The Debate Around Teen Obesity Treatments

The HealthGal Health Guide
  • My next series of blogs will address a number of stories in the media that revolve around....fat.  Fat director doesn't get seated on a plane; teens may be better served by gastric surgery rather than lifestyle habit change; candy makers are cutting the serving size of "fattening candy;" models want to be a size four but the fashion industry demands a size zero; ice dancer puts on weight and skates better; comedian and supporting star on Curb Your Enthusiasm battles his unsatiable appetite.  Each story is unique in its perspective regarding food, over-eating, body size issues, chronic obesity and health, as it relates to diet.  First blog up: The debate on teens and gastric surgery.

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    Once eating habits are entrenched, it can become nearly impossible to retrain a person's relationship with food.  That's because habits like constant over-eating and eating foods with certain pleasurable tastes, train your body to expect both experiences at every feeding.  So though weight issues can be caused by a multitude of behavioral issues and then modified by some physical pre-dispositions, these 2 features of eating are quite powerful.  Studies also indicate that if you are born to overweight parents, it is quite likely you'll be overweight too.  There seems to certainly be a genetic component - maybe a sluggish metabolism, maybe a reduced level of circulating brain hormones that regulate appetite and satiation and that predisposition, if it is there, gets compounded by:


    • Eating habits in the family that might include eating a diet of high calorie, high fat processed foods
    • Rating too much
    • Sedentary behavior
    • Learning from your parents that food can help you deal with emotional feelings. 


    Researchers are still trying to work out which influences are most important when it comes to developing serious weight issues, but the result is that the destiny of an overweight child is to become an overweight teen.  Until recently, the only option for an obese teen was dieting, exercise, behavior modification and some medications approved for the treatment of obesity.  Recently the use of gastric bypass surgery (a permanent surgical solution) and gastric-band surgery (a weight loss surgery that can be reversed) was approved for extremely overweight teens.  Some new studies have compared surgery (either one) to just lifestyle modification, and in these studies the surgery seemed to provide better outcomes.


    The surgical approaches seem to allow reversal of certain health issues associated with ongoing teen obesity including the enlargement of the left side of the heart (which if allowed to continue can result in serious heart disease) and a reversal of insulin resistance, which if left untreated can result in diabetes type 2.  So when you're dealing with teens and the inevitability of early and serious disease you want to offer the teen the treatment that is most likely to prevent devastating health conditions.  The problem is that surgeons still don't know which surgical solution is preferable in terms of long-range weight loss and maintenance.  And all surgical procedures have their own inherent risks.  Surgery also is typically not successful in kids who don't receive serious lifestyle counseling before and after these procedures.  And overall, we don't know what happens to teens in adulthood, both physically and emotionally, if they do have these surgical procedures for weight loss.  We do know they need to take certain supplements for life, or else they risk serious nutritional deficiencies.  The debate surrounding teen obesity treatments will continue.



Published On: March 24, 2010