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Can Weight Loss Surgery Save Our Children From Themselves?

December 30, 2008 8:56 AM

By DAN CHILDS, ABC News Medical Unit

ABC News' Lisa Stark reported today in a World News report and in a story on ABCNews.com that new research suggests severely obese teens with Type 2 diabetes may be able to benefit from weight loss surgery. The study unleashed a torrent of reactions from both the public in general and the medical community, and the ABC News Medical Unit received many comments from experts in baratric surgery and diabetes. Below is some of what they had to say.

A number of doctors told the Medical Unit that performing the operation on teens is a desperate measure for desperate times -- particularly as obesity rates in those age 12 to 19 approaches 18 percent, according to the Centers for Disease Control and Prevention. Study co-author Dr. Anita Courcoulas, chief of bariatric surgery at the University of Pittsburgh Medical Center, is concerned about the teen obesity problem:

“When we find that younger patients are experiencing what we used to think of as adult-type problems, it brings up the question of whether we can apply adult-type treatments,” Courcoulas said. “These are all children with a BMI over 50. These are really big, sick kids.”

New Jersey-based laparoscopic surgeon Dr. Alexander Abkin agreed:

“I, myself, offer teens both gastric bypass and gastric banding; it works great and it does reverse or cure Type 2 diabetes. ... If kids are denied care now, they will grow to be disillusioned about their future as adults, sick with medical problems, socially inadequate because of discrimination and so on. Surgery is one of the avenues to offer that hope.”

On the other side of the debate, physicians, like New York bariatric surgeon Dr. Mitch Roslin, warned that surgery may not be the magic bullet for which many have hoped:

“Having done this for 15 years, if there is weight regain -- and there is in many [gastric bypass] patients -- the diabetes can return. ... I think it is reasonable to aggressively treat young [diabetes] patients, since their internal or vascular age is greater than gestational age. [But] I am becoming more skeptical than many of my colleagues that [gastric bypass surgery] is [the] best operation.”

Dr. Francine Kaufman, head of the Center for Diabetes and Endocrinology at the Children’s Hospital in Los Angeles, concurred:

“This should not be viewed as license for any bariatric center to start looking at this procedure in teens; the procedure should be viewed still as experimental. The take-home message is one of caution. We have no long-term data, no idea what will happen with a dramatic permanent procedure such as gastric bypass ... that has to last 70 to 80 years or more.”

And Dr. Charles Clark, a professor at the Indiana University School of Medicine, said that prevention is the only sure-fire answer to the problem:

“I view with great concern the approach to the problem in the cited article. ... The expense and morbidity of the procedure makes it an unreasonable solution. The only solution to the childhood obesity epidemic will be more successful approaches to its prevention and treatment.”

December 30, 2008 | Permalink | User Comments (6)