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Extreme weight loss: Experts weigh in on bariatric surgery for teens
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As a result, an increasing number of adolescents are considering the drastic option of bariatric surgery as a way to lose lots of weight. But doctors and nutritionists remain hesitant about this option for teens.
Doctors and nutritionists express serious reservations about this option for them, however.
"In special circumstances I do operate on people under 18, but in general I recommend that they wait until they're 18," said Dr. Jim Kane of Suburban Surgical Care Specialists, SC, in Hoffman Estates. "In general, we try to look at this as a real last resort for them."
It is reserved for the most serious cases, where the body mass index, or BMI, exceeds 30. That would mean a 5'7" girl would have to weigh at least Teens tend to lack the maturity - both emotionally and physically - to make them good candidates for bariatric surgery, said Karen Benzinger, a nutritionist with Cynthia Chow & Associates in Chicago.
"With the teen population, there's a lot of unique situations and lifestyle modifications that need to be addressed before surgery," she said. "This isn't a quick fix. It's life-changing."
The bypass surgery, by Lifelong eating habits suddenly require careful planning to ensure adequate intake of protein and needed vitamins. When a stomach can only hold an egg-sized amount of food, Benzinger said, every ounce counts.
"Things like protein become essential, and really being choosy, pretty much for the rest of your life, what you put in your body," Benzinger said. "I always ask teens, 'Are you ready to give up some of your favorite things for the next 50 plus years?'"
Benzinger often works with people trying to qualify Most insurance companies require those interested in the procedure to meet with nutritionists, psychologists and doctors to make sure they are well-prepared for the journey.
"The ideal candidate has to be pretty overweight but, from a counseling perspective, has to be really motivated for change and has researched and thought about the future," Benzinger said. "A less ideal candidate will come in and maybe has a parent really pushing for the surgery. I like to have the clients have the motivation to come in on their own."
Above all, Benzinger said, it's important to get to the root of the issue. If a teen is an emotional eater - using food to deal with other issues - bariatric surgery alone cannot heal those wounds.
"No one wants to be overweight, especially not in their teen years," she said. "Not working out those underlying issues before surgery can be detrimental."
Bariatric surgery for teens should be viewed as a medical necessity and certainly not an easy way for overweight youth to become supermodels, Kane said. Not only does the surgery require drastic lifestyle changes, but teens also need to be realistic about the outcome.
"You still have to fight to lose weight" and keep it off, Kane said. "It's a lifelong battle, and unless they have a good support system at home, they will probably still be plump."
That home-based encouragement is key to long-term weight control, whether from diet or surgery, according to Clint Phillips, a personal trainer in Chicago. Often, poor eating habits develop in the home and, without changes post-surgery, teens can easily slip back into an unhealthy cycle.
"Part of it can be genetics, but part is how you eat at home," Phillips said. "If there's a lot of bad food in the house, good luck trying to raise your kids healthy."
As with any surgical procedure, bariatric surgery has its risks and can cause complications. Although Benzinger is uncertain about recommending the surgery for most teens, she has seen it change lives.
"At first I thought this shouldn't be an option for teens. But I've realized that, for some, it could be a life-saving measure," she said. "The number one thing for everyone to know is that the surgery is not a quick fix."
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