Should we be performing LapBand surgery on Adolescents?
Posted on Tue, Jan 17, 2012
One percent to two percent of all weight-loss, or bariatric, operations are on patients under 21. Many physicians have a legitimate concern on the effectiveness and consequences of such operations. Studies are under way to gauge the outcomes of surgery on children as young as 12. Allergan, the maker of the popular Lap-Band, a surgically inserted silicone band that constricts the stomach to make the patient feel full quickly, is seeking permission from the Food and Drug Administration to market it to patients as young as 14, four years younger than is now allowed. Hospitals across the country have opened bariatric centers for adolescents in recent years but one has to wonder, is this safe?
First, it's worth noting that the long-term effectiveness of weight-loss surgery on children, even adults, is still in question. And the push toward surgery on the young has brought some resistance from doctors who say it is too drastic to operate on patients whose bodies might still be developing and who have not been given much time to lose pounds on their own. There is also concern that having a surgery which so drastically alters one's organs could have undesirable consequences on a child's maturation to adulthood, or in the case of women on their reproductive health.
Parents have been generally hesitant to rush their overweight children onto the operating table, and with good reason. In children, there is rarely the threat of imminent death because of one's weight, and surgery is never simple. Lap-band surgery is a serious procedure, and anytime a patient needs to be anesthetized for a procedure, there are significant risks involved. Not only that but the procedure is a costly one, both physically and financially. (Although it is worth noting that Medicaid in most states now covers bariatric surgery).
Additionally, lap-band surgery can have significant side effects, although the most common one seems to be that it may simply not result in long-term weight loss. A Belgian study of adult patients found that nearly half had their bands removed within 12 years for various reasons, according to the study’s principal author, Dr. Jacques Himpens. As a result, patients did not lose much weight, they regained what they had lost, they had frequent heartburn or vomiting, or the band would slip or perforate the stomach. Another study in Germany found that 30 percent of patients needed new operations within 14 years, some because they wanted bands removed, and others because of complications like slippage.
But perhaps the strongest reason not to use lap-band surgery on adolescents’ is that the procedure is not a cure-all. Lap-band surgery is more akin to pressing "reset" rather than a "weight-gain cure". For every patient that successfully undergoes the procedure, there is a second story about how hard they had to work to maintain a new lifestyle of healthy eating and regular exercise. Far too many Americans have the procedure without making any lifestyle changes, only to find themselves at their old weight, or even bigger. Permanent weight loss takes a mental dedication that many adolescents have not yet achieved. Teenagers are rebellious, and don't resound well to rules or self-disciple. This makes them poor candidates for such a significant surgery.
There are no shortcuts, no "easy ways out". There are only tools to help us reach our goals. Dieting, exercise, surgery, medication, counseling, all can work in combination to help us reach our goals. Many cannot do it alone, and that is okay. It's the reason why we founded The Petteruti Center for Life Extension,to be a guide in our struggle to achieve our dream.
In the end, our success is entirely up to us, and in some ways that is a very encouraging thought.
-Dr. Stephen Petteruti
The Petteruti for Life Extension Center is located in Warwick, Rhode Island. Dr. Stephen Petteruti is the Medical Director who is board certified in family practice and bariatric (medical weight loss) medicine. To lean how we can help you achieve your healthy weight, call us at 401-921-5934.