When Healthy Eating Isn't Enough for Severely Obese Teenagers

As the obesity epidemic in the United States continues to rise, a small number of teenagers are finding that traditional methods of weight loss just won’t cut it. For those adolescents with severe obesity, weight loss surgery — or bariatric surgery — may be an option. While healthy eating and exercise are recommended first when trying to lose weight, this surgery could be a life-changing (or even life-saving) choice for some obese teens.

What Does It Mean to Be Severely Obese?

The term “severe obesity” refers to those with an exceptionally high body mass index (BMI) — one that’s greater than or equal to 120 percent of the 95th percentile. It also refers to anyone who has failed to respond to traditional weight-loss strategies and has developed comorbidities.

These medical comorbidities may include issues such as type 2 diabetes, hypertension, cardiac hypertrophy, sleep apnea, nonalcoholic fatty liver disease (NAFLD), abnormal kidney function, depression and impaired quality of life. Teenagers who are affected by severe obesity may be candidates for bariatric surgery.

Bariatric Surgery Could Mean a Second Chance for a Healthier Life

More and more teenagers are electing to undergo bariatric surgery when other options to improve their health fail. While there are lots of criteria to consider, it’s possible that a teen with severe obesity could greatly benefit from surgical intervention. For teens with comorbidities, weight loss potentially can stop the development of these diseases, or even reverse them entirely.

As of 2019, approximately seven percent of girls and almost 10 percent of boys ages 12 to 19 years are severely obese in the United States. Statistically, these kids will likely remain in the obese range as adults. In fact, 65 percent will have “Class 3” obesity as adults, meaning a BMI of 40 or higher.

When thinking about bariatric surgery for your child, it’s important to consider the long-term implications. Having bariatric surgery now could lengthen your child’s life. Severely obese teens have a greater prevalence of cardiovascular risk factors compared to children with lesser degrees of obesity. They’ll also have more health complications and a higher risk of mortality compared to those who developed obesity during adulthood. This is why adolescents with severe obesity should be considered for a surgical option after they’ve failed a medically supervised weight-loss program.

Your Teen’s Physical and Emotional Maturity

Even though bariatric surgery has evolved significantly in the last 20 years, for children who are still growing, the procedure could cause lifelong issues with vitamin deficiency and absorption. Although rare, these issues could affect future growth and bone development.

It’s essential that teens who undergo weight-loss surgery make healthy and responsible post-surgery choices. Emotional maturity is the key to following a nutrition and lifestyle plan set by their physicians, or the surgery could prove to be ineffective.

In cases where your female adolescent is sexually active, surgery can affect their fertility. During the process of losing weight, fertility rates can suddenly reverse. Therefore, girls choosing to undergo bariatric surgery should discuss contraception and fertility issues with their physician, or even opt to go on birth control afterward.

Not a Miracle Cure

Research suggests that dietary and behavioral interventions alone rarely achieve significant long-term success for adolescents with severe obesity. This procedure ultimately can prove to be ineffective without a healthy diet. Teenagers who wish to undergo bariatric surgery still need to demonstrate that they are able to control their weight through eating in moderation and lifestyle choices. 

When considering bariatric surgery, adolescents and their families should consult with a multidisciplinary team of physicians. In addition to their specialized pediatric surgeons, teens also may be required to meet with a dietitian, pediatrician, personal trainer, psychiatrist or psychologist and other experts. Remember, at any age, anyone going through this surgery will need lots of information and support before and after the procedure. Healthy living, even with benefits of bariatric surgery, is a lifelong commitment.