Specialties

Adolescent Bariatric Surgery

If childhood and teen obesity trends continue the average life expectancy may be reduced by as much as 2-5 years. Childhood obesity is associated with the development of: Type 2 diabetes, atherosclerotic cardiovascular disease, LVH, and some forms of cancer. An additional consequence of the increased morbidity associated with childhood and teen obesity is the rise in health care costs.

Severe Pediatric Obesity:

  • BMI > 40
  • BMI Z score >2.5
  • Children with severe obesity start with early onset morbid obesity
  • 4 y.o. who weighs >80 lbs
  • 8 y.o. who weighs > 160lbs

BMI Tracking:

  • Children (age 12) with BMI>99% followed into adulthood (age 27)
  • 100% BMI>30
  • 90% with BMI>35
  • 65% with BMI>40

Consensus Recommendations

Adolescents Being Considered for Bariatric Surgery Should:

  • Have failed 6 months of organized attempts at weight management, as determined by their primary care provider
  • Have attained or nearly attained physiologic maturity
  • Be very severely obese (BMI >40) with serious obesity-related comorbidities or have a BMI of >50 with less severe comorbidities
  • Demonstrate commitment to comprehensive medical and psychologic evaluations both before and after surgery
  • Agree to avoid pregnancy for at least 1 year postoperatively
  • Be capable of and willing to adhere to nutritional guidelines postoperatively
  • Provide informed assent to surgical treatment
  • Demonstrate decisional capacity
  • Have a supportive family environment

Adjustable gastric banding is one type of restrictive procedure

  • Laparoscopic
  • Used to be the Second most frequently performed bariatric surgery
  • Mean excess weight loss at 1 year of 42%
  • Requires implanted medical device
  • Lowest rate of complications

Vertical sleeve gastrectomy is another restrictive options

  • Laparoscopic
  • May be an option for carefully selected patients, including high-risk or super-super-obese patients.
  • Mean excess weight loss at 1 year of 60-70%
  • No implanted medical device

Conclusions:

Surgery should only be performed on individuals who meet the specific criteria outlined in this presentation. Patients must be made aware of all of the potential risk and complications associated with this surgery. Practitioners who are assisting adolescent patients with the decision to have bariatric surgery should make sure to research the available facilities before making referrals. Pediatric patients should only be referred to bariatric centers that have both a multi-disciplinary team and experience working with adolescent patients.

The decision to have bariatric surgery should never be taken lightly and should be made on a case-by-case basis.

Adolescent Programs Nationwide

  • Craig T. Albanese, MD, leads Packard Children’s Hospital’s bariatric surgery team.
  • Cincinnati children’s hospital Dr. Thomas Inge, Surgical Director of the Surgical weight loss program
  • Daniel DeUgarte, MD UCLA Fit Program
  • George Fielding, M.D:NYU Medical Center Opens New York Area’s First Comprehensive Adolescent Obesity Treatment Program
  • Mass General : Janey Pratt, MD, is the co-director for Surgery at the MGH Weight Center and head of the Adolescent Weight Loss Surgery Program

Weight Loss Surgery Win/Win with weight loss and cholesterol

In a study presented at the “2016 American Heart Association Scientific Sessions” prepared by Cincinnati Children’s Hospital in Ohio; results across the board showed weight loss surgery not only helped teenage boys to lose weight, but bariatric surgery also increased the functionality and amount of high density lipoprotein or “good cholesterol” in their bodies. This is an especially promising body of research because it shows unequivocally that weight loss surgery is not just an option that an individual should consider if they wish to lose weight.

This research proves that weight loss surgery should be considered as an option that any overweight individual should consider if they hold high risk factors for heart failure, have heart conditions, or simply wish to improve their health in general. Both the functionality and the amount of high density cholesterol or “good cholesterol” skyrocketed a year after having the surgery performed, and overall metabolic health increased as well.

Weight loss surgeries are considered extremely safe and bariatric surgeries with the best long term outcomes are:

  • Verticle Sleeve Gastrectomy, or “Gastric Sleeve”
  • Laparoscopic Gastric Banding, or “Lap-Band”

Advanced Surgical and Bariatrics has done the highest volume of bariatric surgeries in the tri-state area, and the most adolescent bariatric procedures in the country, while maintaining the safest outcomes.

To schedule an appointment for a free consultation on either surgery, please fill out a contact us form on our website, or call our office.


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