Things have been happening in the world of bariatric surgery. Before catching up with recent developments, let’s take a peek at some of the highlights from past discussions. For the convenience of readers, Childhood Obesity News has gathered much of the information from individual posts that have already appeared in three “roundups,” so let’s start by plucking from them some of the main ideas.
The notion of bariatric surgery for young people was kept in the “experimental” category for quite some time, but about 10 years into this century, the rules have changed and the anxiety levels around the previously controversial practice began to subside.
One of the main sticking points is the legal limits our society sets with regard to age. If a person is considered too young to drive, drink, marry, or vote, should we be letting them have life-altering elective surgery?
One of the enduring problems has been lack of long-term followup, because there are not enough patients who had this kind of surgery 10, 20, 30, or 40 years ago. From short-term observation, the failure rate was hovering around 20% or worse. The majority of teens who undergo surgery come out the other side with the same emotional problems that led them into obesity in the first place, because the psychological infrastructure to help them is simply not there.
In 2010 a survey of doctors revealed that half of them would not even consider recommending bariatric surgery for an adolescent. Ideological disagreements have existed ever since this kind of intervention became a possibility. While recognizing that something needs to be done before an individual’s obesity progresses too far, the reluctance to have that something be surgery is almost instinctual.
When surgery was recommended, several different options were open, and it took a while for consensus to form around the question of “best practice” in this area. By 2016, the AGB, or adjustable gastric band, minimally invasive and potentially reversible, had become the procedure of choice. At the same time, the duodenal switch surgery was recognized as more effective overall, but also as demanding of commitment from the patient that is not always present.
Whenever the topic of bariatric surgery for teenagers is broached, two conditions must be thoroughly understood. A preparation period is required, because the patient needs to either lose a certain amount of weight through conventional means first, or to demonstrate that they are incapable of losing weight through conventional means. Then, afterward, every day of life will be lived a certain way, forever, for 30, 40, 50 years or more.
It is a lot to sign up for, and of course we always mention that in both the period leading up to surgery and the subsequent decades of constant maintenance efforts, Dr. Pretlow’s W8Loss2Go program (via a smartphone application) can make the difference between failure and fabulous success.
Stay tuned for updates on the bariatric surgery field.
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Image by Kevin Old/Attribution 2.0 Generic (CC BY 2.0)
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