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Battling Childhood Obesity with Bariatric Surgery

Bariatric The United States has a childhood obesity problem. In the past 30 years, obesity has more than doubled in children and tripled in adolescents, according to the Centers for Disease Control and Prevention (CDC). Obese youth are more likely to become obese adults and are at risk for long- term health effects.

How Children’s National Treats Obesity

While obesity is a growing problem for the U.S., approximately 18 percent of school-aged children are obese in Washington, D.C.
Children’s National Health System treats obese kids and teens in two ways through the Obesity Institute:
  • IDEAL (Improving Diet, Energy and Activity for Life) Clinic: For children ages 2 – 18 who have been classified as obese, this clinic offers personalized, medical intervention and treatment for children and their families.
  • Weight-Loss Surgery Program: For adolescents who have been classified as morbidly obese and have other health conditions caused by obesity, weight-loss surgery may be an appropriate treatment.
Children’s Weight-Loss Surgery Program aims to help adolescents who are morbidly obese. Bariatric surgery is still a relatively new procedure in adolescents, and it is important that the surgery is performed by a pediatric team who understands the special needs of young patients — the physical and physiological differences as well as behavioral and psychological factors that influence health.

Children’s multidisciplinary team includes child psychologists and psychiatrists, physical therapists, nutritionists, anesthesiologists,  and staff nurses. A pediatric team like Children’s can also follow children long-term to track their progress and help ensure a healthy lifestyle.

Does My Child Need Weight-Loss Surgery?

Evan Nadler, MD, director of the Bariatric Surgery Program, recommends surgery for patients who are significantly overweight and have a medical issue related to their weight that cannot be addressed with lifestyle and dietary changes alone.

“If a child is on medicine for diabetes and that is secondary to their weight and we’ve been unable to help them lose weight, we offer surgery as an option,” Dr. Nadler said.

Dr. Nadler and his team have performed about 65 weight-loss surgeries since the Obesity Institute opened in 2007, and most of these are sleeve gastrectomy procedures. What makes the sleeve gastrectomy different than the more familiar LAP-BAND®, is that about 80-90 percent of the stomach is actually removed to decrease intake.

 “About 20 percent of all weight-loss surgery patients regain their weight no matter what procedure they have,” Dr. Nadler said.  “Adolescents who undergo sleeve gastrectomy don’t seem to be any different, though we don’t have as much long-term data on those groups.”

Weight-loss surgery is not a quick fix, but Dr. Nadler said it can provide a necessary start for patients who have struggled to maintain a healthy weight.

“The kids can actually make the behavior changes after surgery that they couldn’t before, because of the positive reinforcement,” Dr. Nadler said.

Because it’s so difficult to maintain a healthy weight, Dr. Nadler recommends his patients visit the IDEAL clinic, or their local weight management clinic if they are  out of state, to help with this transition.

The IDEAL clinic combines the work of a pediatrician, nutritionist, and social worker to help kids keep the weight off.

“What makes me happiest is when I see kids who not only get better health from losing weight, but when I see the vast social changes with kids who used to be ostracized from their classmates or shy away from activities, re-enter normal adolescent society after operation, that really brings it home for me,” Dr. Nadler said.

Maria’s Journey: Weight Loss Surgery


How to Qualify for Bariatric Surgery

  • Be at least 14 years old
  • Reach a certain level of physical development
  • Have a history of obesity for at least 3 years
  • Unable to lose weight another way   
  • Have a BMI of at least 35 with an obesity-related condition, or a BMI greater than 40 without an obesity-related condition
For more information, visit the Obesity Institute’s web page.
 


 
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