In the U.S., more than a third of children and adolescents are overweight, which can lead to greater risk of disease as they get older. Weight loss surgery can be an effective way to reach a healthy weight, reduce the likelihood of chronic disease and increase one’s self-esteem, according to Faisal Qureshi, M.D., Chief of Division of Pediatric Surgery at Children's Health℠.
"Obesity continues to be an epidemic," Dr. Qureshi says. "But parents, children and pediatricians should not think of it as a personal failure. There are options out there to help children become healthier."
While some parents may be concerned that weight loss surgery is not safe for their child, the multidisciplinary team of experts at Children's Health ensures that all of a patient's needs are met to lead to successful results.
What is bariatric surgery?
During bariatric surgery, a portion of the stomach is removed, reducing the ability to eat large amounts of food at one time. The surgery helps to:
- Reduce caloric intake
- Change the way your body processes food
- Change the way you are stimulated by hunger
What are the benefits of bariatric surgery?
Bariatric surgery has many long-term benefits and helps prevent other health-related problems seen in overweight adolescents and adults. By losing weight, you greatly reduce risk of diabetes, heart disease, fatty liver disease and metabolic disorders later in life, says Dr. Qureshi.
In the short term, patients can expect to lose 50-60% of their excessive weight within the first two years of surgery by maintaining a healthy diet and good exercise habits. There are also numerous psychological benefits of weight loss, including improved confidence about one's self image and a more positive outlook.
How old do you have to be to have weight loss surgery?
Patients must be at least 13 years of age and have severe morbid obesity to be considered for weight loss surgery. A child has severe obesity when their body mass index (BMI) is equal to or greater than the 120% of the 95th percentile. Parents should talk to a primary care provider to find out their child’s BMI.
Additionally, eligible patients must have demonstrated a minimum of six months of attempted weight loss through diet and exercise. Often, working with a pediatrician or family doctor to lose weight is demonstration of this effort. This "pre-work" is important, as these habits and lifestyle adjustments are critical to one's success after the surgery.
"Weight loss surgery is not a quick fix," explains Dr. Qureshi. "We're just opening the door, the patient and the family have to make changes in their life to make sure that the surgery is most effective."
Is weight loss surgery safe for kids?
Yes, if all of the criteria listed above are met, bariatric surgery can be a safe and effective option for children who are struggling with weight loss. However, patients will need support throughout their journey.
"When patients are referred to a regional comprehensive, multidisciplinary pediatric bariatric and metabolic surgery center, such as the one at Children's Health, the safety outcomes are excellent," Dr. Qureshi says.
What does the process look like?
Children's Health has created a highly-collaborative and supportive process engaging our pediatric specialists who work closely with the patient and family throughout the entire process. First, the prospective patient and his or her family meet with the surgeon to determine if the patient meets the criteria for surgery. The patient then meets with a psychologist and dietitian to evaluate ability to achieve long-term success. Based on a patients’ medical history, they may also meet with a cardiologist or gastroenterologist to ensure that all of their health needs are being met prior to and after the procedure.
Perhaps the most crucial part of the pre-surgery process revolves around family commitment. The family must be supportive during the process and willing to make the necessary lifestyle adjustments required to achieve success.
Some of those adjustments may include:
- Increasing the number of meals cooked at home
- Limiting calories to 1,200 per day before surgery and sometimes less after
- Drinking more water
- Eating more protein
- Exercising several times per week
What other tools are available to patients with severe obesity?
In recent years, medication for weight loss management has been approved for children 12 and older. In many cases, weight loss medication can be paired with bariatric surgery to treat severe obesity before and after surgical intervention, if needed.
"Obesity is a complex issue and no patient is the same. Different options exist for different patients, and you must be evaluated by a team who understands that," Dr. Qureshi says.
Are there alternatives to bariatric surgery?
Many of the lifestyle adjustments required for weight loss surgery candidates also work for children who are struggling with their weight and who do not need surgery. For example, drinking more water, eating more protein, and cutting calories and sugar are great ways to improve your diet and lose weight. In addition, children exercise and physical activity are an important part of a weight loss program.
It is important to understand that obesity is a biologic condition that is influenced by various factors – not just related to the individual and their health choices. In order to ensure the health of your child, teen or young adult with a BMI above 35, you should schedule an appointment with a specialist who may consider surgical options. "Sometimes, simply meeting with a specialist can help to set the child on a positive course for weight loss," says Dr. Qureshi.
Learn more
The Children's Health Bariatric Surgical Center works with adolescents and their families to address the problem of obesity. We provide the medical, surgical, nutritional, emotional and social support necessary for successful outcomes for adolescents who are candidates for weight loss surgery. Learn more about our program.
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