Gastric Surgery For Overweight Kids – Last Best Chance Or a Bridge Too Far?

With childhood obesity dramatically on the rise, some pediatric hospitals have begun to offer gastric bypass surgery for teenagers and even younger children. The Texas Children’s Hospital in Houston, for example, reports the performance of two or more bariatric procedures on adolescents almost every month.

In recent years, gastric surgery has become an acceptable, although drastic measure of last resort for adult patients who suffer from extreme obesity and have not been successful at weight loss by traditional means.

The intent of the procedure is to modify the gastrointestinal tract by either reducing the size of the stomach or by altering the intestinal drainage, for the purpose of reducing food intake. An alternative to permanent stomach size reduction is called “banded gastroplasty,” which is designed for similar purposes, but uses a rubber-band-like device.

Both techniques have shown some success among adults, however, there is no established track record available yet for adolescents and younger kids.

Some pediatricians have voiced concern about making such severe alterations to the gastrointestinal tract at a young age, when many of the patients are in fact still growing up. Especially during growth spurts, children and adolescents need all the nutrients they can get. If their digestive system is inhibited at that crucial time, they may face additional health risks, e.g. from malnutrition.

Undergoing the operation, of course, is only the beginning, and perhaps the easiest part. We don’t have enough data yet to let us predict how these children will fare in later years. We know that a certain percentage of adults, who had the procedure, have gained at least some of their weight back.

Life-changing interventions of such severity can only succeed if certain conditions are put in place. Especially young people are extremely dependent on support from their social environment when they undergo significant lifestyle changes. Competent follow-up counseling is also required.

Last, but not least, the parents must understand that if they are not part of the solution, they are part of the problem, and their kids will keep paying the price.

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