Adolescent Bariatric Surgery

In general, a child isn’t likely to be considered a potential candidate for bariatric surgery before age 12. Even then, other avenues will be explored for how the child could potentially overcome obesity without invasive methods; surgery is considered a last resort.

Each child is different and bariatric surgery is not appropriate for all children dealing with obesity. It offers an option for children who have not been able to maintain weight loss and control their health through their diet and lifestyle alone.

To qualify for bariatric surgery, patients must be recommended for bariatric surgery by our bariatric care team after undergoing an evaluation process:

• The patient will be entered into a six-month weight loss program if they have not already completed one
• They must complete the workup for bariatric surgery, including our online information session
• There is a research component associated with this program; all patients approved for surgery will need to sign a consent form for data collection
• Patients must be over their ideal body weight (BMI greater than 40 kg/M2 or BMI greater than 35 kg/M2 with medical problems)
• We also use percentile of BMI; obesity of >99 percentile of BMI for age or severe obesity of >120 percentile of BMI for age

Risks to Know

Every child has unique risk factors for weight-loss surgery. All risks will be assessed, evaluated and communicated before surgery, including short- and long-term risks like:

• Bleeding and leakage risk
• Development of other health conditions
• Infection at the surgical site
• Nutritional deficiency concerns
• Weight regain

Two years after bariatric surgery, the overall complication rate has been reported in some studies as between 2.5% and 9%. Most importantly, the care we provide is customized to each child’s unique situation, and we’ll work with your child and family to weigh the risks with the benefits.

Meaningful Benefits

While weight loss is the primary benefit associated with bariatric surgery, there are other important long-term benefits. With bariatric surgery, we see a large improvement in comorbidities, or health issues, associated with obesity.

Results can vary from patient to patient, but research shows there is evidence for:

• Better lifestyle choices
• Blood pressure remission of 74%
• Greater physical activity
• Improved self-confidence
• Remission of abnormal kidney function by 86%
• Up to 66% reduction of dyslipidemia (lipid imbalance)
• Up to a 95% resolution of Type 2 diabetes

We understand that weight-loss surgery for teenagers and children is a big decision. That's why we'll first discuss your child's previous attempts at weight loss and explore more conservative options to see if they're your best next step.

While weight-loss medications like Saxenda® and Qsymia® may be approved for adolescent weight loss, it's best to seek the guidance of a health care provider before starting your child on a medication regimen. Our experienced team will talk with your family to evaluate whether medical weight loss is right for your child. We want to empower your teen or child with the best solutions for their needs, and we'll craft a weight-loss plan that's centered on their whole health.

Nonalcoholic steatohepatitis, or NASH, is a condition that’s caused by fat buildup in the liver and is commonly linked with obesity. Because weight-loss surgery can lead to a lower BMI and improved health outcomes, it can be used as part of a well-rounded NASH treatment plan. Our teams have the expertise to treat NASH in teenagers. We’ll help you decide whether a conservative solution or surgery will be the best method for your child.

Research has shown that weight-loss surgery in adolescents can lead to a partial resolution of Type 2 diabetes, but this is still being studied every day. We’ll evaluate your child’s Type 2 diabetes to determine how to best treat it.

Sleeve gastrectomy is a restrictive procedure that does not require rearranging anatomy. Gastric bypass is both restrictive and malabsorptive but requires anatomy rearrangement.

In the short-term, bypass surgery allows for faster weight loss with a quicker resolution of some of the comorbidities but at a higher long-term risk of complications and nutritional issues.