Weight-Loss Surgery for Teens Who Can’t Lose Weight Any Other Way

I'm behind in my reading thus this late response. I had a normal weight as a child. I began putting on weight in college which continued through a master's degree and first professional job. I tried everything from diet pills as a teen, then Weight Watchers, OA, Atkins and liquid protein fasts in my 40s. I wanted to date like other women and paid a huge price in that area. An experiment with Redux in the 1970s worked for me. How do I know it worked? Because I would eat a "normal" amount and then stop eating - no struggle, no pressure, no cravings. For 79 days, I lost weight easily and did not feel deprived. Then Redux was pulled off the market for good reason. Finally, in my 50s, I opted for a sleeve gastrectomy and lost 100 pounds. That was 15 years ago and I've only gained back 20 pounds. Many factors are part of the "causes" of obesity including living in an obesogenic culture; childhood trauma is also implicated. This is not to discount the other "causes." Now in my 70s, I wish that surgery had been available when I was a teenager. Still, I am convinced the root cause is in the brain and likely related to serotonin among other neurotransmitters (as we are finding with so many other conditions.) If I could save anyone from all the devastating emotional and social pain from obesity, I wouldn't hesitate for a minute. We need to stop blaming the "victim." People need to get off their high horses and have a little compassion for those whose "affliction" is so visible.

Many people find help for food, weight, and body obsession in a free 12-step recovery program called Food Addicts in Recovery Anonymous (FA). Some of us have been diagnosed as morbidly obese while others are undereaters. Many members have maintained a healthy body weight for 5, 10, and even 20+ years. Visit the website (www.foodaddicts.org) for more information.

Do these children and young adults suffer from metabolic disorders outside of diabetes? It would seem that such extreme weight gain signifies a problem that goes beyond simply consuming too many calories.

I would have this Surgery in a Heartbeat. One problem: I’m not fat enough. 5ft9in, currently around 180 pounds. Each and every year or so, I lose then regain 30 to 50 pounds, now on the heavier end. Lifelong SUGAR Junkie, it’s my Drug. It only gets more difficult to lose weight, and especially maintain any loss, as you age. This can be a very useful tool for well selected and motivated young people to regain Health. Please, stop blaming and shaming, it’s difficult enough. Seriously.

I'm disappointed with the reader comments here. Obesity is a very serious problem and it's always caused by overeating. This _is_ treating the cause, by making it more difficult to overeat, and making people feel very full after eating smaller amounts. Obesity isn't caused by "hormones" or "leptin" or "cell phones" or "microbiomes." These people will have a lifetime of misery and pain if they don't get their obesity under control. And it will be very expensive for us all. Obesity will bankkrupt any universal health care plan we may implement here. This is the best option we have today to get these people to eat less food.

To doctors and parents of that 15 year old boy: would he have gained so much weight if he had not spent his childhood cycling through diets? Research has long shown that repeatedly going through (inherently) unsustainable, restrictive diets causes significant metabolic changes, as the body reacts to loss of calories as if it were being starved, changing the body to retain calories. When people are on restricted diets, they begin focusing intently on food, their next meals. They talk about food and fantasize about the things they cannot eat, even if the foods wouldn’t typically entice them when not dieting. Then when the diets end, the weight comes right back on or then some. The person may start sneaking food or binging, or other disordered eating habits. My point is that bariatric surgery should not be considered inevitable. And it’s a shame that children are resorting to it, so early in their lives, though it’s to their ultimate benefit, for the most part. What if we paid closer attention to how bodies work, based on empirical studies that aren’t underwritten by diet or drug companies. Are diets healthy in the long term? Or do we just want them to be? We may be better off shifting our focus and resources to prevention, including making access to whole, fresh foods and plentiful exercise and available to all.

I've come to believe that eventually studies of the microbiome will yield good outcomes here. I KNOW that my childhood best friend would eat far, far less than I did, and she always weighed so much more. Now that I am over 50, my slender young assistant eats second breakfast and finishes my lunch while I gain weight. I simply can no longer accept that calories in/calories out is the only factor at work here. Please let's stop blaming these kids and their families.

I find food is a drug just like alcohol, drugs and shopping (and more) which I personally need to manage everyday. Temptation to overdo for some of us is just a daily thing. But, I find, it gets easier with a fellowship and some kind of spiritual practice. Therapy and music has been wonderful too.

