Guidelines Backlash, the Biggies — Surgery, Part 1

As we have seen, plenty of experts have a lot to say about the concept that kids as young as 12 (and in extreme cases, even younger) should be prescribed weight-loss drugs. It turns out to be a pretty controversial topic. But that debate almost fades into the background when compared to the real shocker. For patients as young as 13, bariatric surgery also is now on the table.

Before approaching this subject in light of the new American Academy of Pediatrics guidelines, let’s look back on some previous Childhood Obesity News discussions. So far, there have been three related “roundups.” The first was titled “Many Aspects of Bariatric Surgery for Teens.” The second was “Another Teen Surgery Compendium,” and the most recent was “The Third Bariatric Surgery Roundup.” A multitude of angles have already been covered but there is, astonishingly, still much more to consider. So today’s post wears two hats. It is also, officially, the Fourth Bariatric Surgery Roundup. Here goes:

Bariatric Surgery, Qualifications, and Conscience
“MBS” stands for metabolic and bariatric surgery, and for an adult, five major decision criteria must be taken into consideration. When the candidate is a minor child, issues become much more complicated.

Bariatric Surgery and Consent
Even a highly motivated mature adult, who is willing to practice total compliance, can find some aspects of post-operative care barely manageable. What happens when the patient is not even old enough to drive or vote?

Bariatric Surgery and the Mind
Adherence to post-op dietary and medication regimens is vital to success. What happens when the patient is cognitively impaired, psychiatrically unstable, or developmentally disabled? What happens when that already troubled patient is a minor child?

More on Bariatric Surgery and the Mind
When the patient is young and the procedure involves far-reaching lifestyle changes, forever can be a long, long time. What happens if a complication like substance abuse later enters the picture?

Still More on the Mind and Bariatric Surgery
One expert says, “Co-morbid psychosocial and emotional problems of obesity generally act as causal or maintaining factors of obesity and thus significantly affect the treatment outcome.” Weight-loss surgery alone does not straighten out any mental or emotional kinks the patient may have possessed in their pre-surgical life.

Body, Mind, and Bariatric Surgery
Just a couple of years before the controversial decision to endorse surgery for young obese patients, the American Academy of Pediatrics issued a couple of significant reports on the subject.

The Evolution of Thought about Pediatric Bariatric Surgery
Bariatric surgery is not only about reducing appetite. It is an investment in the future. Some experts feel that the only real justification for inflicting this kind of surgery on a child is that it will prevent a severity of obesity that ushers in one or more complications, known as co-morbidities.

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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.
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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