Lap band surgery acceptable only for morbidly obese adolescents over 15

By Dr. Ananya Mandal, MDMar 24 2010

Lap band surgery is a procedure that involves placing a ring around the stomach and thus restricting it. It is a controversial procedure undertaken in obese patients to decrease food absorption.

The Royal Australasian College of Physicians has released guidelines that this operation is safe in patients above 15 years of age. The adolescents above 15 with morbid obesity (body mass index over 40) who have been unsuccessful in weight reduction by non-surgical techniques and have completed puberty before surgery are eligible for this procedure according to the guidelines.

Pediatrician and college spokeswoman Louise Baur said the guidelines, endorsed by the Australia and New Zealand Association of Pediatric Surgeons and the Obesity Surgery Society of Australia and New Zealand, were formulated to provide adequate care to the rising number of obese adolescents. 1-2% of Australian adolescents are obese and maybe in need of this surgery. She said while genetics plays a role in obesity there are other factors too. “….environmental issues affecting food and physical activity in our society, has resulted in two out of three men, one in two women and one in four adolescents being affected by overweight and obesity,” she said.

"It is not a large number of young people, but there is a small, significant proportion of young people with severe obesity who need additional therapy." "We are recommending that weight-loss surgery be considered in young people aged 15 years and over who have finished puberty and who have severe obesity - a body mass index greater than 40." she said.

According to Professor Bauer the long term effects of this surgery is not adequately studied in patients younger than 15.

"We know that obesity surgery can really improve life longevity for adults who have severe obesity," she said. "We have recommended laparoscopic banding surgery for young people because, first of all, there is experience with its use in Australia and also because it is potentially reversible.” “I think that is an important thing to think about when we are dealing with young people, particularly when we are not sure necessarily of the long-term effects."

She however pointed out that, "It’s important to understand these new procedures are no quick fix.''

The Ethics of Obesity will be one of the sessions featured at the World Congress of Internal Medicine being held in Melbourne this week.