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Weight-Loss Surgery for Teens May Be Gaining Advocates
Date:10/8/2010

n we can get to these kids with BMIs in the 40s, we can have a decent chance of turning around their morbid obesity. When BMIs are higher than that, very often we can get their weight down, but they're still going to remain morbidly obese even after treatment. Once they get into the high 50s and beyond, I think we've done the kid a disservice."

Another small study, involving 50 severely obese Australian teenagers, found that those who underwent gastric banding surgery were much more successful in losing weight. The target goal of losing more than half their excess weight was achieved by 84 percent of the teens who went through weight-loss surgery, but only 12 percent of the kids who tried dieting and exercise.

Bariatric surgery for children is currently recommended primarily for those who either have a BMI of 35 or above and have major health problems related to their obesity, and for children with a BMI of 40 or above who are showing early signs of obesity-related health problems, Inge said.

Not every child meeting those criteria would be a good candidate for weight-loss surgery, however.

Because bariatric surgery can deplete the body of key nutrients needed for healthy development, children should have already undergone the majority of their linear growth, said Dr. Lori Laffel, chief of the pediatric, adolescent and young adult section at the Joslin Diabetes Center and an associate professor of pediatrics at Harvard Medical School.

"Their bones need to be as close as possible to what they will possess in adulthood," Laffel said. "You don't want to compromise opportunities to attain maximum bone density and maximum bone mass."

That would limit weight-loss surgery for the most part to girls older than 13 and boys older than 15, Laffel said.

The teenager also should display a certain level of emotional maturity and have a supportive family, Laffel and Inge said. Weight-loss surgery places very strict dietary requirements on p
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