Last updated: May 17, 2011
Courtesy of Sanders Family
Bariatric surgery is not for the moderately overweight. Although there are no consensus national guidelines for bariatric surgery for adolescents, doctors generally follow the same national guidelines for adults: The patient should have a body mass index (BMI) of 40 or higher (for example, someone 5'4" would have to weigh at least 233 pounds to qualify), or a BMI of 35 (a weight of 204 for someone 5'4") or greater with serious obesity-related health problems, such as type 2 diabetes.
Doctors usually don't perform the surgery on children until they have gone through puberty and have stopped growing. This is because there could be increased likelihood of a nutritional or vitamin deficiency after surgery, which could hinder bone growth and sexual maturation, Dr. Michalsky says.
The post-surgery recovery is no picnic. Patients stick to a liquid diet for weeks and then gradually phase in solid food.
Because bariatric surgery limits the amount of food patients can eat, adequate nutrition after surgery is important. Teen and adult patients alike need to take vitamins and minerals following surgery, in some cases for the rest of their lives. Iron is a common deficiency that puts patients at risk of anemia.
Sometimes just the process of preparing for surgery is enough to trigger serious lifestyle changes that can help teens avoid it. Although bariatric surgery is much safer since it was first introduced in the late 1960s, it does carry a risk of side effects and serious complications such as stomach leakage (after gastric bypass and sleeve gastrectomy) and malfunctioning gastric bandsthat can require corrective surgery.
Some extremely obese teens find presurgery prep can even change their lives for the better. Josh Caudill, a high school senior in Austin, Ind., weighed 472 pounds and had tried the Atkins diet, Weight Watchers, and several fad diets when he decided to investigate weight-loss surgery. "I kept trying and I just couldn't do it," he says. "I was getting [to the point] where walking was hard."