Delaying Weight-Loss Surgery May Leave Teens at Risk

[MsJacquiiC]

The time frame in which gastric bypass surgery can be used to reverse morbid obesity in teens could be much shorter than previously believed, U.S. researchers say.

Our new data show that when we intervene when a patient is between 100 percent and 150 percent over ideal weight, we can expect successful resolution of obesity

Their study included 61 teens who had laparoscopic Roux-en-Y gastric bypass at Cincinnati Children's Hospital Medical Center. One year after surgery, overall body mass index -- a measurement of weight in relation to height -- among the teens had decreased by 37 percent. However, because of their weight before surgery, the teens were still considered to be morbidly obese even after they lost weight.

The study, which the authors said was the first to specifically show that teens' starting weight strongly influences their postoperative weight, was published online Sept. 23 in the Journal of Pediatrics.

"Current guidelines for adolescent weight-loss surgery suggest that we begin to consider surgery only after a teen is 80 percent to 100 percent overweight," the study's lead author, Dr. Thomas Inge, an associate professor of surgery and pediatrics at the Cincinnati Children's, said in a news release from the hospital.

"Our new data show that when we intervene when a patient is between 100 percent and 150 percent over ideal body weight, we can expect successful resolution of obesity," Inge said. "But by the time the teen is 200 percent over their ideal weight for age, the surgery will reduce their weight substantially, but many of the patients will still remain morbidly obese."

The findings suggest that waiting until teens are "super obese" before performing weight-loss surgery may not resolve their obesity or related long-term medical problems, such as joint damage, the researchers noted.

Doctors "have to do a better job of identifying teens who are gaining enormous amounts of weight quickly and get help for them earlier," study co-author Dr. Stavra Xanthakos, an assistant professor of pediatrics and pediatric gastroenterologist, said in the news release.

When a teen begins to gain weight rapidly, doctors should use a staged approach to manage the weight problem.

"If the weight gain is not effectively stopped with initial nutritional or exercise measures, then even more intensive treatments or programs are indicated, and ultimately some very serious thought has to be given to surgery," Xanthakos added.



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Body Mass Index BMI A statistical method of figuring out the degree of excess or insufficient weight based on one's height & weight. Though the controversial BMI does not actually measure the percentage of body fat, it is a useful tool to estimate a healthy body weight based on how tall a person is.

Morbid Obesity A condition in which the Body Mass Index is 40.0–49.9, which is roughly equal to 100 pounds or more over ideal body weight; a weight level that is life-threatening. A BMI greater than 50 is termed as "super obese." CLICK HERE TO OPEN THE JOURNEY BMI CALCULATOR!

Roux-en-Y Gastric Bypass A type of gastric bypass procedure which combines restrictive and malabsorption techniques - meaning, it reduces the amount of food a patient can comfortably eat (restriction), and also reduces the amount of calories that can be digested in the small intestine (malabsorption). This combination of bariatric methods leads to greater weight loss and the roux-en-y procedure is seen as one of the best ways to treat clinically severe obesity. See WLS Videos for animated surgery technique.

Laparoscopy Laparoscopic surgery, also called minimally invasive surgery is a modern surgical technique in which operations in the abdomen are performed through small incisions as compared to larger incisions needed in open surgical procedures. Laparoscopic surgery belongs to the broader field of endoscopy. The key element in laparoscopic surgery is the use of a laparoscope: a telescopic rod lens system, that is usually connected to a video camera. Also attached is a fiber optic cable system connected to a 'cold' light source (halogen or xenon), to illuminate the operative field, inserted through a 5 mm or 10 mm Trocar to view the operative field. The abdomen is usually insufflated with carbon dioxide gas to create a working and viewing space. The abdomen is essentially blown up like a balloon (insufflated), elevating the abdominal wall above the internal organs like a dome. The gas used is CO2, which is common to the human body and can be absorbed by tissue and removed by the respiratory system.

Obesity Obesity results from the excessive accumulation of fat that exceeds the body's skeletal and physical standards. Obesity has been defined as a weight more than 20% above what is considered normal according to standard age, height, and weight tables, or by a complex formula known as the body mass index. According to the National Institutes of Health (NIH), an increase in 20 percent or more above your ideal body weight is the point at which excess weight becomes a health risk. CLICK HERE TO OPEN THE JOURNEY BMI CALCULATOR!

Overweight It is defined as a Body Mass Index (BMI) of 25 to 29.9. Body weight comes from fat, muscle, bone, and body water. It is important to remember that although BMI correlates with the amount of body fat, BMI does not directly measure body fat. As a result, some people, such as athletes, may have a BMI that identifies them as over their ideal body weight even though they do not have excess body fat. CLICK HERE TO OPEN THE JOURNEY BMI CALCULATOR!