Question:
weight loss surgery for adolescents/pediatrics
Hello everyone! I am post op 20 months and have returned to college! I have been assigned a series of papers and chose weight loss surgery as the topic. The third paper I have to ask others for opinions on controversial topics. So I am asking for help from all of you! I need your thoughts and opnions on weight loss surgery for adolescents/pediatrics. Do you feel it should be performed? under what limitations? Please let it loose! I can't give you my opnion publicly - I have to remain neutral but I can email you privately should you want my opnion or have ay questions! Thanx so much! - Heather M. Cox — GONEWITHTHETWINS (posted on December 2, 2008)
December 2, 2008
I feel it would be appropriate for obese adolescents. If I had this weight
loss tool available to me as a teenager i think I would be a happier and
healthier adult. I started gaining weight at puberty and havnt stopped. Ive
hit a plateau over the last 3 or 4 years but i think if I would have been
able to have surgery as a teen I would be a healthier adult right now. I
have yet to get an approval for my surgery now but I think that teens
should have the option of getting this life saving tool if their doctors
feel its appropriate. Living as a obese teenager is detremental to your
self esteem and can cause long term depression.
— jenbn
December 2, 2008
I think it should be an option for those teenagers who are morbidly obese.
Possibly as a last option after everything else has failed. I wouldn't
have fallen into that catagory as a teenager, but was one of the
"fat" girls in school. Just being a little over weight was awful
in school, I couldn't imagine being the size I am now then. But the main
focus on the surgery for everyone, especially a teenager, should be to be
healthy. As long as surgery is not being used for looks, but for health
and fending off diabetes, high BP, etc. I'm all for it!! I think it should
be completely covered by insurance, etc. too!
— Teri K.
December 2, 2008
I think it would depend on the severity of the case. My son is following
in my footsteps now by being a heavy 13 year old and he is always obsessing
about being 'fat'. Well, he is 5' 3" and weighs 180 and while that is
heavier than the norm, he is very active in sports and his doctor tells me
that he hasn't hit his growth spurt yet and that will help. Now, if he
couldn't get up and move and couldn't play sports and couldn't lose the
weight the old fashioned way, then I'd consider it for him. I just wish I
knew then what I know now about nutrition and exercise and maybe I wouldn't
have had to resort to the surgery. Once you weigh 388 lbs, its not easy to
get moving and exercise. So I guess my answer is I wouldn't be opposed to
it if the case was severe.
— [Deactivated Member]
December 2, 2008
Hi Heather,
My opinion is this... It depends on several things.
1. How obese the child is. If they are not morbidly obese, I feel that WLS
is a drastic step for and adolescent. I feel that they first must try diet,
exercise and proper nutritional training.
2. how old they are. If is child is too young and still growing rapidly, I
feel that they would have trouble getting the amount of nutrition that
their body would need to help them grow strong muscles and bones.
3. do they have health issues. If they do not have health issues I feel
that they should try the things stated in #1. I do not feel that they
should have surgery because of vanity or because of the way they look.
4. How old they are. If they are in their later teen years and have tried
all other ways to loose weight and get healthy then weight loss surgery
should be considered.
Hope this helps
Denise
— deejacobs
December 2, 2008
I think other methods of weight loss should be encourage first. This should
be used as a last resort. There are children who need this intervention in
order to be healthy. It is life changing and could be depressing to a
teenager or preteen. It makes social eating very difficult. Teens and
preteens do a lot of socializing that involves food. Also as children
become young adults they may want to drink and with this surgery the
changes will make drinking much more dangerous for them.
This should only be done as a last resort and I would think it would be
better to wait til they are at least 16 and only if they have other health
risk factors.
— trible
December 2, 2008
Personally, I think it is absolutely appropriate as a last resort. I'm not
sure if there is any way you could contact my surgeon's office, but he
specializes in adolescent obesity and does LapBands on them all of the
time. His name is Dr. Robert Cywes here in Jacksonville Florida. Phone
number 904-399-4004.
Best of luck,
Dawn Vickers, RN, BLC, CLC
— DawnVic
December 2, 2008
I agree with all the others. I feel that over 18, no problem, under that
age, it would have to be after a lots of other attempts, nut's etc.
Lapband only under 18. The change I think is too radical for anyone under
18..
