Doctors consider weight loss surgery for children

By Liz Kerstetter
February 22, 2007

Emily Buerger

With the number of weight-loss surgeries almost quadrupling in the last five years among adults, many experts are beginning to question whether or not children should be considered for any type of the bariatric surgeries.

Bariatric surgeries are intended only for people with a body mass index of at least 40 and who have life threatening health risks if they do not lose weight. Experts at four major hospitals in the United States who have seen the successes and know of the improvements made to the surgeries are now questioning whether or not it is safe for children who meet these requirements to have a type of surgery performed.

Annmarie Havens, a recipient of gastric bypass surgery, feels that if it will benefit a child’s health to get the surgery, they should be considered for it.

“Children are smarter than a lot of people give them credit for,” Havens said. “I feel that if a child is old enough to ask about the surgery, then he or she is old enough to become educated to make the decision [for or against surgery].”

Bariatric surgeons perform two different types of weight-loss procedures, both of which decrease the volume of the stomach. Gastric bypass surgery, which is the more commonly performed, consists of a portion of the stomach being stapled off from the rest of the stomach. The bypass surgery has produced more timely results for patients, but has a mortality rate of about 1 in 100 patients.

Gastric banding, although currently less popular that gastric bypass surgery, is medically safer than bypass surgery. Gastric banding consists of placing a silicone band around a portion of the stomach and can be adjusted according to the patient. Banding is more easily reversible and has a mortality rate of 1 in 1000 patients.

Younger surgery recipients, if considered for the operation, will still go through the same preliminary process. “Before my surgery, I had to meet with many other doctors,” Havens said. She had to be cleared by a primary care physician, a pulmonary doctor, a gynecologist, a heart doctor and a gastroenterologist in order to have the surgery.

“After that you have to attend meetings with other patients that have either had the surgery or are going to have it, and there is a support group,” Havens said.

The lack of long-term studies on the effects of gastric bypass surgery on children makes a risky surgery even more complicated. The main question is whether or not drastically cutting the size of the stomach will have an affect on the body’s growth and maturity.

CNN health correspondent Kat Carney explained that when people have gastric bypass surgery, “They have to take calcium supplement. And when you’re talking about kids, a lot of their bones aren’t fully developed.” Studies are currently being done on how the surgery will effect bodily growth.

There are concerns not only about the health of the body, but also about the health of the brain. Can a teenager handle the changes a gastric bypass surgery will bring? Havens thinks that each patient is different and “may or may not be ready to handle it.” For those who do feel ready for the surgery, Havens recommends at least three to six months of therapy.

“I think it is needed. It is a life-changing event and [people] need that support,” Havens said.

Regardless of age, Havens, who has been through the ups and downs of having gastric bypass, said, “My final words would be to anyone considering either of these [surgeries], is to be prepared mentally, know what you are physically doing with your body and expect the unexpected.”

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Liz Kerstetter

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