Friday, June 15, 2007
Obesity surgery safe for teens? Let's have a closer look!
So the latest scoop in all the papers is that an obesity surgeon, Dr Varela of the UT Southwestern Medical Center in Texas has reported on a study which suggests that obesity surgery is "safe" for adolescents. He presented his findings at the 2007 ASBS convention in San Diego.
The study apparently compared 309 adolescents aged 12-18 years (first 30 days post op) with 55,000 older patients who were likely mostly gastric bypass patients. The teens probably were mostly lap band patients which is significant since the lap band which does not involved any cutting or stapling or rearranging of the GI tract is thought to not interfere with the digestion process. By contrast, gastric bypass surgery in which most of the stomach and some of the small bowel is bypassed has a complication and fatality rate similar to open heart surgery i.e. 2 percent of patients die within 30 days of surgery ((report delivered to the College of surgeons in Oct 21, 2003.[Study title: The Impact of Bariatric Surgery on Patient Survival: A Population-Based Study])
The finding of this study was that since none of the 309 adolescents died, bariatric surgery is "safe for teens".
Even if the teens did receive the safer lap band surgery, the study's conclusions are questionable. And one bariatric surgeon I asked about it, did opine this. He wrote that people should know that although lap band surgery can be done with reasonable safety, even healthy teens can and do die from it.
It's especially questionable to do surgery on teens since clinical studies (without the fatal flaws of the Varela study) have suggested that anyone can "get healthy" WITHOUT ANY weight loss at all by simply changing the life style to healthier food choices and frequent exercise. It is sad that with all we know about obesity and the fact that dieting can not only pose severe health risks but also doesn't work in the long run for 95 percent of the population... knowing all of this, parents are STILL advocating this as a good idea for teens, unfortunately, often encouraged by their medical providers.
It's clear that "the world" is buzzing about this study. The contact phone number for Dr Varela has been removed from his website and even those of us who could obtain it from cached web pages, found they were no longer answering their phones today.
And the scary thing about this study is that it's a well known fact that teens are obsessed with the need to "fit in" and really are not at all interested if how they accomplish this could have catastrophic repercussions in their adult lives. Statistics show us that there are more teens starting to smoke cigarettes today than there were in the 1960's before the dangers of tobacco usage were known. It is suspected that many teens smoke in an attempt to control their weight.
Teens seeking a quick solution (which obesity surgery appears to be, from the TV ads where teens obtain most of their information) and parents worried by the barrage of media items stating that obesity in children is especially dangerous (and suggesting that parents who do not starve their kids into slimness are abusive) seem an EXTREMELY fertile field for those who would like to sell obesity surgery - a large group of people who will NOT ask the HARD questions (such as the long term repercussions or efficacy of obesity surgery) and will not bother to do much research before making their decisions.
The ideal population from a marketing point of view.
I would hope that parents of teens pushing for Weight Loss surgery would do some research in better places than the news media. Here is one informed consent information website they can visit:
There are many facts which are not getting out through the mass media - for example, at the 10 year point,according to the Swedish Obesity study which is one of a very few long term studies of bariatric surgery, only 35 percent of gastric bypass patients were "cured of diabetes" at the 10 year point after surgery. (the surgeons claim a 70 percent cure rate immediately after surgery). Even more interesting is that fact that a full 33 percent of type II diabetics are not overweight and have never BEEN overweight - and this strongly suggests what seems obvious to some of us i.e. that genetics are the most prevalent factor in type II diabetes.
And if the teens want to fit in by obtaining obesity surgery, they should re-think this because part of fitting in is NOT having to vomit after visiting a restaurant with ones friends (or worse yet as numerous gastric bypass patients have described to me) suffering involuntary vomiting, possibly at the restaurant table (a small study of 10-15 year post ops observed that 68 percent complained about involuntary vomiting). That type of stuff will set them apart much more, I suspect, than even extreme obesity.
I keep remembering the article which appeared in the Denver news media a few years ago. A smiling young man was pictured and the article told us he'd had a very drastic type of obesity surgery which includes the cutting away of 75-80 percent of the stomach and the bypassing of most of the small bowel. He was still slim at the age of 22 (he had his surgery when he was 18) but the article stated he already had, at that tender young age, "severe osteoporosis".
As a surgeon friend of mine has said: "fat and healthy still trumps slim and sick!" I hope people will think out these decisions and review ALL their options before making their choices.