New York – As the popularity of stomach surgery has skyrocketed among obese adults, a growing number of doctors are asking, “Why not children, too?”
For decades, the number of kids trying weight-loss surgery has been tiny. The operations themselves were risky, with a death rate of about 1 in 50. Children rarely got that fat, and when they did, pediatricians hesitated to put their developing bodies under the knife. Only 350 U.S. kids had such an operation in 2004, according to federal statistics.
But improvements in surgical technique and huge increases in the number of dangerously obese children have begun fueling a change of heart.
Four hospitals, led by Cincinnati Children’s Hospital Medical Center, are starting a large-scale study this spring examining how children respond to various types of weight-loss surgery, including the gastric bypass, in which a pouch is stapled off from the rest of the stomach and connected to the small intestine.
Three more hospitals have approval from the U.S. Food and Drug Administration to test how teens fare with a procedure called laparoscopic gastric banding, where an elastic collar installed around the stomach limits how much someone can eat.
The FDA has hesitated to approve a gastric band for kids, but surgeons at New York University Medical Center reported in the Journal of Pediatric Surgery that it holds promise.
The 53 boys and girls, ages 13 to 17, who participated in NYU’s study shed nearly half their excess weight over 18 months, while suffering relatively minor complications. Their mean weight at the study’s start was 297 pounds.
Crystal Kasprowicz of St. James, N.Y., said she lost 100 pounds from her 250-pound frame after having the band installed at age 17. “I’m a totally different person,” she said.
Kasprowicz said she used to take medication for a rapid heartbeat and was showing signs of developing diabetes. Dieting didn’t work, she said. Her heart problems made it hard to exercise. Even walking upstairs was a challenge.
Now, she’s off the heart drugs. Her blood-sugar levels are in check. She also feels better about herself.
Similar studies are underway at the University of Illinois Medical Center in Chicago and at the Morgan Stanley Children’s Hospital of New York-Presbyterian.
Children are candidates for surgery only after they have spent six months trying to lose weight conventionally under hospital supervision. So far, not a single one has slimmed down enough to take surgery off the table, said Dr. Jeffrey Zitsman, associate attending surgeon at Morgan Stanley Children’s Hospital of New York-Presbyterian.
Thomas Wadden, an obesity expert at the University of Pennsylvania School of Medicine, said teens who are candidates for surgery “have to be selected with caution to make sure that this aggressive step is absolutely necessary.”
