Obese Teens Face Slim Risks From Surgery

Ashlee Kopp's early teenage years were miserable.

Weighing nearly 300 pounds at age 10, she felt trapped by her weight and the stigma it carried.

"I was really sad. I was never happy, and I came home from school crying daily," she said. "It was horrible."

She tried to slim down. But after three years of diets, a personal trainer and a dietitian, Kopp found herself at nearly the same weight as when she started.

"It wasn't helping," said her grandmother, Sharon Burnside. "Ashlee would lose a little, but then gain more."

Desperate for "a way out," Kopp looked to obesity surgery after seeing it on TV. "I wanted it so bad, but my grandma said, 'Let's research it first,'" she said.

While Burnside's concern was warranted, as bariatric procedures all involve surgery, a new study shows that obesity surgery appears as safe for teens as it is for adults.

University of Texas Southwestern's Dr. Esteban Varela and his colleagues found that 30 days after surgery, only about 5 percent of teens experienced complications -- a rate nearly half that seen in adults.

There were no adolescent deaths from the surgery, compared with one out of every 500 adults who died from complications due to their procedures.

Moreover, when the study authors focused on a subset of bariatric surgeries called restrictive procedures -- such as laparascopic gastric banding that decrease caloric intake by effectively decreasing the stomach's size -- the complication rate in teens went to zero.

The new study findings came from an examination of 309 adolescents and more than 55,000 adults who had obesity surgery at academic centers throughout the United States. The results are being presented today at the American Society of Bariatric Surgery meeting in San Diego.

"Based on these results, surgery seems safe," said Varela. "We can start thinking about offering it more to parents and adolescents as part of the treatment … for morbid obesity."

Relative Health

One reason why teens may face fewer complications than adults do is because they usually start out healthier.

"Adolescents have fewer medical problems," said Varela. "When adolescents do have medical problems, they have only been there for a few years."

But although obese teens may have fewer health problems than their adult counterparts, they do have more medical problems than their slimmer peers.

Teenager Kopp, for example, had high blood pressure, shortness of breath, frequent respiratory infections and borderline diabetes.

Obese teens may also face such problems as high cholesterol, arthritis, skin infections, sleep apnea, liver disease, imbalanced hormones, depression, anxiety -- not to mention social alienation.

The presence of obesity-related illness lowers the threshold for surgery. Bariatric surgery is usually offered to patients with a body mass index -- a commonly used ratio between weight and height -- of greater than 40. But when a patient has a medical condition caused by obesity, the body mass index threshold is reduced to 35-40, making surgery an option.

Problems Down the Road?

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While Varela's study showed less immediate complications for teens getting obesity surgery, it did not look at longer-term complications, including the possibility that such procedures could render teens' digestive systems incapable of absorbing the nutrition they need.

"We don't know what's really going to be the impact of malnutrition issues over time; we need long-term clinical trials," said Varela.

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