What They Say About Bariatric Surgery for Kids — Part 2

A lot of news stories elicit massive commentary when first published, but only some of them sustain interest for very long. In the past weeks, Childhood Obesity News has explored many angles of the American Academy of Pediatrics opus, “Clinical Practice Guideline for the Evaluation and Treatment of Children and Adolescents With Obesity.”

We looked at a piece called “Children with obesity should get proactive treatment, including medication, surgery: new guidelines.” The word choice in that headline is indicative of how the reactions fall into categories. Some ask for treatments that are not just proactive, but aggressive. Others go further and insist on treatments that work. This might lead to a discussion based on the question, “Define work?”

If a weight-loss method involves expensive and potentially harmful endless dependency on pharmaceuticals, can it fairly be said to work? Can an intervention be honestly defined as effective, if it involves the removal of a major organ? Does it really work if it requires a lifetime of walking a nutritional tightrope? Can a person take in enough essential vitamins to compensate for the missing body parts, and at the same time not eat enough food to stretch the remaining stomach and invalidate the surgery?

Putting the cart before the horse

That good old saying is about doing things backward. Let’s be real. Tennis elbow could be eliminated by amputating the entire arm. Certain behaviors can be stopped by slicing out part of a person’s brain. Weight can be lost by taking a drug that may considerably increase the underpants laundry bill.

But just because a thing can be done, does not mean it should be done. And, important as these questions are, there is something even more basic going on. As Dr. Pretlow expresses it,

Even with the new recommendations, only the symptoms are still being treated, not the underlying cause.

Exactly. This fairly obvious fact has been noticed by laypersons and healthcare professionals alike, both immediately and in the ongoing second wave of responses. If more attention were paid to the underlying causes, we would not have to worry about the potential for various ugly complications like the ones listed by Christine Byrne in her article for Self.com, including…

[…] gastroesophageal reflux disease, chronic nausea and vomiting, the inability to eat certain foods, weight gain or failure to lose weight, low blood sugar, malnutrition, ulcers, bowel obstruction, and hernias.

And when certain statistics are aired, concern rises:

The guidelines also state that between 13 and 25% of those who get bariatric surgery will need a follow-up procedure within five years.

Your responses and feedback are welcome!

Source: “Children with obesity should get proactive treatment, including medication, surgery: new guidelines,” 6abc.com, 01/10/23
Source: “The New Obesity Guidelines for Kids Are Appalling,” Self.com, 02/02/23
Image by Stephen Edmonds/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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