Bariatric surgery rates rise among adolescents

By Dr. Ananya Mandal, MDSep 21 2010

According to recent surveys more and more adolescents need bariatric surgery for morbid obesity. This procedure was earlier reserved only for adults. Researchers say that from 2005 to 2007, the rate of gastric banding has jumped nearly seven-fold among youths aged 13 to 20. The process involves placement of a band around the upper part of the stomach using a laparoscope. The study appeared in the journal Pediatrics.

For the study, researchers examined records of 590 patients in California aged 13 to 21 who underwent elective bariatric surgery between 2005 and 2007.

The rates are going up “as diet and activity are proven again and again to be ineffective at getting morbidly obese patients to lose weight,” said study co-author Dr. Daniel A. DeUgart, a pediatric surgeon at the University of California, Los Angeles. Some experts, including DeUgart, believe the surgeries are needed; others express concern that teens may be risking their health looking for a quick fix. Most of the weight-reduction surgeries (93 percent) were performed in hospitals that are not affiliated with nationally recognized children's hospitals, the study authors reported.

Rates of laparoscopic adjustable gastric banding, called LAGB, increased 6.9% from 0.3 to 1.5 per 100,000 of the population. Rates of another procedure, laparoscopic Roux-en-Y gastric bypass, decreased in the same period, from 3.8 to 2.7 per 100,000 people during the study period. Laparoscopic Roux-en-Y gastric bypass involves the creation of a smaller stomach pouch and a bypass of part of the intestine. Surprisingly white teenaged girls, who represent 28% of overweight teens and young adults, underwent 65% of the two procedures. Researchers say 78% of weight loss surgeries were performed on females with a median age of 19 years, and 18% of the operations were done on youths aged 18 years and younger. Authors say hospital complications occurred in 5.6% of patients.

All this is considering the fact that LAGB procedure has not been approved for patients 18 years and under by the U.S. Food and Drug Administration. Authors of the study believe additional long-term studies are needed to fully assess the safety, costs, and results of weight loss surgery in the adolescent population.

Dr. Edward Livingston, a gastric surgeon at the University of Texas Southwestern School of Medicine, is concerned about the popularity of weight-loss surgeries and the surgeons themselves. “These operations clearly help some people, but they're trying to sell it as a solution for everybody…If you follow the rules it works. But most people who get to be 400 pounds aren't very good at following rules.” Many teens aren't emotionally ready for a huge change in how they look at food, Livingston added. “When you force that kind of change on them, you can run into trouble,” he said.