— Kathy Thomas
December 2, 2008
My views are quite different than all the others. I do not feel that WLS
is right for adolescents or pediatric patients. This is so much more than
a weight loss tool. I was morbidly obese when I graduated kindergarten and
continued to climb the scales until I had my RNY. I think back on how life
would have been different if I were a skinny kid. The mental issues
associated with obesity, WLS, and the lifestyle changes that have to occur
after surgery is to much for most kids. When I was in high school, I
wanted to be like everyone else. I loved McDonalds and beer. If I had WLS
I may have missed out on crucial maturing years. As a pediatric or
adolescent patient it is imperative that they diet and exercise. I had the
RNY and I have to exercise everyday. Having the surgery alone is not
enough. I just think that WLS requires informed consent. My parents could
not have predicted if I would have did well post op. Parents should not be
allowed to consent, for a minor child, to have elective WLS. The question
is not if an obese person could benefit from the surgery. We all know that
answer is yes. The question should it be a child? NO
— mary_rn
December 2, 2008
Heather,
I do not think this is appropriate for pediatrics at all. Their bodys
and brains are still growing and they need to have the extra fat for the
development of their mylan (however you spell that!) sheath for proper
brain development. Teenagers.....well that may be a different story. I
think it would be okay, but ONLY IF they have proven that they cannot loose
the weight other ways, and they are excercising and eating right. A
thorough pshyc. eval should also be done...more than an adult has to go
through. These kids are still not done growing, so one would need to be
careful and dilligent about making sure they get all of their nutritional
needs met after surgery. I do think that possibly gastric banding would be
more appropriate for teens than RNY and the like surgeries, as it may be
less risky and the doctors can open up the pouch of a female when she is
ready to become pregnant......just some thoughts...thanks for allowing me
to "vent" them.
— [Deactivated Member]
December 2, 2008
Having struggled with obesity my entire life (now 45) I would definitely
say yes to weight loss surgery for severly obese adolescents. However,
because they are not teens and are unable to clearly understand WLS and the
eating guidelines,etc.. I believe that the childs caregiver(s) should have
to go through a series of educational classes and have to demonstrate that
they fully understand the WLS and all that it entails when it comes to
diet, etc..Being an obese child pretty much means becoming an obese adult.
Obesity causes health problems not to mention emotional problems from being
shunned, picked on, etc.. If a child can be spared from these problems with
WLS and have a better future then they should not be denied. But, all
other attempts at weight loss should be attempted prior to surgery.
— [Deactivated Member]
December 2, 2008
I do not think it is appropriate for children under 13 it is far too risky!
but if you have a teen who is morbidly obese, has developed diabetes,
elevated Bp and all the other things associated with morbid obesity AND has
exhausted all the other options then surgery is ok. BUT the teen would
need to be followed very carefully by a doctor and nutritionist due to the
different dietary needs of teens. It would still be very dangerous for a
teen to have the surgery so the benefits MUST outweigh the risks. As for
me speaking from the standpoint of a parent who has two overweight (not
morbidly obese) teenagers who knows that they probably carry the gene for
obesity, I am working very closely with them now on the importance of
exercise and proper nutrition. My kids have seen what I have been through
both pre and post op and are in no hurry to get any kind of surgery. THey
would both rather get healthy the traditional way. I would love to see the
public schools address the problem of overweight and obese children so no
kid will ever have to go through what I did as an obese teen.
— Pittysmama
December 2, 2008
Well Heather, I personally think that there should be certain restrictions
on WLS for people under the age of 18. My daughter is only 12 and weighs
198lbs. Of course i would like for her to be thin and active. However, her
genes also play a part, as they do for myself.
I am scheduled for my WLS in January and I am hoping that when I am able to
become more active, we can do more together which will help her lose some
weight. At this point, I don't think that WLS is appropriate for her, as
she is not mature enough to make the correct choices necessary for the
proper weight loss. I think that a lot of it depends on the maturity of the
child, not necessarily just their age. I know a lot of adults that aren't
mature enough to handle this type of thing.
I do think that before any adolescent (not child) should have some
extensive counselling prior to wls. I don't think that ANY child (under 12)
should have this surgery. I really feel that the person should at least
have been through puberty first. Bodies change so much and have so many
raging hormones during puberty that adding wls to that mix would be
dangerous.
So, in closing, I feel that wls for younger people is appropriate, with
some conditions that HAVE to be met. Not just being overweight either,
morbidly obese only. With extensive counselling, after having exhausted ALL
other means of weight loss available.
Good luck with your essay. I would love to hear your views on this subject,
please pm. me.
— anitak
December 2, 2008
I think WLS should be an option if a child has type II diabetes or other
threatening health issues. I also think documented attempts at weight loss
should be reviewed. I worry about having adolescents think this is one
more easy fix because it is still a lifetime commitment after surgery (as
we all know).
I worry that we have raised a whole generation that expects someone else to
fix their problems. That said, I do think health issues should be the
directing force behind the decision to have WLS or not.
