Teens seek obesity surgery


Chelsea Hale, who weighed 314 pounds before having obesity surgery at 17 years old, is now about 170 pounds. (The Associated Press)

Published: Wednesday, December 11, 2013 at 2:02 p.m.
Last Modified: Wednesday, December 11, 2013 at 2:02 p.m.

U.S. teens seeking weight-loss surgery have a startling number of health problems that used to be seen only in adults, according to a major government-funded study.

Half the teens had at least four major illnesses linked with their excess weight. Three out of four had cholesterol problems; almost half had high blood pressure or joint pain; and many had diseased livers or kidneys.

These kids weighed three times more than what is considered healthy, they weren't just teens "who want to fit into that cheerleading outfit better," said Dr. Thomas Inge, the study's lead researcher and a surgeon at Cincinnati Children's Hospital Medical Center.

The study offers reassuring evidence that obesity surgery is generally safe for teens, echoing previous short-term research. While it is a drastic, last-ditch option, major complications including accidental injury to internal organs occurred in just 8 percent of teens.

The study involved 242 teens who had surgery at five U.S. centers from 2007 through 2011. Results for the first month after surgery were released online recently in the journal JAMA Pediatrics. The National Institutes of Health paid for the study.

In a recent scientific statement, the American Heart Association said obesity surgery may be the most effective treatment for what it called "severe obesity" in teens, a condition it said affects about 5 percent of U.S. children and is increasing nationwide. The group's threshold for severe obesity is a body mass index of at least 35; the average BMI in the study was 51.

Because lifestyle changes and medication rarely work for such obese teens, the statement says obesity surgery should be considered for those with related health problems who are psychologically mature enough to handle it.

A three-year follow-up report on more than 2,000 patients in the adult study was also published online recently in the Journal of the American Medical Association. It showed adults generally had fewer obesity-related illnesses than in the teen study, and most weight loss occurred within the first year after surgery. Gastric bypass surgery, the most common operation in the U.S., resulted in more weight loss and more improvement in related illnesses than stomach banding, as other studies have shown.

In the teen study, whether obesity surgery resulted in lasting weight loss and better health remains to be seen; the researchers are still following the participants and calculating data.

Chelsea Hale of Cincinnati has shrunk from 314 to 170 pounds since having surgery three years ago at age 17 at Cincinnati Children's. Before surgery, Hale had a hormonal problem, heart blockage and sleep apnea — all linked with obesity and all have since subsided.

"I feel good, I can pretty much physically do anything," said Hale, now in nursing school.

Like 28 percent of the teens studied, she had gastric sleeve surgery, which involves removing part of the stomach and creating a smaller tube or sleeve-shaped stomach.

Some teens in the study say they can no longer tolerate certain foods, including sugar, meat or dairy products.

Kids must be severely obese to qualify. But many are so large that even when surgery results in substantial weight loss and better health, they can't shrink their BMI to below the obese range, Inge said. That underscores the need to find ways to prevent severe obesity, he said.

University of Colorado heart specialist Dr. Robert Eckel, an American Heart Association spokesman, said the study shows obesity surgery should be considered a reasonable approach for kids, but that the study results may represent a best-case scenario, since surgeons involved were all highly experienced.

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