Media Contact: Keith.O’Connor@baystatehealth.org, 413-794-7656
SPRINGFIELD – Adolescents whose health is at risk because of their many failed efforts at losing weight have a new option at Baystate Children’s Hospital, where bariatric surgery is now available to them in the form of a sleeve gastrectomy.
“Despite the fact that obesity has declined somewhat in the country, there are still many children whose weight remains dangerously high. For some of these adolescents whose weight exceeds 200-300 pounds, many are at risk for or already suffering from serious health problems such as diabetes, hypertension, heart disease, depression, sleep apnea and liver disease, which can make it harder for them to lose weight,” said Dr. Rushika Conroy, a pediatric endocrinologist at Baystate Children’s Hospital.
Weight loss from lifestyle modification generally results in a loss of about 10 percent of total weight in a year. These young adults are not reaching a healthier weight fast enough to address the serious medical conditions accompanying their obesity. While there is a medication to help adolescents with their weight loss, its side effects are a deterrent to their taking the prescription, noted Dr. Conroy. And, that’s where bariatric surgery is an option.
Studies on adolescents having bariatric surgery suggest the operation is as safe for them as for adults, but not enough teens have been followed after the sleeve gastrectomy to know if there are any long-term effects on their future growth or development.
“Whether you are a child or an adult, in order to lose weight, you need to reduce your caloric intake so that you burn off more than you take in,” explained Dr. Conroy.
By reducing the size of the stomach with a sleeve gastrectomy, the amount of food one eats is decreased and caloric intake goes down. The surgery also changes levels of the hormones that control appetite, so one is less hungry and fuller for longer periods of time.
During a sleeve gastrectomy, part of the stomach is permanently removed, leaving a smaller-sized stomach in its place. The new stomach resembles a banana and can hold about ½ cup of food (equal to four spoons of rice, one scoop of ice cream, or a container of
applesauce) at a time. The surgery is done laparoscopically with tiny incisions through which
cameras and surgical instruments are passed. After the surgery, patients are on a liquid diet, after which soft foods such as applesauce or oatmeal are introduced into the diet before they can begin to eat solid foods about four weeks later.
To be eligible for the surgery, patients must be 18-22 years of age and meet the requirements - having a body mass index (BMI) over 40 kg/m2 or over 30 kg/m2 with at least one obesity related comorbidity, such as sleep apnea, hypertension, diabetes, or liver disease. Testing, including blood work and various radiologic exams, will be done prior to surgery to assess for other existing obesity-related conditions, and to make sure the patient is healthy enough for surgery. Patients will also undergo six months of pre-surgery requirements involving visits with a weight management doctor, surgeon, dietitian and psychologist. Also, before being accepted to undertake the surgery, doctors want to know if a young patient has any mental health issues so that they can be treated and managed appropriately. Psychologists also assess the patient’s family and social dynamics at home to ascertain if they have a good support system to help them succeed at their weight loss.
“Support is crucial. These younger patients will be making a huge change in their life, and if they do not have someone at home to support and encourage them in their efforts and to help purchase the right foods, it will be a much more difficult process for them to undertake on their own,” said Dr. Conroy.
“Because of the length of time involved in pre-op before the surgery, we are offering the program to obese patients as young as 17 years old, who could potentially be ready to undergo their surgery as early as their 18th birthday,” said Dr. Conroy.
The sleeve gastrectomy is not a magical answer to weight loss. There are many dietary modifications that a patient must make in tandem with the surgery. As a result, Dr. Conroy said they begin to help their patients change their dietary habits from the minute they enter the bariatric surgery track of the hospital’s Pediatric Weight Management Program, through surgery and importantly after surgery, as well.
“Patients must understand that the sleeve gastrectomy is non-reversible, and will forever change how they eat. That means munching on a double cheeseburger and gulping down a 12-ounce bottle of soda will be things of the past and eating small meals that equal about the size of a snack cup of applesauce become the norm,” said Dr. Conroy
“Binge eating can stretch the small stomach, which can cause ulcerations or tears in the wall of the stomach. As a result of their limited eating capability, it is so important for the program’s dietitian to make sure patients are eating the right amounts of the correct foods in order to get sufficient vitamins and minerals to maintain their health,” she added.
Potential patients who want to make an appointment with the weight management physicians at Baystate Children’s Hospital for their first pre-surgery appointment, or pediatricians who are interested in learning more about the program for their patients, can call 413-794-0813. For more information on Baystate Children’s Hospital, visit www.baystatehealth.org/bch.