— psrd370
December 2, 2008
Hi Heather, I read the first few post and have to say I agree with most of
what was said. I think an adolescent has the ability to follow the rules of
eating the way bariatric patients have to, however, the younger age group
you inquire about cannot. For one thing, I know of heavy toddlers and young
kids who when they hit puberty have a growth spurt and thin out. It would
have been a mistake for kids like these to alter their digestive tracts. I
don't know, It seems cruel to me to think of a younger child being deprived
of food. But olderteens can benefit from the surgery. They will learn new
eating habits that will carry them thru their entire lives...if they are
willing to change. thats the bigger part. You can perform surgery on
anyone, but what they do with it is not up to us. Its up to them. Look at
how many adults regain weight because they cannot or refuse to change their
eating habits. I catch myself thinking at times...I can't wait until I can
eat this or that...well ..it isn't going to happen! I cannot afford to eat
like I did before surgery. My health and well being depends on it. Ok
enough heavy talk...This is an interesting subject for a class. Will be
curious how it all turns out! hugs, Kim
— gpcmist
December 2, 2008
Hello Heather,
I haven't read any of the replies so this may repeat what others have
said.
I have not researched your topic because I don't have children but I think
pediatric or adolescent wls is a bad idea. I was a fat child and teen but
when I graduated from college, my lifestyle totally changed and I lost
about 75 pounds using diet and exercise. I was able to maintain this loss
for over 10 years... until my lifestyle changed again. I got married and
became much more sedentary. I gained back the weight and more. I tried
every diet for the next 14 years with no success. My last resort was wls,
which has been very successful. Anyways, my point is that child/adolescent
obesity may resolve like it did in my case through lifestyle change. Wls
seems too drastic for that early in a person's life. The body of a
child/teen is in flux. Just because they are overweight at that age doesn't
mean they always will be. They may shoot up in height, or discover sports,
or any number of things that could help with the weight problem. I guess in
certain cases, it might be indicated but honestly, I can't think of many.
Maybe in the case of extreme morbid obesity.
— Leona P.
December 2, 2008
Great topic! For a child (peds) I have to say no way, their bodies are
still developing and all "regular" weight loss options need to be
tried first. I do realize this makes a lot of mental health issues for
these children. Perhaps some therapy for these issues would be good at
this age. But they need to learn correct eating habits and encouraged to
be physically active. As adolescents, perhaps a different story. Maybe the
lap band as it is reversible. This way as medical science progress in
development of WLS they can opt for a more evasive surgery later down the
road, when they have matured into full adulthood.
— chell1957
December 2, 2008
I think that if the child's health is in danger and the child in 16 years
or older and ALL OTHER measures have been attempted then I am for the
surgery. I had the bypass but for a young person I would recommend the
band since it can be undone. I know there are risks but many of my
illnesses and health issues as an adult could have been avoided if I had
this option as a young person.
— leclibrarian
December 2, 2008
I think that WLS should only be a last resort option for older teens, say
16 and up who are severly obese. But only the band and only if all else
fails. Before resorting to it, the teen and the entire family should be
screened. I have been obese all of my life. Why? Because my family,
particularly my father, fed me mountains of food. I was given food to eat
at all hours of the day and night. I was fed for being sad, being bad,
being good and just about any other reason they could think of. My dad
used to cook rice and beans and fried chicken in the middle of the night
and wake me up to eat it. Not everyone's dad does that but some of them
do, hopefully not to the same extent. My mother was no better. For a
family of 5, and my 2 younger siblings didn't eat much, she would cook 2-3
chickens for dinner so that there would be enough for me to eat a whole
chicken's worth or more. So I think before a teen becomes a WLS patient,
the entire family should be evaluated for this type of behavior and friends
of the family be interviewed as well and ask for their honest opinions to
see if the family members are being truthful. I say that only because if
someone asked my parents, such as school officials did, they may say that
they don't allow me to over eat and that I do it on my own, when in fact,
it was them shoveling food down my throat. And the teen and their family
should go through rigorous training for life with the band. Because it is
not easy and most teens don't want to eat properly. This can cause them to
be unsuccessful and that would damage them emotionally. Proper eating
techniques must be drilled into them because the terror of a band slip and
emergency surgery would be too much for a teen who is essentially still a
child in many ways. And most teens are in a hurry these days for some
reason or another. Another reason to drill them with proper eating
technique. So they aren't always getting stuck and having to puke. This
can be very stressful for someone already in a stressful period of their
life. This should not be a decision to be made hastily. There should be
an evaluation and education period of at least 10 months and no less.
