What They Say About Bariatric Surgery for Kids — Part 1

Recently, we followed early reactions to January’s American Academy of Pediatrics guidelines, then offered a retrospective look at what had been said here about the topic, previous to those new guidelines, with a comprehensive catalog of various aspects and angles (the pages known as Bariatric Surgery Roundups, #1 through #6). This has obviously been a hot topic for a long time.

Here is a look at some additional pieces that have appeared in the press in the recent past. The older gastric band method, in vogue until around 2008, was less invasive and less permanent than some other styles of weight-loss surgery, but had high complication and failure rates. As patient Amy Scheiner described,

A reversible, inflatable device was placed around the top portion of my stomach, creating a smaller “pouch” and limiting the amount of food I could consume.

By way of contrast, the current favored option, the gastric sleeve or sleeve gastrectomy, is done laparoscopically, with generally five small incisions. About 80% of the stomach is removed. The hospital stay is short (a day or two), and the overall recovery time is not long.

On the other hand, the lasting metabolic changes might not all be positive. The big problem is, it’s not like having a broken arm casted until it mends, and then the child goes on their merry way, good as new. The surgical option requires genuine long-term (as in, life-long) commitment and inflexible adherence to strict nutritional requirements. As Gina Kolata noted in The New York Times,

You have it the rest of your life. You cannot reverse it. You can’t say, I want my old intestines back. It’s gone.

Specialist Monika Ostroff is the executive director of the Multi-Service Eating Disorders Association. She has worked with many patients who developed eating disorders after bariatric surgery, some of whom were operated on as teenagers. Ostroff says that the surgery completely changes the way in which a person can nourish their physical body, from food amounts and types to their method of chewing. If patients are not adequately prepared for these radical changes, disaster can ensue.

The “forever” aspect is a very big deal to some people. Dr. Katy Miller (a hospital medical director in charge of adolescent medicine) was quoted:

[I]t is a very serious surgery that carries profound impacts for the rest of a patient’s life.

Your responses and feedback are welcome!

Source: “I Had Weight-Loss Surgery at 17, and It Worked — but It Didn’t Address My Real Problem,” Slate.com, 02/01/23
Source: “An Aggressive New Approach to Childhood Obesity,” NYTimes.com, 01/26/23
Source: “New childhood obesity guidance raises worries over the risk of eating disorders,” NPR.org, 02/15/23
Source: “New Guidelines Underscore How Complicated Childhood Obesity Is for Patients and Providers,” NYTimes.com, 01/20/23
Image by faungg’s photos/CC BY-ND 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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