Adolescent Obesity & Teen Obesity

There is an epidemic in the United States of both childhood and adolescent obesity. The latest statistics show that more than 12 million people between the age of 2 and 19 are overweight and the numbers just keep rising. This only increases the chance that these people will be effected by several diseases that have only been seen in adults in the past, including heart diseases and type 2 diabetes.

Weight loss surgery in adolescents still remains relatively uncommon though, although the number of surgeries in adolescents has increased more than 3 fold, they are still not common. Less than a percent of weight loss surgery patients are in their teens. If there is a great risk on a child or teens health then a surgery many suggest weight loss surgery providing the risks from the weight are greater than that of the surgery itself. Teens who are obese can suffer from high blood pressure, liver problems, joint problems, lung and breathing problems and diabetes.

When should an adolescent consider Weight Loss Surgery?

The concern about weight loss surgery in adolescents stems from a lack of research. Very few people know what problems might stem from having weight loss surgery prior to becoming an adult and as such it is often not recommended for them to undergo surgery. Weight loss surgery in adolescents cannot guarantee the same weight loss as it can in adults. Weight loss surgery also does not remove the need for long term healthy eating and exercise.

If the only option given by a physician is weight loss surgery then the patient will be referred to a center with multidisciplinary weight management teams. These specialists will focus on adolescent obesity management and will also have psychologists, physical activity instructors, nutritionists and weight loss surgeons on staff. There may also be additional specialists in the field of adolescent medicine their too.

When is the right time for an adolescent to undergo weight loss surgery is a controversial decision and is often tied directly into just how severe the case of obesity is and what health problems the patient is also suffering from as a result of the obesity. That is why each decision is carried out on a case by case basis.

The American Academy of Pediatrics has said that those adolescents who are considering weight loss surgery should :

• Should be as close to physical maturity as possible this is around age 13 for girls and about age 15 for boys, although can be older.
• Have a BMI of 40 or greater, making them severely obese and have major problems associated with their obesity, or they should have a BMI greater than 50 with less obvious or severe problems associated with their obesity.  This BMI is measured against a BMI growth chart which plots how they expect the adolescent to grow and factor that into surgery recommendations.
• Should have tried weight management for at least 6 months and failed to lose the weight required as determined by a doctor.
• Should be prepared for comprehensive psychological and medical evaluation both before and after their surgery takes place.
• Not endeavour to become pregnant for at least a year after having the surgery, although becoming pregnant after weight loss surgery is safe, it is not recommended due to the stress put on the body and the fetus due to the heavy weight loss after the surgery. Any situation after weight loss surgery in which you plan to become pregnant should be carefully monitored.
• Provide consent for all surgical treatment
• Be able to make appropriate decisions as judged by the physicians, which is not necessarily limited by their age.
• Be able to stick to a strict bariatric surgery nutritional program after the surgery is completed which will be laid out by the nutritionist. It is very important that after any form of weight loss surgery the patient sticks religiously to the diet that is specially set out for them and takes any supplements that are recommended to help improve their health.
• Have support from their family

Some adolescents will not be able to undergo weight loss surgery, these can include those with:

• A cause of obesity that is medically correctable.
• Substance abuse within the past year.
• They’re currently pregnant or they plan to become pregnant within the next 2 years.
• The inability to properly comprehend the outline of the procedure, or unwillingness to understand the consequences of the procedure.

Treating Diabetes Type 2

Teens who have received gastric bypass surgery went into remission of their type 2 diabetes after their surgery according to a study in January 2009. Many adolescents who underwent surgery left the hospital not needing any medication for the diabetes that they had previously. Diabetes type 2 can be put into remission via weight loss surgery in adults, although recent studies have shown that it has the same result in teens. This is based on a study carried out on 78 adolescents with diabetes type 2 11 of which had gastric bypass surgery and the remaining 67 only had their original medical treatment for their diabetes.

