Weight-Loss Surgery for Teens

Many teens try for years to eat healthy and exercise but still struggle with overweight or obesity. If healthy lifestyle habits alone have not worked for your child, then weight-loss surgery (bariatric surgery) may be an option. This type of surgery makes changes to the digestive system. These changes limit how much food the stomach can hold. This can help your teen reach and stay at a healthier weight.

There are different types of weight-loss surgeries available. The 2 procedures most often used for young people are:

• Gastric sleeve surgery (sleeve gastrectomy). This is the most common procedure. Part of the stomach is removed. A slim tube (sleeve) is made from the part that remains. This sleeve becomes the new stomach.

• Gastric bypass surgery (Roux-en-Y gastric bypass) . A small pouch is made at the top of the stomach. This becomes the new stomach. The pouch is linked to the center part of the small intestine. The top of the small intestine is bypassed.

After each of these procedures, the new stomach is much smaller. So a person must learn to eat and drink less. They will also feel full sooner.

Read on to learn more about these procedures. Your child’s healthcare provider can help you and your child decide if this type of surgery may be right for them.

Helping a teen get to a healthier weight now can also benefit them later in life. That’s because obesity can lead to long-term (chronic) health problems such as:

• Type 2 diabetes
• High blood pressure
• High cholesterol
• Sleep apnea
• Heart problems
• Joint problems

In general, weight-loss surgery may be advised for teens about age 13 and older who meet certain standards and who have either:

• A body mass index (BMI) of 35 or higher (or 120%) and health problems linked to obesity or:
• A BMI of 40 or higher (or 140%) and no other health problems

Your child’s healthcare provider can measure your child’s BMI and talk with you about the results.

If you and your teen are thinking about weight-loss surgery, it’s important to talk with their provider. The provider can help you see if surgery may be right for your child. And they can help you find a bariatric surgery center that is experienced in working with teens.

Like any surgery, weight-loss surgery has risks. Some possible risks and complications include:

• Excess bleeding
• Infection at the incision sites or in the belly (abdomen)
• Blood clots in the legs (deep vein thrombosis) or lungs (pulmonary embolism)
• Bowel blockage
• Pain after eating
• Lack of certain vitamins and minerals

Other risks for gastric sleeve surgery:

• Leaks in the sleeve
• Narrowing (stricture) in your sleeve

Other risks of gastric bypass surgery:

• Food moves too quickly from the stomach to the small intestine, causing nausea, abdominal cramping, and diarrhea (dumping syndrome). If food is eaten too quickly, vomiting may occur.

Weight-loss surgery is a major life change for a teen. It is a huge commitment. But you and your child are not alone. Getting ready for this procedure takes a group effort between the bariatric surgery center’s healthcare team, your child, and your family. This healthcare team may include:

• Bariatric surgeon
• Pediatric specialist
• Registered dietitian
• Mental health provider
• Exercise therapist
• Program coordinator

The team will assess your child to be sure they are a good candidate for weight-loss surgery. Your teen should:

• Be mentally and emotionally mature
• Understand and be ready to commit to making diet and lifestyle changes after surgery
• Have support from their family
• Not have an untreated eating disorder or mental illness
• Not be pregnant or breastfeeding
• Not have a substance use problem

The team will meet with you to decide whether gastric sleeve or gastric bypass surgery is best for your child. To get ready for the procedure, your teen will need to:

• Have a physical exam
• Have blood tests, ultrasound, and other tests to make sure they are healthy enough for surgery
• Talk with a mental health provider to make sure they are ready for surgery
• Go to nutrition classes or meet with a dietitian
• Meet any other requirements from their healthcare team

Your teen will also need to:

• Not take certain medicines during the week before surgery
• Follow all directions for not eating or drinking before surgery
• Follow any other directions from their healthcare provider

Both gastric sleeve and gastric bypass procedures are typically done laparoscopically. This means they use very small cuts (incisions). And they are done using a tiny camera-guided surgical tool. These procedures may take about 2 to 3 hours. In general, here is what you can expect from each.

When it’s time for your child to go home, you’ll be given instructions. These will include how to care for your child’s incisions and when to call the healthcare team.

After recovering from the surgery, your child will need to:

• Chew food completely
• Learn how much food they can eat
• Make healthy food choices
• Not eat certain foods
• Get regular physical activity
• Take nutritional supplements as advised
• See a dietitian and other healthcare providers as often as needed

Teen girls should take steps to prevent pregnancy for 12 to 18 months after surgery. Talk to your teen's provider about pregnancy avoidance counseling and contraception both before and after surgery.

Emotional support is also key after weight-loss surgery. Ask the healthcare team about resources such as an in-person or online support group. Connecting with other young people can help your child adjust to their new lifestyle and cope with any challenges.