Most parents feel bariatric surgery should not be available to kids under age 18

C.S. Mott Children's HospitalMay 10 2011

Just as cases of childhood obesity have skyrocketed in number over the last 40 years, so has children's risk for obesity-related illness such as diabetes, high blood pressure, liver disease and other illnesses. Research shows a multitude of issues that contribute to the problem, but no single solution is clear.

Today, the C.S. Mott Children's Hospital National Poll on Children's Health reveals that for most parents, one highly controversial fix - bariatric surgery for teens - should not be available to kids under age 18.

Despite its benefits, bariatric surgery carries potential risks, which are not fully defined for adolescent patients. There is no standard age at which bariatric surgery is presented as an option for severely obese adolescents.

Minority parents more receptive
Overall, less than one-third of parents thought bariatric surgery should be an option for adolescents younger than 18. Black and Hispanic parents were more likely than white parents to consider bariatric surgery for younger adolescents.

In contrast, 13 percent of parents felt bariatric surgery should not be an option at any age - including 1 in 5 Black parents. Among all groups, the most common viewpoint was that bariatric surgery should be delayed until the adolescent is 18 or older.

"Further research is required to explore why low-income and non-white parents were more accepting of bariatric surgery for adolescents, but it might be because these populations are disproportionately affected by obesity and are more familiar with the challenges faced by the severely obese," says Susan J. Woolford, M.D., M.P.H., medical director of the Pediatric Comprehensive Weight Management Center at the University of Michigan Health System.

Longer pre-surgery weight loss period
The poll also showed that for parents who believe bariatric surgery should be reserved for those over 18, most also prefer that adolescents participate in a weight loss program for at least one year before considering bariatric surgery - six months longer than the minimum time generally required by doctors.

"Pediatric guidelines say bariatric surgery should be performed on adolescents only after at least six months of participation in an intensive weight-loss program," Woolford says.

"During this time, patients and their parents have the opportunity to implement lifestyle changes that are important for success after surgery. But parents in this study suggest a longer period," says Woolford, who is also a clinical assistant professor with the Child Health Evaluation and Research unit in the Division of General Pediatrics.

Guidelines include adopting a low-fat, low-calorie diet, and implementing a regular exercise routine. Continuing these behaviors and taking regular supplemental vitamins and proteins following surgery are required to avoid serious complications.

"It is critically important that adolescents and their parents understand the risks and benefits of bariatric surgery. Studies suggest that many severely obese adolescents could achieve improved health as a result of bariatric surgery, but this requires them to be fully committed to following all medical recommendations," Woolford says. "Therefore, decisions about bariatric surgery for adolescents require careful consideration."