Childhood Obesity and Bariatric Surgery

Childhood obesity and adolescent obesity is linked with many serious health issues in adulthood.  Unfortunately, there is little evidence that preventive measures such as lifestyle interventions and pharmacological treatments are effective.  There are several surgical procedures for children and adolescents but the long term effects remain uncertain.

Researchers from University College of Gjovik and the University of Oslo, Norway in a paper “Bariatric surgery for obese children and adolescents:  A review of the moral challenges” concluded that surgery on children’s healthy organs to discipline their eating behavior in order to help them to be socially acceptable or to compensate for poor parenting is ill advised.  There needs to be more evidence on outcomes and risk factors.  There also needs to be a valid consent or assent.

In making a decision on bariatric surgery for children and adolescents, parents need to look at the moral implications with regard to values, viewpoints and arguments before they make the decision to go forward.

bariatric surgery child obesity

Long Term Outcomes and Benefits of Bariatric Surgery for Children

There is little evidence on the benefits of bariatric surgery on youngsters.  The overwhelming research has been on adults and those results don’t necessarily generalize to a children and adolescents.  If, after 100 – 150 procedures there are few complications then it might be permissible to perform this procedure, but only in specialized, high volume centers where the doctors have plenty of experience.

Much consideration needs to be given to how this procedure might affect psychological and social development.  Few studies address these issues.  The other moral consideration is informed consent.  Should a parent make the decision for a child, or is a child or adolescent mature enough to have a say?  Surgery should not replace self discipline.

Studies show that one third of obese adults were sexually abused as children.  So as part of the assessment process for children and adolescents, this should be addressed.

Preconceptions on Bariatric Surgery for Youth

Overweight children and adolescents are often the target of discrimination and prejudice.  And medical practitioners are known to also discriminate against the obese, by assuming they are ill prepared to take care of themselves.  So, few referrals are made for surgery among this population.  But should this social problem be addressed with surgery anyway?

Bariatric surgery poses particular questions for minors because it uses medical interventions to alter everyday behavior when there are other solutions available such as dieting, exercising, and cognitive behavioral therapy that pose no risk to healthy organs in the body.  Also this surgery does not address the many unknown causes of obesity.

In conclusion these researchers posed the following questions that need to be addressed when making a decision such as bariatric surgery for a child or adolescent:

  • Who to operate on
  • When to do it
  • Who is to decide
  • How to decide
  • Who is to operate
  • How best to prepare
  • How to follow-up

 

And the most important question would be how to generate more high quality evidence in a morally acceptable manner.

I would love to know your option on this topic of Childhood Obesity and Bariatric Surgery. Please Comment!

 

 

What Is Gastric Dumping Syndrome?

Weight Loss Surgery and Gastric Sleeve Dumping Syndrome

 

What Is Gastric Dumping Syndrome
Causes of Gastric Dumping Syndrome

Gastric Dumping Syndrome is a common bariatric surgery issue, specifically with Gastric Sleeve and Gastric Bypass.  After having weight loss surgery the way a person eats changes dramatically.  Gone are the large meals because the stomach is reduced by approximately eighty to eighty-five percent leaving only a sleeve or tube that is the shape of a banana.  The new stomach you have after gastric sleeve surgery does function normally so you do not have as many food restrictions but you just cannot eat as much.

 

What is gastric dumping syndrome and why do you get it?

 

This is the problem that can develop, especially if there are foods eaten that are have a high content of sugar.  It is also referred to as rapid gastric emptying.  It is very common to have this after having gastric sleeve surgery.  Normally a person will experience it after eating but in some cases it will happen one to three hours later.  There are some people who have gastric dumping syndrome at both times.

 

When you have had gastric sleeve surgery the opening that is between your stomach and small intestine has been removed.  The opening at stomach, called the pylorus acted as a brake before surgery to help your stomach empty slowly.  Since there is no longer a “brake” the stomach contents just rushes into your small intestine. As a result your body reacts by adding a big amount of gastric juices to your small intestine.

 

What are the symptoms of gastric dumping syndrome?

 

Gastric dumping syndrome is actually a group of symptoms.  Some of these symptoms can include:

 

  • Gastrointestinal
    1. Nausea
    2. Vomiting
    3. Abdominal cramps
    4. Diarrhea
    5. Fullness feeling

 

  • Cardiovascular
    1. Flushing
    2. Feeling lightheaded and/or dizziness
    3. Rapid heart rate and/or heart palpitations

 

If a person has gastric dumping syndrome one to three hours after eating there are other symptoms that can happen.  These later symptoms are caused by dumping a large amount of sugar into their intestine.  The body responds by releasing a large of amount of insulin which is used to absorb this extra sugar.  This can cause hypoglycemia, which is a low level of sugar in your body.  These symptoms can include:

 

  • Hunger
  • Sweating
  • Feeling lightheaded and/or dizziness
  • Confusion
  • Fainting
  • Rapid heart rate and/or heart palpitations

 

In conclusion

 

Doing a study on more than one thousand people who have had gastric sleeve surgery, all have experienced gastric dumping syndrome at some point in time.  Two-thirds had the early symptoms while the other third had the later symptoms.  There were a few who had both symptoms.  As you can see, it is a common problem after having weight loss surgery.  It is not a life threatening condition and can be easily remedied by changing their eating habits such as

 

  • Eat smaller meals
  • Avoid drinking anything with meals
  • Limit your intake of drinks and food with a high sugar content
  • Increase the amount of fiber in your diet
  • Stay away from foods that are acidic
  • Lie down at least ten to fifteen minutes after eating