After Teen Surgery

Gastric sleeve-themed items by Etsy craftspersons
Gastric sleeve-themed items by Etsy craftspersons

A piece in GeneralSurgeryNews.com makes an excellent point –

Although bariatric surgery is performed on unprecedented numbers of teenagers today, the number of procedures performed—and the availability of insurance coverage—barely registers compared with the size of the obese population of young Americans.

The demand far outstrips the supply. If more patients could afford it, no doubt the supply of available bariatric clinics and doctors would increase. Part of the expense is in the ongoing nature of these procedures. It’s not just a one-and-done. There are preparatory stages, the testing and history taking and counseling.

Costliness is also affected by the fact that sometimes, there is more than one surgery, either by design or because something went wrong the first time. Christina Frangou’s article was published only last month, but the latest available statistics are from 2009, when 1,600 kids under 18 had some form of digestive tract-altering surgery.

Of the study participants, 13% required at least one additional abdominal procedure during the three-year period, most commonly gallbladder removal. In all, 30 patients required a total of 47 additional procedures.

She notes that before surgery, only 5% of the subjects were iron-deficient, a number that rose to more than half, after surgery. Their ability to squeeze the goodness out of other nutrients is also affected. Lab work is needed to stabilize the levels of everything. For these and other reasons, bariatric surgery is a long-term commitment that includes continuing interface with the medical profession, and it’s not the kind of commitment just anyone can make.

The usual post-op course (after for instance an appendectomy or a knee replacement) is for a wound to close, infection to be avoided, and all the customary care to be taken so the patient will emerge in a better state than she or he previously endured. After a certain point, it’s over, and the patient many not see a doctor about that body part for years, or ever.

After bariatric surgery, however, follow-up is vital and and perpetual. There is no return to normalcy. Life is not like it was before, and not like most other people’s lives. It requires deliberate maintenance under a stringent set of rules, and who wants that? Young people, especially, find it difficult to adhere to such discipline.

Basic principles

An underlying assumption is that bariatric surgery on the young should only be undertaken when other methods have failed. The paradox is, sometimes the patient has to lose weight first, or else the operation will be unacceptably dangerous. But if they can do that, doesn’t it indicate that other methods actually do work? A question naturally comes to mind: why then resort to surgery at all? Why not continue with traditional methods like, for instance, eating less and exercising more?

Overeating and slothfulness are not the only causes of childhood obesity. Ideally, children and teens who contemplate surgery would sign up with W8Loss2Go, and put the big decision on hold for a while. The long-range outcome for bariatric surgery is not overwhelmingly impressive. Sure, a lot of patients get better for a year or even a few years. Also, a lot of patients eventually return to their former sizes. W8Loss2Go, on the other hand, advocates and teaches a relearning that lasts a lifetime.

Your responses and feedback are welcome!

Source: “Teens Gain Big Benefits From Bariatric Surgery,” GeneralSurgeryNews.com, 12/07/15
Image by Etsy craftspersons

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About Dr. Robert A. Pretlow

Dr. Robert A. Pretlow is a pediatrician and childhood obesity specialist. He has been researching and spreading awareness on the childhood obesity epidemic in the US for more than a decade.
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Presentations

Dr. Pretlow’s invited presentation at the American Society of Animal Science 2020 Conference
What’s Causing Obesity in Companion Animals and What Can We Do About It

Dr. Pretlow’s invited presentation at the World Obesity Federation 2019 Conference:
Food/Eating Addiction and the Displacement Mechanism

Dr. Pretlow’s Multi-Center Clinical Trial Kick-off Speech 2018:
Obesity: Tackling the Root Cause

Dr. Pretlow’s 2017 Workshop on
Treatment of Obesity Using the Addiction Model

Dr. Pretlow’s invited presentation for
TEC and UNC 2016

Dr. Pretlow’s invited presentation at the 2015 Obesity Summit in London, UK.

Dr. Pretlow’s invited keynote at the 2014 European Childhood Obesity Group Congress in Salzburg, Austria.

Dr. Pretlow’s presentation at the 2013 European Congress on Obesity in Liverpool, UK.

Dr. Pretlow’s presentation at the 2011 International Conference on Childhood Obesity in Lisbon, Portugal.

Dr. Pretlow’s presentation at the 2010 Uniting Against Childhood Obesity Conference in Houston, TX.

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