Weight loss surgery for older children

The terms "overweight" and "obese" refer to serious medical conditions in which excess body fat accumulates to the extent that it may have an adverse effect on health. Obesity is measured by body mass index (BMI), a calculation using height and weight. BMI does not measure body fat directly, but is an indicator of body fat for most adolescents.

Being overweight or obese can cause an increase in many health-related illnesses and contribute to a decrease in quality of life. Obesity puts adolescents at risk for:

• Elevated cholesterol
• Fatty liver disease
• Hypertension
• Polycystic ovarian syndrome
• Pseudotumor cerebri
• Sleep apnea
• Type 2 diabetes

Treatment options

At our Healthy Lifestyles Center, a team of dietitians, exercise specialists, psychologists, medical and surgical specialists, and nurses provide comprehensive lifestyle management for the treatment and prevention of obesity and weight-related medical conditions. Through specially-designed programs and services, team members work closely with adolescents and their families to promote healthy weight-management, eating, exercise and lifestyle habits with a focus on lifelong change.

Treatment options include:

• Behavior modification and support
• Increased physical activity
• Medical management
• Nutrition therapy
• Surgery

Adolescent bariatric (weight loss) surgery

Bariatric surgery may be considered as an additional treatment option for older adolescents with severe obesity and significant weight-related medical conditions. Bariatric surgery is a weight loss tool and adolescents must make lifelong changes to be successful. 

In the surgery, also known as laparoscopic sleeve gastrectomy, 80% of the stomach is removed. The remaining stomach is the shape of a tube or banana. Initial volume of the stomach is approximately 2 oz.

CHoR is the only accredited adolescent bariatric surgery center in the region, and one of several in the Mid-Atlantic region.

Benefits of adolescent bariatric surgery

Research shows that adolescent bariatric surgery, in conjunction with a healthy lifestyle, is an effective treatment for severe obesity. Surgery benefits can also include improvements in:

• Gastroesophageal reflux
• Psychosocial function
• Quality of life
• Self-esteem
• Sleep

Surgery benefits can also include the reversal of weight-related illnesses including type 2 diabetes and cardiac abnormalities such as hypertension and high triglycerides.

Qualifying for adolescent bariatric surgery

All surgery candidates must meet established criteria; participate in six months of medically supervised lifestyle intervention; and complete a comprehensive psychological evaluation. Candidates must have a BMI ≥40 or ≥35 with severe comorbidities. It is also crucial that candidates for surgery be physically mature and understand the risks and benefits of surgery.

Surgery is not appropriate in the event of:

• Active unstable liver disease
• Alcohol use
• Cardiac instability
• Clotting disorders
• Non-compliance
• Poorly controlled psychopathology
• Pregnancy (current)
• Smoking (current)

What to expect

Download our Recipe for Success chart to learn more about bariatric surgery.

• Extensive preoperative education is provided by a dietitian, including a diet plan and manual with step-by-step directions.
• Surgical patients must also commit to a liquid diet for two weeks before surgery and two weeks after surgery, gradually increasing to a regular diet with healthy lifestyle choices.
• The hospital stay after surgery is typically a few days.
• Initial food volumes will be less because of the stomach's size, but they will gradually increase over time.
• Bariatric surgery patients require lifelong follow-up care.