Long-term Outcomes Of Weight Loss Surgery In Children And Adolescents?

Obesity is now an alarmingly common health issue among children and adolescents. In 2017-18, the Australian Institute of Health and Welfare reported that 25% of 2-17 year olds were overweight or obese and over 8% were obese.

That has many negative consequences for children. Overweight and obese children tend to:

• Become overweight or obese adults
• Develop diabetes or cardiovascular disease at a younger age
• Face problems with their nervous and musculoskeletal systems, breathing, kidneys and liver that stem back to their weight
• Have lower self-esteem, reduced social and emotional wellbeing.

No-one wants their kid to go through that. But it can prove very difficult for some children to lose weight with diet and exercise alone. So, what else can be done to help them?

Bariatric surgery is one option.

How does that sit with you? Does the thought of weight loss surgery for kids make you uncomfortable? Does it seem risky or just plain wrong? Do you think they should wait until they’ve grown up before having weight loss surgery?

Those feelings are quite common. We’re going to explore them, give some responses and look at the results of a new landmark study of 2,500 children and adolescents who had bariatric surgery.

Responding To Discomfort About Weight Loss Surgery In Under-18s

Any overweight or obese child or adolescent should be encouraged and supported to lose weight. We start by improving their diet and activity levels and, for many at the lower end of the weight scale, this may well be enough. But a child or teen with severe obesity (a BMI above 35) is unlikely to lose weight with diet and exercise alone. They need more help, which may include surgery.

All surgery carries some risk, which is why we’re always cautious about recommending it. Those risks include general ones like anaesthesia and specific risks relating to the particular procedure your child is having. Your surgeon should talk through all the risks with you so you can make an informed choice about whether or not to proceed with surgery.

But the risks of performing surgery have to be weighed against the risks of doing nothing.

As noted above, a child or adolescent with obesity faces many serious risks to both their physical and mental health. We tend to minimise those risks, referring to their ‘puppy fat’, but they are significant and potentially life-limiting. The risks of doing nothing may well be greater than the risks of an operation that will help them to reach a healthy weight.

Waiting until they get older before doing surgery may also mean leaving them in a risky situation for many more years. During that time, they will probably endure teasing at school and may well develop one or more obesity-related conditions.

What Does a New Landmark Study Tell Us?

There is now some very reliable new data to guide our decisions about weight loss surgery in kids and teens.

In late 2021, the Journal of the American College of Surgeons published the results of a clinical trial conducted in Saudi Arabia. The Saudi researchers had completed a 10-year prospective study of 2,504 people aged 5-21 at the time of their weight loss surgery (a laparoscopic sleeve gastrectomy, in this case). After the surgery, the researchers followed up each patient at regular intervals to see how much weight they lost, whether they continued to grow normally and how their health changed over the next 10 years.

The results are fascinating.

Before their surgery, these kids were in bad shape. They were severely obese and living with co-morbidities like diabetes and cardiovascular problems.

A decade after their surgery:

• They had lost (and kept off) an average of 71% of excess weight
• More than 70% of affected patients no longer had type 2 diabetes
• Lipids (a measure of cholesterol) and blood pressure were now normal in nearly 60% of those who had had elevated results before their surgery
• They had continued to grow taller at the normal rate for their age.

The researchers concluded that surgery had enabled these children and young people to lose weight, keep it off in the long-term and resolve obesity-related health problems without affecting their growth.

Now, what if the surgery hadn’t happened? What shape would most of those people be in today? It’s highly likely that the vast majority of those obese children would now be obese teenagers or adults still living with a number of other serious and preventable health conditions and probably also battling the stigma and low self-esteem that’s often experienced by people with obesity.

How Dr Phil Lockie Can Help

If your child or teen is struggling with obesity, please come to see us. We can help you understand your options, explore medical treatments for obesity, connect you with our dietitian and, if necessary, discuss how weight loss surgery may help.

Book an appointment today.

Disclaimer

All information is general in nature. Patients should consider their own personal circumstances and seek a second opinion. Any surgical or invasive procedure carries risks.