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For Obese Teens, Surgery Is the Last Resort
Extreme obesity plagues more than 5 million teens and young adults, experts estimate. These youths tend to be at least 100 pounds or 100 percent above their ideal body weight.
Teens who have a body mass index (BMI) of 40 or greater are considered extremely obese. BMI is a way of calculating whether a teen or adult is overweight or obese. It is based on a measure of weight and height. A teen is overweight if his or her BMI is 25 to 29.9. Moderate obesity is 30 to 34.9, and severe obesity is 35 to 39.9.
The toll for that extra weight includes an increase in risk for heart disease because of high blood pressure and high cholesterol; obstructive sleep apnea, which can affect learning and quality of life; a high risk for type 2 diabetes; and a shortened lifespan. Psychological problems include poor self-esteem, depression, eating disorders and social discrimination.
Reducing stomach size
What's a parent to do? More and more are looking at the same last resort as adults: gastric bypass or adolescent bariatric surgery (ABS). Such surgery, in effect, reduces the stomach's size by about 95 percent. People who have this surgery generally feel full after eating one to two cups of food. Because less food can be eaten, the teen will need a vitamin and mineral supplement. The supplement should include B complex vitamins, vitamin E, iron, calcium and vitamin D. Calcium and vitamin D are especially important for bone strength.
No one's sure how many surgeries have been done or are being done on children. Still, they're clearly on the rise. Studies of a small number of teens who have had ABS found that teens can lose up to 59 percent of their initial body weight.
ABS isn't right for all obese teens. Doctors do not yet know the long-term outcome of ABS. In a recent Pediatrics article, Dr. Thomas Inge wrote that ABS is warranted in most cases only when adolescents:
Have tried but failed at organized weight-loss attempts of six months or longer.
Have a BMI of at least 40.
Have finished most of their skeletal growth. That generally means girls must be at least 13 years old and boys 15.
Have obesity side effects that weight loss would help fix.
In addition, ABS should be done only when the risk of surgery is the lowest. Risk increases as BMI increases. Teens who are in the super obese BMI category (BMI greater than 50) may have less successful surgery than teens whose BMI is lower.
Children must be willing to make a major change in their diet and make a significant effort in a supervised weight loss program for 6 months.
Parents and children must also understand the risk for complications, including the slight but real risk for death.
Long-term follow-up for ABS is a must. So is a strong commitment from you and your teen. There is a real risk of regaining weight. The surgery is only one step in a life-long weight loss program, which also includes dietary changes, vitamin and mineral supplementation, and exercise. A teen who has ABS should get nutrition counseling immediately after surgery. Because the teen will be eating less food, it's especially important that he or she follow a well-balanced diet.
Here are important suggestions for teens who have ABS:
At mealtime, lean protein should be eaten before other foods.
Drink 8 to 12 8-ounce glasses of fluids every day. These beverages should be sugar-free.
Don't snack between meals.
Get 30 to 60 minutes of exercise every day.
Take a multivitamin every day.
The risk for gallstones and peptic ulcers increases for a teen who has ABS, and this risk continues through life. The doctor may prescribe medications to reduce the risk for these conditions. The teen may need to avoid certain other medications, such as some non-steroidal anti-inflammatory drugs.
Hours: Monday - Friday, 6 am - 6 pm
What Makes This Center Different from other Surgery Centers?
The Surgery Center of Weston LLC is a 100% physician-owned ambulatory surgery center and provides the highest quality care in a warm, personal outpatient setting.
Advanced technology and techniques have made it possible to do more procedures than ever in outpatient centers such as the Surgery Center of Weston LLC. Since the Center is designed exclusively for outpatient surgery we are able to offer you a more convenient and personalized setting at a lower cost. Still, the Surgery Center of Weston is similar to a hospital in several important respects.
- Your surgical team includes board-certified anesthesiologists, registered nurses and other qualified personnel specially trained in surgical and recovery care
- Our surgical suites and special procedure rooms are equipped with the latest technology and the most sophisticated and reliable equipment.
- We meet the strictest standards of care required by national surgery center governing bodies, Medicare and the State of Florida
Prepare for Surgery
The Day of Your Procedure
After Your Procedure
Prepare for Surgery
Once your surgery has been scheduled, your doctor will give you specific information. You will also get a call from one of our specially-trained nurses prior to your surgery date to review your pre-operative instructions. This includes what to eat or drink, medications to take, and arrival time.
These instructions will help ensure your comfort and reduce the possibilities of complications.
- Do not eat or drink anything after midnight (including water, mints and chewing gum) the night before your surgery. And follow all preparation instructions, thoroughly. Undigested food can cause serious complications and incomplete preparation may cause your procedure to be postponed. Our pre-op nurses will discuss these matters with you in detail.
- Bathe or shower and brush your teeth (without swallowing any water).
- Wear loose, casual clothing, leave jewelry at home and bring a case for your eyeglasses. You will be given a bag to hold your personal items.
- Arrange for an adult to drive you home, and if possible, stay with you for the first 24 hours after surgery.
- If you experience any health changes prior to surgery, or if you suspect you are pregnant, notify your doctor. Please report even minor symptoms such as low-grade fever, cough or cold.
- Diagnostic studies and lab work will be taken care of by your doctor. They will arrange for any tests and discuss where they can be performed.
- If your child is having surgery, feel free to bring a favorite toy. Stuffed animals or blankets help comfort and reassure small children.
The Day of Your Procedure
On the day of your appointment, plan to arrive at least one hour before your scheduled surgery so you can fill out necessary paperwork and be prepped for surgery by our nursing staff. Children must be accompanied by a parent or legal guardian.
After Your Procedure
After surgery you will be moved to our fully-equipped recovery area where you will remain under close observation by our anesthesiologist and recovery nurses until you are ready to go home. Most patients are able to leave one or two hours after the procedure. Your surgeon will provide instructions on diet, medications, rest and post-op visits, and our staff will give you a written summary of these instructions.
We Welcome Your Suggestions
No one is better qualified than you to measure our success. Please complete the confidential patient questionnaire and return it to us the week after your surgery. Your comments and suggestions will help us continue to provide the level of care you expect and deserve.
The Center provides superior care in a cost-effective manner: Our fees include all routine supplies, equipment and nursing services required for your procedure. Your physician may request special items, such as braces, implants, or x-rays, for which you may be charged. Your surgeon, anesthesiologists, and pathologist (if applicable) will bill you separately for their services.
You will be called prior to your surgery day to verify insurance information and make financial arrangements. The Center participates in Medicare, Medicaid, and many HMOs and PPOs. If your insurance requires special authorizations, referrals or claim forms, it is important that you bring them with you. Please bring all current health insurance identification cards. Depending on your type of insurance, deductible and co-payment requirements, you may be asked to bring a deposit with you. The Center accepts MasterCard and Visa. Special financing may also be available for cosmetic procedures.