Bariatric Surgery for Children

This post looks back at the last few years of progress in the area of weight loss surgery for children. As of 2012, the idea was gaining traction in some quarters, and cases of children as young as 12 were being studied.

In the same year, writer S.E. Smith wrote that marketing weight loss surgery to children is wrong because it is invasive and dangerous, and can irreversibly transform the metabolic system. The very fact that opinion is so divided is one of the ways in which children are hurt. Smith feels that it is a no-win situation, where you’re not supposed to be fat, but elective surgery isn’t exactly cool either. Smith writes,

When they get surgery, they’re told they are cheating and taking the easy way out. Because nothing says “easy way out” like having a chunk of your stomach removed and your intestines rerouted, as is the case with extreme procedures.

Smith is repulsed by the advertising of bariatric surgery, especially to children; and characterizes it as disgusting, and would like to see stricter federal regulations against it. The writer also described the obesity epidemic as a mythical construct that legitimizes bullying, stoked by rhetoric that is damaging, hateful, awful, and vile:

Fat hatred kills… When fat children are so bullied that they commit suicide… It kills when fat children go on extreme diets that are unhealthy for growing bodies, or when they descend into disordered eating because all they want, the only thing they want, the thing they need most in the world, is to not be fat anymore.

In 2013, the Downey Obesity Report mentioned a meta-analysis published in JAMA Surgery about adult bariatric surgeries. The researchers waded through 164 studies concerning 161,756 patients with a mean age of 44 years, and found a complication rate of 17% and a re-operation rate of 7%, figures that should have made everybody think twice about putting children through this ordeal.

Dr. David L. Katz wrote in 2014 about surgery being an acceptable way to reduce what he called the “worsening global obesity pandemic,” and said he recommended it for patients that were appropriate candidates. But he seemed to feel that in many cases, appropriate candidates have been misidentified — particularly in the Middle East, especially Saudi Arabia, which had jumped on the pediatric bariatric surgery bandwagon with great enthusiasm.

Dr. Katz wrote,

Lacking the capacity and resolve to feed our children less or better, or get them to exercise more, we send them through the operating room doors instead…
What does it say about modern culture […] that it sanctions putting children under general anesthesia to compensate for its anachronisms, profit-driven excesses and exploitations? Nothing very flattering.

Epidemic childhood obesity is a cultural crisis. Turning to the literal cutting edge of biomedical advance to address it is not a solution, but an abdication.

Your responses and feedback are welcome!

Source: “Young, Obese and in Surgery,”, 01/07/12
Source: “Fat Hatred Kills: Marketing Weight Loss Surgery to Children Has Got to Stop,”, 03/12/12
Source: “Bariatric Surgery Safety and Effectiveness Supported,”, 12/20/13
Source: “Childhood Obesity: Just Cut It Out,”, 02/18/14
Image by C.J. Sorg/Attribution-ShareAlike 2.0 Generic (CC BY-SA 2.0)

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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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