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Bariatric Blunder: Teen Tragedy

Bariatric Blunder: Teen Tragedy

If you could keep your child off the operating table, wouldn’t you?

A Feb. 24 New York Times article reported some doctors believe bariatric surgery is the only hope for certain obese teenagers, but University of Minnesota physiologist Aaron Kelly perhaps unintentionally pointed out the concerning cart-before-horse situation early in the article.

“We’re at a point in this field where surgery is the only thing that works for these kids but we don’t know the long term outcomes,” Kelly is quoted as saying.

If long-term outcomes are unknown, is it really wise to hack into a teen’s abdomen and likely saddle him or her with another 60 years of complications? The idea seems like a perversion of the do-no-harm oath doctors take. It feels like we’re gambling with kids’ lives.

Doctors, of course, are trying to help teens whose weight puts them at risk for Type 2 diabetes, high blood pressure and the many ravages of obesity. But are they really helping?

The Times noted two studies that reported “most of the participants in both studies lost at least a third of their weight and kept it off for at least five years.” That positive is offset by this rather damning stat, also reported by the Times: “Despite their weight loss, 63 percent of the teenagers were still severely obese after the surgery—only one reached a normal weight—and nearly half had nutritional abnormalities.”

If about half were still severely obese and having nutritional problems—without even considering the as-yet-unknown long-term negative effects of the surgery—did the doctors really accomplish anything?

Perhaps the kids aren’t as fat, but they’ve done nothing to change their lifestyles and are likely to remain obese. Except now they have complications from surgery in addition to only slightly diminished risk for diabetes and other obesity-related ailments.

In one terrifying paragraph, author Gina Kolata noted that researchers are already concerned with the long-term effects of nutrition deficiencies caused by the surgery. What happens when you surgically alter digestive systems and deprive developing kids of vitamin D and vitamin B? Nothing good—at least that much is certain.


We're rolling the dice with kids' health if we don't know the long-term effects of bariatric surgery. (iStockphoto.com/Tashi-Delek)
Dr. Thomas Inge, leader of one study, suggested more kids could have reached a normal weight if the surgery had been performed before their weight got so out of control.

What if we didn’t let their weight get out of control in the first place? What if we used diet and exercise to help them anytime they before they reached 17 years old and about 340 lb.?

Doctors suggested it’s not easy to alter lifestyles, but perhaps we just aren’t trying hard enough. The article talks about a 240-lb. 15-year-old who has tried “diets and exercise to no avail”—but what diet and what kind of exercise? And does “tried” mean “exerted maximum effort with” or merely “sampled for a brief unsuccessful period”?

Certain rare genetic conditions might suggest a need for bariatric surgery, but our affiliated gyms have produced so many dramatic results with clients that we’re disinclined to believe surgery is the “last best hope” for more than a very small handful of people.

We know lifestyle improvements can prevent and reverse obesity, and we’re failing children twice if we allow them to get fat and then send them to the operating room without making every effort to alter their lifestyles. According to the studies noted above, we’re 50-60 percent likely to then have a still-obese child with lifelong complications from surgery.

Is it tough to get a teen to lose weight by eating correctly and exercising? It can be, yes. It’s certainly harder than throwing your hands in the air and signing a kid up for bariatric surgery.

But kids can lose weight by learning about nutrition and fitness. So can adults. Take Phil and Marlo Brown, who weighed a combined total of 1,100 lb. Through diet and exercise they’ve lost more than 560 lb. together. Don’t tell them it can’t be done.

Don’t tell your kids it can’t be done, either.

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