Should kids get weight loss surgery?

The use of weight-loss surgery has surged in recent years. But it's not just adults who are getting it. Increasingly, adolescents are receiving invasive surgery to treat obesity and it's been a heated topic of debate among experts.

Two recent studies express caution about recommending the procedure in children.

In a survey of pediatricians and family practitioners, half said they would not recommend the surgery to people under 18. The findings, published last week in the journal Obesity Surgery, stressed that the surgery is still new and no one knows the long-term effects on children.

Meanwhile, a review article in The Lancet takes a tougher stance. It urges against weight loss surgery for teens, saying it should be used only as a last resort after diet, exercise and lifestyle changes have been exhausted. The authors write:
“The risks of bariatric surgery are substantial, and long-term safety and effectiveness in children remain largely unknown. Therefore, surgery should be reserved for only the most severely obese, and even then, considered with extreme caution.”

But then there's this research from just a couple months ago, indicating a type of bariatric surgery called gastric banding showed promise in teens.

The NYT took a fascinating look at the question recently. Those who endorse the procedure say simply that it works and children shed weight dramatically in the first year. More hospitals are offering obesity surgery for teens and specialized centers which once served only adults have expanded to adolescents.

After all, the health risks for obese teens are great. Nationwide, more than 17.4 percent, or more than 5 million adolescents were obese in 2004, a jump from 14.8 percent in 2000. Obesity leaves teens at risk for type 2 diabetes and health problems once thought strictly the domain of adults: sleep apnea, hypertension and pyschosocial problems, studies have found.

But many experts caution that the surgery could cause adverse affects on a child's growth and development. Consider that children are coming to the operating table both emotionally and physically immature, the NYT article points out.

Of course the overarching problem, say some experts, is that there hasn't been enough research to conclude whether such surgery is effective long term -- or safe.
Most programs that provide the surgery do so as a part of a clinical trial to study their effectiveness and safety.

source: weblogs.baltimoresun