Surgery Is No Quick Fix for Obese Teens
In addition, a young person must have the psychological maturity and family support to make permanent lifestyle changes, explains Thomas Inge, MD, the surgical director of the Surgical Weight Loss Program for Teens at Cincinnati Children's Hospital Medical Center.
"Two to three months are needed to really get to know the family and make sure the child really knows what they are getting into," Dr. Inge says. (The surgery may also require financial support: Many families pay out-of-pocket for the procedure, which usually costs between $10,000 and $20,000, although insurance companies do sometimes agree to cover it.)
Dr. Inge says it takes a team of pediatricians, psychologists, exercise physiologists, dietitians, and social workers to get a true sense of whether a teen is ready for the surgery and to help that patient prepare for the surgery and follow-up. For instance, surgeons typically require that a patient make lifestyle changesbecoming more active and eating healthierbefore undergoing the surgery. Doctors can evaluate whether a patient has made sufficient changes by tracking her weight and performance in a quarter-mile walk test, Dr. Inge adds.
"We really look to make sure that kids are interested in the surgery, that they're not just being pushed into it, [and] that they have some understanding of what they're going to have to do to make sure their surgery is successful," Mackey says.
Life after surgery
The post-surgery recovery is no picnic. Patients stick to a liquid diet for weeks and then gradually phase in solid food.
"My body was different day to day," recalls Michelle Montanti, 19, who had the procedure when she was 15 and weighed 250 pounds. She has since lost 110 pounds. "One day I could tolerate mac and cheese; the next day I was throwing up. It's a really hard transition."
Shaina can still eat only soft food or food that has been mashed up.
Bariatric surgeons like to say that the surgery is just a tool, not a magic bullet. Multiple follow-up visits with the surgeon and support team are required in the first year, and in order to get results from the procedure, young people must be committed to becoming more active and eating healthier for life, which often requires getting their families to do the same.
"You really have to learn the difference between listening to your stomach and listening to your head," says Montanti, who is attending culinary school and aspires to make cooking and nutritional videos for other bariatric surgery patients. "You have to retrain your body how to eat."