ADOLESCENT WEIGHT LOSS SURGERY
Weight loss surgery for adolescents continues to be a controversial topic. Increasing studies confirm the effectiveness of weight loss surgery in treating what is otherwise a very challenging problem, severe obesity among adolescents and teens. A 2008 study by Fielding’s examined the outcome for 73 adolescent patients who underwent laparoscopic adjustable gastric banding. In that study, the mean Body Mass Index was 48. The percentage of excess body weight loss at six months was 35%, then at one year was 57% and at two years was 61%. Two of the 73 patients had their bands removed, and one of them had a serious complication of a gastric perforation and reoperative surgery.
Overall, in the Fielding study, the adolescent patients aged 13 to 17 had excellent weight loss results and excellent improvements in their health with resolution of comorbid conditions. The authors followed their patients closely and encountered and treated vitamin deficiencies and other behavioral problems during the course of their follow up. These authors recommend adjustable gastric banding surgery as the appropriate procedure for adolescents because of its reversibility and lower degree of invasiveness.
That same opinion is echoed by a physician paper from the Society of Adolescent Medicine. They note that while there is a requirement for follow up and band adjustments, and the risk of noncompliance in adolescents, these are not reasons to dissuade adolescents from having LAGB surgery. In their words, a laparoscopic adjustable gastric banding is, “the optimal surgical option for pediatric patients with morbid obesity.”
The less invasive laparoscopic approach and the reversibility of the gastric band have led our center to favor adjustable gastric banding for adolescents in our study, which began in 2005. The possibility of more severe complications, and the possibility that future decades may bring improvements in the treatment of metabolic diseases and obesity, lead us to believe that gastric bypass or duodenal switch procedures are not as attractive as options for our adolescent patients pursuing weight loss surgery.
Weight loss research is happening at many wonderful institutions across the country and around the world.
What is done at centers near you? What is your experience?