Non-Approved Weight Loss Surgery Gaining Among Adolescents
Growing numbers of obese adolescents are choosing to undergo bariatric surgery, even though it has not been approved by the FDA for people under the age of 18, a new study shows.
"There is more of an acceptance of bariatric surgery," Dr. Daniel DeUgarte, surgical director of the UCLA Fit for Healthy Weight Program and the study's senior author, tells ParentDish.
There are several types of bariatric surgery: gastric bypass, in which a small stomach pouch is created and a segment of the bowel is bypassed; the lap band, in which an inflatable device is placed around the top part of the stomach so it can hold less food; and a sleeve gastrectomy, in which part of the stomach is removed.
Researchers at the University of California, Los Angeles reviewed the records of almost 600 adolescents between the ages of 16 and 20 who had undergone bariatric surgery between 2005 and 2007. They found that the number of teens who chose the lap band had jumped seven fold, despite the technique's lack of approval from the Food and Drug Administration for use in minors. Performing the procedure on adolescents is not forbidden, but is referred to as an "off-label" use.
The authors also found that white adolescents accounted for 65 percent of the procedures, despite representing only 28 percent of those who were overweight.
Another item of note, the authors write in the journal Pediatrics, is where these surgeries are being performed. Because the use of the lap band is not approved by the FDA, insurance companies generally don't cover the procedure. Nearly half of adolescents -- 46 percent -- who chose the lap band over other types of bariatric surgery did so not in children's hospitals or in hospitals identified as "centers of excellence," but in ambulatory surgery centers, where procedures are performed on an outpatient basis, the report says. A significant number of patients who opted for the band required follow-up surgery.
More studies should be done on the efficacy and safety of weight loss surgery for adolescents, the authors recommend in the report. DeUgarte tells ParentDish he also is concerned about possible negative effects from the band in the long term.
Surgery should be viewed as a last resort and should be restricted to the most severe of cases, and only after diet, exercise and behavior modification therapy have been tried, DeUgarte tells ParentDish.
Related: Controversial Weight Loss Surgery Center for Teens Opens
Start by teaching him that it is safe to do so.