A Hard Look at Quality of Life

Finding an objective view of quality of life for adolescents who choose to have bariatric surgery is not easy. So it’s worth taking a look at a new publication in Obesity that examines this very subject in 88 adolescents followed for two years after gastric bypass surgery.

These were kids who had severe obesity (average BMI 45.6) at the start of the study. Two years later, their obesity was mild (average BMI 30.1). They go into the surgery with a heavier psychological and social burden from obesity than adults. But after two years, the investigators report:

We found broad improvements in mental health, self-esteem, mood, and obesity-related problems in adolescents 2 years after treatment for severe obesity by gastric bypass. Symptoms of depression, anxiety, anger, disruptive behavior, and self-concept were at the same level as norms for adolescents, indicating a mental health in the normative range, 2 years after surgery.

This is not to say that everything is just dandy after surgery for these kids. They found a significant group (13% of subjects) with severe depression two years after surgery. The authors warn that critical needs for psychological support “are going unmet in adolescents undergoing bariatric surgery.”

Gaps remain. These data are observational and controlled data is scarce to guide kids and their families making decisions about bariatric surgery. Access to care remains a problem, as Thomas Inge and colleagues recently documented, because health plans are quite willing to play games with the lives of kids facing severe obesity.

At least partly as a result of health plans creating difficulties with the financial aspects of caring for children with severe obesity, the resources in an average community are woefully inadequate. Cheerful programs to prevent childhood obesity get more attention.

This needs to change.

Click here to read the study. Click here for more perspective on severe childhood obesity.

Adolescence, photograph © Tirzah / flickr

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August 5, 2015