Getting Real About Teen Bariatric Surgery Outcomes

Back in October, the American Academy of Pediatrics made a bold statement. Teen bariatric surgery is an important, safe, and effective option for youth with severe obesity. Thus, we must solve problems with access to this care for many young people who need it. But a new study tells us that mere access to the surgery will not be enough. Pediatricians need to get real about what surgery can and cannot do.

It can provide important improvements in health status. But it won’t cure mental health problems that can come from growing up with severe obesity. For that, providers should must work in teams that can provide long-term mental health support after surgery.

A Matched-Control Study

Kajsa Järvholm and colleagues followed 81 teens with severe obesity receiving gastric bypass surgery. They followed a control group of 80 teens matched for BMI, age and sex who received nonsurgical obesity care. They had five years of follow-up, with special attention to mental health care.

What they found was that patients in both groups had mental health problems at similar rates – both before and after surgery. The teens who had surgery scored better on self-esteem after five years than the control group. They might have felt better about themselves because they had lost more weight. But otherwise, these two groups were little different in terms of mental health and their need for treatment five years later.

Realistic Expectations

Teen bariatric surgery is clearly very beneficial for the physical health of individuals with severe obesity. Adolescence is a tough time for mental health, especially for youth living with severe obesity. So it’s easy to think that losing a lot of weight will make everything better. Adults are prone to think in those terms and so are youth. But it’s just not realistic. Those same pressures youth face are still there after surgery. Parents are still annoying. Peers still exert pressure that seems unbearable at times.

This study is a good reminder that providers need to help teens undergoing bariatric surgery go into it with realistic expectations. Though it helps with physical health, all the other problems a teen faces will still be there. So follow-up care for mental health issues is important.

Click here for the study and here for further perspective.

Shelling of Beet, pastel in the style of realism by Alexey Venetsianov / WikiArt

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January 26, 2020

4 Responses to “Getting Real About Teen Bariatric Surgery Outcomes”

  1. January 26, 2020 at 7:10 am, Christina Fleetwood said:

    Check the Swedish project at the childrens dept Karolinska Institutet now several years ago. They had a group fairly small (maybe up to 13) with children who were set for surgery. I have forgotten the details but …. last I heard 3 of those had committed suicide – as they had believed they would be free from the problems for the rest of their lives and were not prepared to handle the weight gain that occurred within a – seen out of this perspective – some gained as much and more …..

    The MD is one of the more famous for MDs for children with obesity and …. if you are interested you will certainly find more details…… he has been at the EASO conference’s.

    I belong to the children who were placed in various hospitals at an early age and I look upon things like this with deep sadness and/or fury.

    Christina

  2. January 26, 2020 at 7:31 am, Ted said:

    I feel the fury, too, Christina, because right now youth with severe obesity receive totally inadequate care. Bariatric surgery can be quite helpful, but it’s not magic. It does not solve the problems that living with severe obesity can create. It’s not magic. Just one of many tools that we are not using wisely for the benefit of youth who did not choose this chronic disease for themselves.

  3. January 26, 2020 at 2:22 pm, Allen F Browne said:

    The disease of obesity is a chronic, incurable disease with many complications. A longterm, interdisciplinary approach to improving the person’s health is the best we can do currently. Selling this to youth and adolescents is a continuous process. Ask anyone who takes care of youth and adolescents with type 1 diabetes.

  4. January 26, 2020 at 2:40 pm, Ted said:

    Valuable perspective, Allen. Thank you.