Childhood Obesity Leads to Unnecessary Surgeries How does a 175-pound 10-year-old sound? Or a 200-pound 6-year-old? Or, far worse, a morbidly obese 6-year-old having his gallbladder removed because a high fat diet has caused it to malfunction and become a source of pain? I'm a pediatric surgeon, and these are the children I see every day. I find myself congratulating the parents of normal-weight children - kids we now call thin - the new exception to the rule. This is my new normal, and it's not okay, not by any standard. It's madness and we are not doing enough, as individuals or as a culture, to stop it. The consequences of obesity to a child's overall health are staggering: an increased risk of pre-diabetes, high blood pressure, fatty liver, bone and joint problems, obstructive sleep apnea, and poor self-esteem. An obese child is more likely to become an obese adult, one at further risk for hypertension, coronary artery disease, stroke, Type 2 diabetes, osteoarthritis and some types of cancer. These children need help making drastic changes to their lifestyles and diet to prevent a lifetime of problems. Instead, I'm taking out their gallbladders. Twelve-year-old Marshall Reid, whose efforts to address his own weight problems are profiled in today's Dining section, is an exception to the trend in the operating room: children - or more relevantly, their parents - choosing surgery instead of the hard work it takes to turn a child's diet and habits around. When I was first practicing pediatric surgery, 20 years ago, childhood gallbladder disease was uncommon. There was a mnemonic for identifying the most likely patients to develop gallbladder problems - the Five F's - fair, fat, forty, female and flatulent. Gallbladder disease primarily affected adults. Childhood obesity has changed the demographic of gallbladder disease. Prior to the 1990s, gallbladders were removed from children predominantly because of congenital abnormalities, hematologic or other medical disorders that caused gallstones. But a recent study published in the journal Pediatrics confirms what every pediatric surgeon in the United States already knows: obesity is now the leading cause of diseased gallbladders in children by a wide margin. We are taking out more gallbladders in younger and younger patients - by some estimates, more than four times the number of pediatric gallbladders are removed now than in 1990. For many patients, gallbladder disease and its accompanying symptoms are preventable, but you wouldn't know it from the patients whose parents prefer to book the quick fix of the scalpel instead of the slow, but less invasive route of lifestyle change. Sometimes there's a sense of inevitability: mother, father, aunts, uncles and older siblings have had their gallbladders removed. It's Johnny's turn. By the time a patient gets to me, there may not be much choice about taking out the gallbladder - but it isn't the inevitable result of the problem, especially if gallstones haven't yet developed. Avoiding obesity to begin with, or shedding pounds through diet modification and increased exercise, can prevent gallstone formation and reverse gallbladder dysfunction. Taking out the gallbladder in the face of obesity is like changing the oil in a car when the transmission is going out. Until the source of the problem is addressed, obesity will continue to ravage the rest of the child. Why the concern over hanging onto one's gallbladder? The gallbladder, unlike the appendix, has a function in the human body, storing and releasing bile to aid in digestion. Without a gallbladder, bile drips into the gastrointestinal tract 24/7. While a person can live a normal life without one, some patients do experience side effects, such as chronic diarrhea or acid reflux. No one knows for certain the long-term consequences of taking out the gallbladder over the lifespan of a child, but thousands are going to find out in the decades ahead. There is nothing easy about treating childhood obesity. Drastic changes have to be made and enforced to have any chance of success, but those changes - not surgery - represent a child's best hope of becoming a healthy adult. Marshall Reid and his family offer a strong model: Marshall learned to plan and cook healthy meals, while his parents changed, too. They didn't quit when it would have been easier to go back to their old ways of eating. Marshall led the way, but his parents didn't let him fall back. Together the family instituted meaningful lifestyle change, and if they can stick to it, this could open up a whole new future for Marshall. I'll be rooting for him - and stocking his book in my waiting room. Catherine Musemeche is a pediatric surgeon. She lives in Austin, Texas. You can follow her on Twitter @DrKateM.