for teenagers with persistent extreme obesity if they can maintain a healthy lifestyle afterward, a new study reports.

“If we look at obesity as a disease with the real possibility of eventual organ system failure and special health concerns for adolescents, we need to ask whether health care practitioners are doing enough to manage it,” says Ahmed Khattab, a physician at the Rutgers University Robert Wood Johnson Medical School’s pediatric endocrinology division and lead author of the paper in the Journal of Pediatrics.

“The objective evidence shows that, under the right circumstances and with the right patients, bariatric surgery is an effective treatment for adolescents with obesity.”

Obesity and its related conditions, including hypertension, cardiovascular disease, and type 2 diabetes, are increasing worldwide in adults and children, researchers say. Excess weight and obesity in adolescents cost more than $14 billion per year.

Meanwhile, type 2 diabetes causes more severe insulin deficiency and other complications in youths than in adults and steps to avoid obesity or prevent its complications are often ineffective.

Although bariatric surgery requires lifelong follow-up and monitoring of nutritional deficiencies, experts consider it effective for severe obesity in adults, leading to long-term improvement or remission in obesity-related diabetes and other disorders, sustained weight loss, and an improved quality of life.

Studies of bariatric surgery in adolescents, although scarce, show it links to remission of type 2 diabetes, abnormal kidney function, and other complications of obesity, and that dietary supplements can correct resulting nutritional deficiencies.

When considering bariatric surgery for teenagers, researchers recommend pediatricians follow the guidelines published by the Endocrine Society. They recommend the procedure only for patients who have neared the end of puberty and are close to their final adult height; who have extreme obesity and related complications that persist despite the patient’s compliance with a formal program of lifestyle modification; and who demonstrate the ability to follow a regimen of healthy eating and living habits.

The guidelines do not recommend bariatric surgery for patients who have not mastered healthy eating and living habits or who have unresolved substance abuse, eating, or psychiatric disorders, researchers say.

Source: Rutgers University