Surgery Is No Quick Fix for Obese Teens

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.

Malnutrition is a major concern for patients who undergo a type of bariatric surgery called gastric bypass, in which part of the stomach and small intestine gets bypassed, says Dr. Nadler. "If bypass patients stop taking multivitamins, it can result in life-threatening malnutrition."

In fact, because of the risk, Dr. Nadler performs only the other two types of weight-loss surgery—gastric banding and sleeve gastrectomy, in which surgeons remove a large portion of the stomach. These types are less common than gastric bypass, but sleeve gastrectomy—the surgery Shaina had—is gaining in popularity, Dr. Nadler says.

In addition, patients have to follow other diet rules, especially in the months after surgery, to avoid malnutrition, dehydration, and weight gain. These include eating regular, high-protein meals and not drinking liquids close to mealtime.

Starting an exercise program is equally important for post-surgery weight loss. Brandy Sanders, 19, who weighed 383 pounds when she had surgery in February 2011, has been exercising with her mother for two hours a day. "Before I had the surgery, I could do seven minutes on the treadmill and I almost died," she says. "Yesterday I did 30 minutes and I was just huffing and puffing a little bit."

Brandy has lost 33 pounds so far, and her goal is to get down to 230 pounds. "It would still be a lot more than I should weigh, but it would be a lot better than what I started out with," she says.

Making changes without surgery
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 bands—that can require corrective surgery.

Plus, there is little data on the potential long-term risks of bariatric surgery in adolescents. A recent study did show that young people lost bone mass after gastric bypass. (Dr. Inge and his colleagues don't see this as a major concern, given that these patients started out with a much higher-than-normal bone density.)

However, teens need to have their bone density checked annually for at least 10 years after surgery to make sure it's adequate, says Dr. Inge, who is currently recruiting teens for a 10-year study of bariatric surgery patients.

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Anne Harding
Last Updated: May 17, 2011

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