As part of their effort to address the growing obesity epidemic, the AAP is calling for better access to bariatric surgery for those adolescents who have run out of other options, and is asking insurance companies to cover the surgery.
Their recommendation is based on a new study of 3,705 kids aged 10 to 19 who underwent weight loss surgery, primarily gastric sleeves. Of those kids, only 1.4 percent experienced complications, 3.5 percent were readmitted to the hospital and just 1 percent had to be operated on again. None of the 3,705 children died.
“Our study helps shed light on the safety of bariatric surgery, especially for young adolescents,” said study author Dr. Robert A. Swendiman from the Hospital of the University of Pennsylvania in a press release. “As clinicians we must balance the risks of surgery versus prolonged exposure to the ill effects of obesity in children.”
Physicians emphasize, however, that while this study finds that weight loss surgery in adolescence can be safe and effective, it should not be the first choice to reverse obesity.
“Weight loss surgery should be very high quality, it should be safe and it should be extremely rare,” Dr. Stephen Cook, associate professor of pediatrics and internal medicine at the Golisano Children’s Hospital at the University of Rochester, tells PEOPLE.
Cook says that performing weight loss surgery on children is still “exceedingly rare” — over the nearly 20 years he’s worked at the University of Rochester, he’s seen just one child undergo weight loss surgery. In that case, they had first tried other forms of intervention, but a separate health issue kept the patient from losing weight. Bariatric surgery helped the child lose weight, and enabled him to undergo another surgery to fix his other health condition.
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Cook, who was not involved in the study but served on the AAP committee when planning on this recommendation began, says the goal is not to push for more surgeries.
“The aim is to do a couple different things. It is to show that there are opportunities to do this, but it needs to be very cautiously considered,” he says. “I think it’s really meant to be about safety, because there are places where this is being done but it may not be being done in a safe environment.”
The intention is also to standardize and increase the amount of support each child gets, and to make sure it is covered by insurance.
“Before during and after kids have surgery, they should have behavioral and mental health support. That needs to be provided by insurance companies,” Cook says.
“It’s a double-edged sword,” he added. “It’s helpful to show that there is information on the safety of this, but it’s also something that’s only needed to a point.”
Cook does hope, though, that the AAP’s recommendation will reduce the stigma around obesity.
“I hope this raises awareness on the science side that we need to treat this as a disease,” he says. “A lot of pediatric and health care providers are biased against obesity. For a long time, insurance companies said that obesity was a choice and surgery was a cosmetic benefit and they wouldn’t pay for it. Obesity is a disease and it needs to be treated like that. It’s not a personality flaw or defect.”