Allowing teens to have weight loss surgery is often viewed as a questionable choice, but for 21-year-old Kayla Maryles, who underwent gastric band surgery in December of 2008, it's a choice she would gladly make again.
And she may not be alone -- gastric banding, a laparoscopic procedure that places an adjustable band around the stomach to limit its size, is becoming more common among obese teens. What's more, new research suggests that the procedure is much more effective at helping them lose weight than diet and exercise alone.
Maryles, currently a senior at the University at Buffalo, had struggled with her weight since early childhood. She was physically active and involved in sports, but by the time she was 20, she weighed 250 pounds.
After her mother had surgery and successfully lost weight, Maryles decided to try gastric band surgery.
"I was hesitant as to whether I should have it -- I was always active and I was so young," Maryles says, but a year later she has lost 72 pounds and says she is "really happy" with her decision.
The surgery was painful, she says, but "it was not unbearable -- I would gladly do it over again three times [to get these results]."
Though the FDA is considering broadening its standards on gastric banding to include teens aged 14 to 17, the procedure is currently approved only for adults. Doing the operation on teens is not prohibited, but it is considered off-label use -- and it is hotly debated among doctors.
But new data may help shift the debate in favor of surgery. When compared with those in diet and exercise programs, gastric band patients lose over ten times as much weight after two years, a new study finds.
The study, published Tuesday in the Journal of the American Medical Association, is the first of its kind to compare behavioral weight loss interventions in teens to gastric band surgery.
In the study, fifty obese teens, aged 14 to 17, were randomly assigned to receive the surgery and post-op diet training -- or to have no surgery and go through intensive diet and exercise programs.
Two years into the study, the gastric banding group had lost an average of 76 pounds while the lifestyle group had only lost an average of 6.6 pounds -- with some actually gaining weight during the program.
But does that justify the risks of surgery?
Unlike gastric bypass or stomach stapling, gastric banding is a less-invasive, laparoscopic procedure. The band around the stomach can be adjusted or removed by a doctor.
Nonetheless, there were still a considerable number of surgical complications in the study -- one in three patients required follow-up surgeries.
"These teens are expected to keep the band for 60-plus years," says Dr. Jonathan Schoen, bariatric surgeon at the University of Colorado Hospital. He says the safety of the surgery is "something entirely unproven. There is no doubt that bariatric surgery has a very important role in adolescent morbid obesity. However, which operation will provide the best and longest-term outcome is still a matter of much debate."
David Arterburn, assistant investigator at the Group Health Research Institute, agrees, adding that "adolescents should be well-informed regarding the high likelihood of needing a repeat operation" when deciding whether to take the plunge and try surgery.