Classes, groups, etc. This should improve their chances of success and
minimize the chance of ccomplications and also show that they are truly
willing to do what is required of them and stick to it once they get the
band. As a teen, I would have jumped at the chance for WLS but I know that
I would not have been able to do it without counseling and education. That
is because I was a teenager. That should say it all. Not all teens are
very mature and even the ones who are still will act like a teen under too
much pressure. I've known and still know a lot of teens, some more adult
like than others but they are still goofy nonetheless. So, WLS is not
something to be taken lightly or go into half-arsed, thinking it will be a
quick-fix that will magically solve your problems.
As for pediatric WLS, that should be an absolute NO. How can you do
something that serious to a child who cannot evenn begin to comprehend such
a thing? Who may have complications and later in life have serious
emotional trouble and have anger and resentment towards their parents for
doing it to them. I don't think it is right at all. And small children
are easier to train than older ones or adults. Their parents should be
willing to work with them as much as necessary to teach them proper habits
that will stay with them throughout their lives which is what parents are
supposed to do in the first place. Most of my family is fat. My sister
wanted to break that cycle. She has 2 sets of twins and they were never
given candy or sugary stuff as babies. When they got to start solid food,
they were only given healthy stuff and that is what they prefer to eat.
They are 2 and 4 now and they still don't like sweets and junk food. They
prefer fruit and vegetables to candies cookies and cake. And they are all
normal weight and healthy. One of the kids does tend to overeat but she
likes vegetables and wont turn to junk food. Cauliflower is her idea of a
treat! Genes do play a part in things but proper behavior can still be
instilled. Don't wake the food addicted monster in your children by giving
them garbage to eat in their early years and regardless of genes, they will
be less likely to become out of control.
— ImanAbdulaziz
December 3, 2008
No...Not for children...I think it is the responsibility of the parents to
feed their children healthy food and not bring junk in their homes. EVEN
if they are MO themselves. I was MO and my children were not. I didn't
allow them candy regularly...It was a treat to have desserts and sweets in
my house...I didn't give them food to shut them up in the grocery or dept
stores...They ate what I fed them or they didn't eat. I was not one who
ate unhealthy food...I ate too much food though and had binges (in
secret)....Our children are OUR responsibility...and if we cannot control
our responsibility to teach them good eating habits along with being good
people, I don't think we should be let off the hook for our inability to
say NO to junk and allow them to just have WLS....No way! Kids and even
teens are sooooo wreckless and self destructive...They do what their
friends do...and having surgery is NOT going to suddenly make them
accountable for what food they eat and what drugs they take with their
friends or what dangerous activities they get into....What happens when
they FINALLY are allowed to drink alcohol at age 21!!!!? I think WLS should
be for people 21 (18 is really kinda pushing it in my opinion, but
acceptable) and no younger, unless they can prove themselves a unique case,
because I think there are always the exceptions of course...and there will
be some kid that could truly benefit from and be responsible for changing
their life style to be healthy...But I'm sorry, I don't even think that
most adults that DO have WLS even take their commitment to change seriously
enough...or there would not be as many people gaining their weight back.
On top of all this....so many kids are chubby when they are kids and slim
out at 16-18 years old...I believe that kids who are still growing need all
the nutrients they get from food...malabsorption could greatly harm their
growing bodies, brain, organs, bones, etc! NO WAY! Not kids...not until
there are more long term studies and improvements to the surgeries...I
think in special cases, lap band or reversible wls would be the last resort
for serious health reasons! I think when a parent realises that it's time
to make a drastic change such as WLS for their child, it's time for the
entire family to get help and nutrition education and therapy...NOT
surgery.
That is my opinion...right or wrong...
— .Anita R.
December 3, 2008
I am going to have to agree with Jennifer Curtis. I wish I had had this
tool available to me in my late adolescence. It would have spared me years
of being an obese adult in my 20s, 30s and 40s. Years of pain. I think for
those teens who are significantly overweight and have been, and are totally
unsuccessful at dieting, that this is a good tool.
— zieberrae
December 3, 2008
I would say that for children under the age of 15, no, it's too much at too
young an age, but if they are 15 or older and morbidly obese then it should
be a considered option but only after the teen has tried all other options.
This type of surgery should be a last option and children do not always
have the maturity to make a decision that is so life altering. Also,
children/teens may think of this as a quick fix for being obese and as we
all know that's just not true. This is a tool. I also think that
extensive pyschological testing should be completed when a teen is
considering this type of surgery along with multiple follow-ups with a
counselor with support group attendance (for up to a year) mandatory prior
to surgery.
— dnefews
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