 tightened or loosened to increase or decrease weight loss. Doctors adjust the band at periodic visits by inflating or deflating it through a port placed under the skin. The band may even be removed entirely if necessary, allowing the stomach to return to its normal size.
The cons are that it may not take off as much weight as the surgical bypass and sleeve options, and it may require replacement surgery later. Gastric band devices are not FDA-approved for people younger than 18. Though clinical trials are underway, most teens will not be able to get gastric band surgery.
Figuring out if a teen is a candidate for weight loss surgery is a big decision that requires a team approach, including the teen, his or her family, doctors, nutritionists, and psychologists.
Generally, a teen's body mass index (BMI) — the number calculated from a person's height and weight that estimates body fat — should be 40 or higher, which constitutes severe obesity.
A teen with a slightly lower BMI (35 or higher) also may be a candidate for surgery if there are health problems like diabetes or obstructive sleep apnea. He or she must also be physically mature, which generally means at least 13 for girls or 15 for boys.
The team will consider other things, too: Is the teen healthy enough for surgery? Have other weight loss options failed? Does he or she understand what's involved? Weight loss surgery is serious stuff — both physically and emotionally.
In fact, having the operation is only one step in losing weight. Teens need to build a new relationship with food — eating very small amounts, chewing thoroughly, and evenly spacing out food consumption throughout the day. For many, adjusting to this whole new way of eating and living in a "new" body can be overwhelming.
That's why doctors take a cautious approach when it comes to weight loss surgery for teens, and only recommend it for those who have what it takes to make it a success: the motivation to make lifelong changes and the support of their family to help them do so.
Weight loss surgery, like any surgery, does come with risks. Uncommon but serious risks include:
Other side effects are more common and not quite as serious, but still unpleasant nonetheless. For example, many people who've had weight loss surgery have pain, vomiting, diarrhea, and acid reflux (heartburn) after eating — especially if they eat too much or too quickly. This is why they have to change their approach to eating. If they don't, not only will they continue to feel sick, but in time they can regain weight.
"Dumping syndrome" is a problem associated mainly with gastric bypass. This is when food moves too quickly through the stomach and intestines, causing nausea, weakness, sweating, abdominal cramping, and diarrhea. Because dumping can be made worse by eating high-sugar or high-fat foods, teens need be especially careful about the types of food they eat as their bodies get used to a different mode of digestion. This can be especially difficult for teens, since fast food and sugary snacks can seem like their own food group at this age, and the pressure to fit in can make it harder to make good nutritional choices.
And last but not least, there are the emotional side effects. For example, it can be hard for some teens to figure out a new, healthy relationship with food, especially if they and others in their family have relied on food for comfort in the past.
Some teens may undergo an identity crisis of sorts and have trouble relating to others in their new, thinner body. And others have such high expectations — thinking that the surgery will boost their popularity or bring them more attention — that they're disappointed to find that old problems still exist even at a smaller size.
To be sure, weight loss surgery is not a quick fix and is not considered an "easy way out." There's a lot of hard work involved. But for teens whose health is compromised by obesity and who are willing to make the commitment to a new way of life, the effort may well be worth it.
|Academy of Nutrition and Dietetics Offering nutrition information