Tuesday, July 17, 2012

Using Appropriate Criteria, Bariatric Surgery May be Warranted for Some Adolescents

Bariatric surgery is being used more and more today to fight obesity. And the surgery is effective. In general, to be considered for bariatric or weight-loss surgery, a person’s BMI must be greater than 40. However, an obese person with a BMI greater than 35 can also be considered for the surgery if that person has comorbidities such as diabetes or high blood pressure. And usually, the obese person must be at least eighteen years old to be considered for the surgery.  However, that guideline might change.

With the increase in obesity in persons less than eighteen, bariatric surgery is gaining more consideration as an adolescent obesity treatment.  A past Washington Post article indicated that “As obesity among young people continues to rise, a growing number of clinicians and researchers say that weight-loss surgery may be their best chance to take off significant weight and either correct or avoid such conditions as diabetes and heart disease, which often go hand-in-hand with obesity.”

Indeed, the surgery may be appropriate for some adolescents, but many adolescents who might gain from the surgery decide against the surgery.  A recent study abstracted at Pubmed describes a randomized controlled study and other investigations showing that bariatric surgery may be appropriate for some adolescents. Some “studies demonstrate relative safety along with significant weight loss [among obese adolescents]. In addition, the vast majority of obesity-related comorbidities are resolved following these procedures."

However, even when bariatric surgical providers establish a selection process, and offer the surgery to adolescents wanting the surgery, in the end, most of the qualifying obese adolescents refuse the surgery. According to one study, ‘Most [adolescent] patients initially wanting bariatric surgery changed their minds. The treatment failure criterion presented a paradox, because most patients who met the criterion exhibited difficulty in making the lifestyle changes.’

The high refusal rate illuminates the importance of effective counseling. When bariatric surgery has been determined to be the best approach to an obese adolescent’s weight problem, counseling the patient so that he or she is prepared for the required lifestyle modification is imperative. Having good counseling programs in place can enable a center to boost any patient's chances of meeting weight loss goals.

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