Should weight-loss surgery for kids and teens be more of an option?

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Weight-loss surgery should be more widely used to treat severely obese children and teens, a leading paediatricians' group says.

Severe obesity is a serious and worsening public health crisis among US youngsters, and weight-loss surgery is one of the few effective ways of treating it, according to the American Academy of Pediatrics (AAP) in its new policy statement.

Safe and effective

"Children with severe obesity develop health problems earlier than those with lesser degrees of obesity, including diabetes, high blood pressure, fatty liver disease, and sleep apnoea," said policy statement lead author Dr Sarah Armstrong, a member of the executive committee of the AAP Section on Obesity.

"While lifestyle changes remain the mainstay of treatment, medical care is unlikely to significantly change the trajectory for most children with severe obesity," she said in an academy news release.

Current rates of severe obesity are 7.9% in children, 9.7% among 12- to 15-year-olds, and 14% among 16- to 19-year-olds, data from the National Health and Nutrition Examination Survey shows.

Recent research suggests that weight-loss surgery is safe and effective in youngsters, but significantly underused, according to the AAP.

Significant disparities

"The last decade of evidence has shown surgery is safe and effective when performed in high-quality centres, with the primary care paediatrician and family in a shared decision-making process," said Armstrong.

"Unfortunately, we see significant disparities in which patients have access to weight-loss surgery. Surgery needs to be an option for all qualifying patients, regardless of race, ethnicity or income," she said.

Studies have found that weight-loss surgery in youths leads to long-term reductions in weight and weight-related diseases. For example, a study that followed teens for up to 12 years after weight-loss surgery found an average 29% decrease in BMI (body mass index – an estimate of body fat based on height and weight) for those who had one type of surgery, and significant reductions in diabetes and high blood pressure.

The policy statement will also be presented at the American Academy of Pediatrics annual meeting, in New Orleans.

Image credit: iStock

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