Many Aspects of Bariatric Surgery for Teens

Not long ago, laparoscopic gastric band surgery for adolescents was considered “experimental.” The procedure had been done on minors, but only as a last-ditch alternative, and the Food and Drug Administration had not yet made up its mind.

It is easy to see why there was hesitation. The country had been through years of upset over anorexia and bulimia, and was well aware that teenagers are capable of irrational and self-destructive behavior, especially when body dysmorphia is involved. Nobody wanted to see a wave of elective surgery done on vulnerable kids.

In 2011, the tide turned. The rules changed, and suddenly well over 10% of Americans were theoretically eligible candidates for Lap-Band surgery. Perhaps out of gratitude, the Allergan company stopped asking the FDA to lower the legal age to 14. There was some newsworthy drama around doctors who did not appear to know the meaning of the term “best practices.”

Should preventative surgery be a thing?

One of the most vital parts of any argument for or against teen surgery is the notion of prophylaxis, or taking an action to prevent disease. Is it defensible to remove perfectly good body parts to fend off future trouble? Taking this reasoning to an extreme, why not pull all of a child’s teeth, yes, even the designedly permanent ones? It makes sense, because there is a good chance that at a future time, dental caries will appear.

This insane idea, on some level, makes sense. The only thing it doesn’t take into consideration is the entire rest of the body, which relies on properly chewed food to get its work done. Also, it doesn’t take into account pain from misaligned joints in the head, and the loss of ability to speak clearly, and the resulting grotesque appearance. But full-mouth extraction does prevent cavities, and there may be people who do the cost/benefit analysis and decide that this is the way to go.

The law wants to make sure that some equally radical solution is not practiced on a human, too young to drive, drink, marry or vote, who may regret the consequences later. Of course, not all bariatric surgeries entail permanent removal of anything, thank goodness. This is why the Lap-Band procedure has gained such favor.

Surgery used to be considered a very serious step saved for last resorts. Now it seems to be treated as lightly as an eyebrow-shaping or a pedicure. Over the past few years, the idea of performing irreversible, life-altering surgery on young people has become normalized.

Even with theoretically reversible techniques, life will never be the same and it certainly won’t be easy, for reasons described in “After Teen Surgery,” and that page doesn’t even cover all the possibilities.

In one study of teenagers, more than one out of 10 had to go back for additional surgery. The threat to adequate nutrition is ever-present and needs constant attention. This part is worth repeating:

Overeating and lack of exercise 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. Unfortunately, a lot of patients eventually return to their former sizes. W8Loss2Go, on the other hand, advocates and teaches a re-learning that lasts a lifetime.

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Profiles: Kids Struggling with Weight

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The Book

OVERWEIGHT: What Kids Say explores the obesity problem from the often-overlooked perspective of children struggling with being overweight.

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.
You can contact Dr. Pretlow at:


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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