Bariatric Surgery for Adolescents and Teens: Benefits, Risks, and What Parents Should Know
In Louisiana, one in three children and teens are affected by obesity1. This chronic condition not only impacts physical health but also contributes to weight stigma, bullying, low self-esteem, and other emotional challenges that can affect a teen’s overall well-being.
As the number of adolescents with obesity rises, so does the interest in bariatric (weight-loss) surgery as a potential solution. Once considered an option only for adults, bariatric surgery is now being recommended for teens who meet medical criteria. At Greaux Healthy, we want to provide parents with a comprehensive overview of bariatric surgery for adolescents, including its benefits, risks, alternatives, and important considerations.
1. Understanding Bariatric Surgery
Bariatric surgery refers to the types of operations that help the body lose weight. The most common bariatric surgeries are the Gastric Sleeve and the Gastric Bypass.
Gastric Sleeve (Sleeve Gastrectomy): This surgery removes a large part of the stomach, making it smaller so that you are only able to eat a small amount of food at a time.
Gastric Bypass (Roux-en-Y): This surgery makes your stomach smaller by creating a small pouch. The surgeon skips (or bypasses) the first part of the small intestines and connects the pouch to the lower part. This cuts back on the calories and nutrients your body can absorb.
While these surgeries are the same for adults and teens, adolescent patients require specialized considerations due to ongoing physical growth and emotional development.
2. When Is Bariatric Surgery Considered for Teens?
Bariatric surgery is just one of several treatment options available for adolescents. Your child’s healthcare provider should review all possible approaches, not just surgery, so you can make the best decision together. No matter which treatment option you choose, healthy eating habits and regular physical activity are always an important part of treatment.
Bariatric surgery should be considered as a treatment option for adolescents 13 or older who have:
- A BMI at or above 35 with other medical conditions such as type 2 diabetes or sleep apnea) or a
- A BMI at or above 40 with or without other medical conditions.
- Medical guidelines: The American Academy of Pediatrics (AAP) supports considering surgery for teens who meet these criteria.
- It is recommended that teens considering bariatric surgery should receive a mental health evaluation prior to surgery
If your pediatrician or primary care provider refers your child to a surgeon, it doesn’t mean the surgery has to happen. The consultation is simply a chance for you and your child to learn more about the surgery and understand what you need before and after to be successful.
3. Benefits of Bariatric Surgery for Adolescents
Research2 shows that teens who undergo bariatric surgery often experience large improvements in their health such as:
- Significant and sustained weight loss that improves health outcomes.
- Improvement or resolution of obesity-related conditions such as type 2 diabetes, high blood pressure, and sleep apnea.
- Better quality of life and mental health, with reports of improved self-confidence and social functioning.
“As you lose weight, you will ultimately minimize a lot of those complications associated with obesity you want to avoid, like diabetes.” Dr. Philip Schauer Bariatric & Metabolic Surgeon, Director of Metamor Institute
4. Risks and Potential Complications
Like any surgery, bariatric surgery comes with some risks. This is something you, your child, and their care team should go over and discuss. Some of the risks include:
- Surgical risks: Infection, bleeding, and leaks at the surgical site.
- Complications like nutrient deficiencies, requiring daily vitamin and mineral supplementation, dumping syndrome, and dehydration
- Emotional challenges: Adjusting to new eating patterns and potential stress around body image.
It is critical that parents and teens weigh these risks against potential benefits in consultation with an experienced medical team.
5. The Importance of a Comprehensive Care Team
Successful outcomes depend on more than just surgery. A full care team is essential, including a pediatrician or primary care provider for overall health monitoring, surgeons with expertise in adolescent bariatric procedures, a dietitian to support lifelong healthy eating habits, and a psychologist to help provide emotional support and guidance. Pre-operative and post-operative counseling are critical, as is ongoing support for both the teen and family.
The Metamor Institute in Baton Rouge has a holistic team that includes dietitians, obesity medicine specialists, and surgeons that all have experience with adolescent patients.
6. What Parents Should Know and Do
Parents play a key role in supporting their teen through the decision-making process. Key steps include:
- Asking the right questions: What are the risks? What kind of follow-up care is required? How will this affect my child’s long-term health?
- Helping teens make informed decisions: Ensure they understand both the benefits and responsibilities of surgery.
- Providing emotional and lifestyle support: Encourage healthy routines at home.
- Setting realistic expectations: Bariatric surgery is a tool, not a cure.
7. Alternatives to Surgery
Knowing the other treatment options available can help you and your child make the best decision with their care team. These include:
- Behavioral interventions: Intensive Health Behavior and Lifestyle Treatment (IHBLT) programs focus on nutrition, physical activity, and family support.
- Medication options: Medications, including GLP-1s and other weight loss medications, have shown promise for adolescents and can be used before or after surgery.
- No matter what treatment option you and your child choose, your child will need to follow a healthy lifestyle that includes eating nutritious foods and being physically active.
Bariatric surgery can be a life-changing option for adolescents with severe obesity, but it is not a decision to be taken lightly. Parents and caregivers should weigh the benefits and risks carefully and seek guidance from a comprehensive care team.
Open, honest conversations with healthcare providers are the best way to explore options and make informed decisions. As with all aspects of childhood obesity treatment, family support and long-term commitment are key.
The Greaux Healthy Resource Library has additional information for children, teens, parents and families.
Citations
- National Outcome Measure | Percent of Youth, ages 6 to 17, with Obesity. Child and Adolescent Health Measurement Initiative. 2022-2023 National Survey of Children’s Health (NSCH) data query. Data Resource Center for Child and Adolescent Health supported by the U.S. Department of Health and Human Services, Health Resources and Services Administration (HRSA), Maternal and Child Health Bureau (MCHB). Retrieved November 18, 2024 from [www.childhealthdata.org].
- Weight Loss and Health Status 3 Years after Bariatric Surgery in Adolescents. Inge TH, Courcoulas AP, Jenkins TM, Michalsky MP, Helmrath MA, Brandt ML, Harmon CM, Zeller MH, Chen MK, Xanthakos SA, Horlick M, Buncher CR, Teen-LABS Consortium. Weight loss and health status 3 years after bariatric surgery in adolescents. N Engl J Med. 2016;374(2):113-123. doi:10.1056/NEJMoa1506699