Caution urged in weight-loss surgery for teens [Updated]

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Weight-loss surgery for morbidly obese adolescents has become more popular even though many questions about safety and effectiveness remain, according to a commentary published Wednesday in the New England Journal of Medicine. Until more is known about the long-term effects of such surgery, stringent requirements to qualify for the surgery should remain in place, said the author of the report.

Weight-loss, or bariatric, surgery is much more common among adults, and studies show it produces many benefits for most patients. They lose weight and can even have a complete reversal of diabetes. But less is known about the effects of the surgery on a young person who is just finished growing but will face 60 years or more of dietary restrictions linked to surgery.

In the commentary, Dr. Julie R. Ingelfinger, senior consultant in pediatric nephrology for Massachusetts General Hospital, describes why surgery on a morbidly obese teen can seem appealing. These are patients who are often too obese to exercise and who face certain disease and, likely, a shortened lifespan due to the obesity.


Several large and important studies are now underway to examine the risks and benefits of bariatric surgery on teens. But some critics have asked, she notes: “Whether surgery converts a societal problem into a medical disease.” Already, at least 1,000 teens a year nationwide are undergoing bariatric surgery despite the lack of long-term data on how the surgery affects them long-term.

New guidelines on which teens should be considered candidates for weight-loss surgery will be released within the year, Ingelfinger notes. But until the data comes in from ongoing studies -- which won’t be for several years -- doctors should tread cautiously in qualifying teens for surgery.

“It appears that bariatric surgery for adolescents has caught on, whether ‘right’ or ‘wrong,’ ” she writes. “But the current strict requirements for having a bariatric procedure should not be relaxed until we know more.”

[For the record, 10:35 a.m. Oct. 13: An earlier version of this post incorrectly said Dr. Ingelfinger was chief of pediatric nephrology at Massachusetts General Hospital. She is now a senior consultant.]

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