Childhood obesity is a significant health issue both in the US as well as worldwide. Over 15.5% of children and adolescents are considered obese in the US. There are many reasons for this:
- an abundance of unhealthy food choices and high calorie drinks that are well advertised and easily available
- poor food choices are often available in schools or very near to schools
- technology has had a very negative impact on children’s entertainment choices, resulting in less physical activity compared to previous generations
- anxiety and false perceptions as to how much food is required for children to enjoy a normal growth
- lack of knowledge in families regarding healthy food choices, exercise and proper sleeping patterns
The statistics regarding the future of children suffering from obesity are staggering. 50%-77% of children and adolescents who are obese continue to be obese during adulthood. This percent rises to 80% if at least one parent is obese. Nearly all adolescents with severe obesity will remain obese in adulthood with increased morbidity and mortality rates due to serious chronic diseases caused by the excess weight.
All of these reasons combined make this a significant problem that requires a delicate touch and a sensitive approach. The treatment of affected families requires experienced teams that have the sensitivity, knowledge and commitment of time to care for children.
Although the initial weight goal should be to achieve weight loss with dietary interventions, exercise and behavior modification, this is often difficult to accomplish. Often to achieve this goal, the entire family’s interpersonal relationships, dynamics and habits have to be carefully analyzed and assessed. For carefully selected children and adolescents who suffer from severe obesity, bariatric (weight loss) surgery is also a valid option. Several studies have shown that bariatric surgery in young ages can be safe and effective and it has been endorsed by Pediatricians and Endocrinologists.
There are several criteria that need to be met before a child or an adolescent could be considered for bariatric surgery:
- the obesity has to be severe, associated with serious health problems and be resistant in conventional weight loss methods
- children are usually at least 12 years of age and it is preferred that they have attained at least 95% of adult stature and is adequate sexual and bone maturation
- the family must be supportive
- the child must want the surgical intervention and understand what is involved
- evaluations by the child’s pediatrician, social worker and psychologist are also important
It is my experience that if there is an experienced medical team in place with the commitment to provide the necessary support to these children, the results can be very promising with conservative and surgical weight loss interventions.
Yannis Raftopoulos, MD, PhD, FACS, FASMBS, is the Director of the Holyoke Medical Center Weight Management Program and Associate Professor of Surgery at the University of Connecticut. To learn about the Weight Management Program at Holyoke Medical Center, attend an upcoming information session, held monthly in English and Spanish. Visit www.HolyokeHealth.com/events or call 413.535.4757 to register.