(NaturalHealth365)  As most of us are well aware, obesity – defined by the World Health Organization (WHO) as an abnormal or excessive accumulation of body fat that presents a health risk – is quite literally a growing problem.  The WHO estimates that the global prevalence of overweight and obesity among children aged 5 to 19 increased from just 4% in 1975 to 18% in 2016.  Looking at the United States in particular, the statistics aren’t any better: about 1 in 5 American children and adolescents between the ages of 2 and 19 were living with obesity in 2017-2020, according to the U.S. Centers for Disease Control and Prevention (CDC).  Post-pandemic, that figure has almost certainly gone even higher.

Perhaps it’s no surprise that more and more drastic measures are being taken to combat the youth obesity problem – as evidenced by the rising rates of weight loss surgery (also known as bariatric surgery) among teens.  And while one could certainly argue that there are important health benefits to losing excess body fat, new research reveals that weight loss surgery for teens could lead to some unintended consequences.

Teens with severe obesity should have access to bariatric surgery, three-letter agencies insist – but do we know the true risks?

In December 2019, the American Academy of Pediatrics (AAP) issued an updated policy statement asserting that teens with severe obesity should have the option to pursue weight loss surgery because there are “no studies to date [demonstrating] significant and durable weight loss” in this demographic as a result of lifestyle modifications like diet and exercise.

“Severe” obesity (sometimes called Class III obesity) is generally defined as having a BMI of greater than 40, where BMI is a person’s weight in kilograms divided by the square of their height in meters.  (For reference, a BMI greater than 30 is considered obese, greater than 25 is considered overweight, between 18.5 and 24.9 is considered a healthy weight, and less than 18.5 is considered underweight.  While the BMI tool has plenty of criticisms and should not be used as a sole indicator of a person’s health, it is considered a good screen or estimate of a person’s weight-associated health risks.)

In their policy statement, the AAP describes teen weight loss surgery as “safe and effective” (don’t we just love that phrase?).  Of course, that claim nicely glosses over the potential adverse effects and complications associated with this surgery, which include (but are not limited to) infection, bleeding, blood clots, bowel obstructions, hernias, ulcers, acid reflux, gallstones, the need for revision surgery, weight regain (aka bariatric surgery “failure”), and even death.  And a new study highlights yet another potential risk of weight loss surgery for teens: weaker bones!

The study, published in the peer-reviewed journal Radiology, followed 54 obese youths between the ages of 13-24 for two years.  25 of these youths underwent a type of bariatric surgery called sleeve gastrectomy, while the rest underwent dietary and exercise counseling without surgery (as the control group).  While the mean BMI for the weight loss surgery group decreased by an impressive 11.9 (and actually increased in the control group by a mean of 1.49), the researchers discovered that the surgery group also experienced a decrease in their bone strength and density, as well – definitely not the outcome anyone would hope for!

And in addition to developing weaker bones, the teens from the surgery group also ended up with a greater amount of fatty tissue deposits in their bone marrow (known as BMAT), which has been associated with poor bone quality and an increased risk of fractures.

While this was a small and relatively short-term study (thus limiting the strength of its evidence), the results do highlight the fact that the long-term consequences of weight loss surgery for kids and teenagers are still largely unknown.  Critics, such as integrative pediatrician Dr. Michelle Perro, speaking to Children’s Health Defense, say that these results demonstrate “yet another reason to call for an immediate cessation of barbaric bariatric surgery in children and address the real root causes of childhood obesity, and abandon Band-Aid solutions.”

If not weight loss surgery, then what?  How to help teens with healthy weight management

As we are not experts in obesity, we do not presume to claim that weight loss surgery is always the “wrong” choice for every teen.  We will say that if parents are considering weight loss surgery for their severely obese teens, it’s critical that their medical team discuss all the potential benefits and risks of the intervention in order for parents to make informed choices.

Unfortunately, as we’ve discussed, we simply may not yet know all the risks of teen weight loss surgery.  So, by consenting to the procedure, parents could unknowingly subject their children to future health risks that could match or even exceed the risks associated with severe obesity.  Plus, no matter how one feels about weight loss surgery, not all teens (or adults, for that matter) are appropriate candidates, anyway.  So what can parents and teens do?

Clearly, sustainable weight loss is a highly nuanced and challenging issue.  Factors, including environmental, socioeconomic, and (of course) lifestyle choices related to diet and exercise.  That said, here are some of the suggestions offered by many experts to help the kids in your life maintain a healthy weight:

• Eat organic food (as much as possible) and don’t buy processed foods to avoid unwanted chemicals that wreak havoc on your metabolism.  And, stay well hydrated with clean (purified) water to promote detoxification.
• Limit screen time (including TV, videogames, and internet use on phones, tablets, and computers) to no more than 2 hours per day total – and no screen time for kids under 2
• Find enjoyable ways to get your kids active – children and teens aged 6-17 should get at least 60 minutes of some form of moderate-to-vigorous physical activity every day
• Make sure your kids get enough quality sleep (teens need about 8-10 hours per 24-hour period!)
• Reduce temptation by limiting the amount of calorically dense, nutrient-poor, processed foods you bring into your home and give to your kids, and instead encourage the whole family to eat more nutrient-dense whole foods

Sources for this article include:

RSNA.org
AAP.org
Childrenshealthdefense.org
Livescience.com
CDC.gov
Mayoclinic.org
JAMAnetwork.com
Obesitymedicine.org
CDC.gov
WHO.int
NIH.gov