Those teens who were extremely obese and undertook bariatric surgery lost around 35% of weight within their first year after the surgery took place with nearly every patient seeing their diabetes completely disappear. Those who did not have surgery and were managed medically instead saw their weight stay roughly the same and all are still taking medication for their diabetes. The adolescents that had the surgery also showed lower blood pressure and cholesterol levels as a result.

Of those who were also suffering from metabolic syndrome, that is known to greatly increase the risks of a stroke, diabetes and a heart attack, that underwent lap band surgery found their condition cured as a result. A recent study on 24 morbidly obese teenagers who had the lap band surgery has shown that their BMI decreased significantly while their waistline and blood pressure returned to a healthier weight within 6 months after their weight loss surgery. All of these improvements were recorded to last longer than the first year.

Out of 5 of the participants that had metabolic syndrome only 2 of them still had it over 1 year after the surgery took place according to the study.

Weight Loss Surgery and Adolescent Obesity -Eligibility

Coupled with counseling and a full physical exam, the doctor will also need to run plenty of tests that will help to decide whether the risks of the surgery outweigh the potential gains of the benefits the patient will receive. Some of these are:

• Liver tests
• Lipid profile to check blood cholesterol levels
• Blood Counts
• Thyroid Function Test
• Fasting glucose and hemoglobin measurements
• Pregnancy Test for Female Patients
• Bone age assessment
• Nutrient Deficiency screening
• Sleep Study

Which Weight Loss Surgery Suits Adolescent Obesity?

It’s not known how exactly which the best form of weight loss surgery is for adolescents. Both a gastric band and gastric bypass have been proven to be effective when treating adolescent obesity. The differences between the two procedures  are a gastric banding is an adjustable band which is put around the stomach in order to restrict the intake of food. On the other hand a gastric bypass is where a small pouch is created in the stomach which then sends food from the smaller newly created stomach pouch straight to the reattached small intestine which allows food to bypass the duodenum.

The main difference between the two is that the gastric bypass is permanent and involves cutting and stapling the stomach, whereas the band is able to be adjusted and even removed.

Another difference between these two types of surgery are the actual weight loss itself. From a gastric bypass the weight loss is rapid and will happen within the first year and then it tends to reach a plateau after 18 months. With a gastric band on the other hand, the weight loss is far more gradual and adolescents that undergo a gastric banding will tend to lose 5 to 10 pounds per month.  Teenagers who have a gastric band tend to lose weight quicker than adults who have the same weight loss surgery because they have more energy and receive more positive social feedback.

Scheduling Weight Loss Surgery for  Adolescent Obesity

Adolescents will often undertake weight loss surgery during a school break. There is a much quicker recovery time for a gastric band than there is for a gastric bypass procedure; gastric banding sees only about a week of recovery allowing it to take place during short school breaks. On the other hand a gastric bypass surgery may be better scheduled for the longer summer break.

Healing time is not the only thing to consider when looking at weight loss surgery. The patient must be ready to deal with solid foods again and during their recovery they have to slowly build themselves up to normal food intake, starting off with just liquids. After around six weeks all patients should be once again on solid food no matter which surgical option they have gone with. The procedures may also have some specific restrictions applied to them throughout the recovery for example, some heavy lifting and gym type exercises may not be appropriate.

A lot of adolescents who have weight loss surgery often find themselves eager to return to school to show off how they now appear. Often they will not only look, but feel different, and most teens who undergo weight loss surgery find themselves far happier and that their personality changes for the better.

Adolescents after having Weight Loss Surgery

Some will find that weight loss surgery is just the beginning of their journey though. Some teens will need contouring surgeries to remove any excess skin that they might have after their weight loss. They must also be sure to watch what they eat at all times, even if their friends are doing something different.

They will always receive long term psychological and medical follow ups after any weight loss surgery. It’s important to know that there is no quick fix when it comes to weight loss. Weight loss surgery is a commitment and has an intense follow through that people must be willing to stick to. It’s also important to realize that weight loss surgery can improve overall quality of life and a persons self-esteem. Adolescent Obesity should first be handled through diet and exercise first under your doctors supervision.