Could we have some data on long-term results? What percent of kids who have this surgery at various ages manage to maintain the weight loss and associated medical improvement for how many years? What percent backslide a bit or wind up with a worse BMI than before? Years ago when I considered this surgery, I viewed a medical center presentation by a nurse who glossed over a graph that revealed that the 5 or 10 year (I forget which) outcome for surgery vs no surgery was the same, at least for adults. When I confronted her after the session, she put a finger to her lips... Don't tell!

Many commenters are wondering if perhaps these children have undiagnosed disorders or if all avenues have not explored. My son is obese. (I am not.) We go to the children’s weight clinic at Boston Children’s Hospital. I am happy to tell everyone that yes, these doctors do test for all possible underlying disorders. His team also includes a psychologist and a nutritionist. I don’t think any good medical team would ever suggest surgery unless it was the last option. I first took my son there when he was 7. He’s now 11. He’s not a candidate for surgery, but maybe he will be one day. It has been a long road with some success and some failure. I put so much time and energy and angst into his weight that it’s a part-time job. Sometimes I just look at his body and feel disgust at how I let it get to this point, and yes, he does now have a dis-ordered relationship to food. We work on that now, too. He and I have a bad relationship because I’ve pushed him so hard about food and exercise. I worry about his weight every day. I don’t know much about the surgery, but I have an inkling of how all the years of effort and treatments and self-loathing on everyone’s part would get families to that door.

What is the cause of the obesity? Is it eating too much of the wrong things or it is some sort of disorder? If it’s a disorder, then shouldn’t that be the thing that’s treated? If it’s eating too much of the wrong things, then shouldn’t that be treated? I realise that it’s not easy and takes a huge amount of time, expense and commitment but it seems like it must be a healthier outcome for children than surgery...

Bariatric surgery is only the beginning of lifelong treatment. It helps lose hopefully enough weight to reduce/ eliminate medical problems that often accompany excess weight.. type 2 diabetes, hypertension, joint stress, difficulty exercising. But eating is a lifelong experience that humans require to live and exposure to food that can make it more difficult to chose wisely 100% of the time for rest of life. Support is a key factor in maintaining weight loss or continuing to lose weight and will be needed for a lifetime. There will often be slips but with support patients can often get back to their healthier lifestyle

I am 57 and had gastric bypass surgery 9 years ago and it was the best thing I have ever done for myself. For the first time in my life I was able to keep the weight off and maintain a 120lb weight loss. It is no quick fix as you must change your eating habits and start exercising. I wish I could have had the surgery at 16...it would have changed my whole life. No teen should have to live with being obese if there is a surgery available that can help them to not only lose the weight but keep it off as well.

I had a friend who had surgery for her weight. She didn't do any of the recommended activities --ate wrong, didn't exercise, drank too much alcohol. She wasn't obese to begin with, so in order to have insurance pay for it as medically necessary, she had to *gain* weight, which she easily did. After surgery and an initial weight loss, she still didn't eat right and didn't exercise, and guess what --she's back where she started. She must have lied to everyone, therapist, physicians, nutritionists. Husband. Unless you have a true metabolic disorder, exercise and portion control really are the main way to go. You don't get to 400 pounds eating lettuce and tuna.

Obesity among children and adolescents is a symptom of our culture, ALL of it. It's not just the fact that we live in the most over stimulating food environment ever available to human kind or that it's increasingly difficult not to have our eyes glued to a screen. It's also the fact that our ways of relating to each other have changed. Parents try their best. But this is not an easy world in which to be a parent. Children need time and attention. When work, financial concerns, cultural pressures create family stress, the children are often the family members that absorb those stressors. The best team of doctors, dietitians, and mental health therapists are not going to do any good unless there is a concerted effort to determine how to best heal the family unit. To focus on the child's diet and exercise without addressing the diet and exercise of the parents and entire family (yes, it happens often) and then to turn to extremely invasive surgery such as gastric bypass is to me, the ultimate betrayal to that child. My heart aches every time I see an overweight child.

I am interested in longer term outcomes. How do these young people look and feel five and ten and twenty years down the road? The adults I know who have had the procedure do not do well. After the initial delight in weight loss and diabetes reversal, one committed suicide, one became a smoker of cigarettes and when he gave them up put the weight back on, and another seems to obsessively eat the highest calorie food she can find. Another had her procedure reversed--she was nauseated all the time. I have no moral objection to these procedures. I am just not sure they work long term.

This seems entirely wrong. Not addressing root cause. More of the same we get from the medical/pharma system. God forbid the experts try a low/zero carb approach. Get rid of the empty calories (Gatorade, fruit juice, Cheetos, industrial vegetable oils). Start there and see what happens. Dietary guidelines are a 40 year failure. This is sad.