Gastric Bypass for Kids?!

Itís horrifying. One of my memories is coming home from school and my Grandmotherís bridge club would be in the living room. Two card tables full of ladies who would pinch my arm and say things like, ìSheís big but sheís solid.î They would discuss my weight and Grandmom would just laugh and send me off to the kitchen for some of the food they were all eating. It was an annoying experience but I always got the message from my Grandmother that my body was fine the way it was. I wish all kids had this kind of support. But times have changed. The climate of fat hatred is virulent. Doctors are willing to perform surgeries on children when they admit they donít know the long-term side effects. What ever happened to first do not harm?

Being "just like everyone else" physically did NOT make my life perfect as a child. Or even any better. I was still picked on, teased, and generally made miserable growing up. I just got picked on for things like my accent, hair, and random other things that I had even less control of than whatever shape my body happened to be. *sigh*

Not all of this is being done in the name of vanity, Paul. The indidence of Type II diabetes is skyrocketing in children as more and more kids become increasingly obese. That means that these kids start having to worry about amputations, blindness, etc early in life. For kids in that situation, this surgery can be a lifesaver. Nevertheless, it is a terribly drastic step. The best case would be prevention, of course, not an after-the-fact cure.....

No, not all of it is being done in vanity; I acknowledge that. But it has been established in prior research that diabetes and obesity are not necessarily linked - similar to the old "300,000 people die from obesity" statistic, it's something that has been repeated so often many see it as fact. I see this type of surgery being promoted to the wrong candidates.

I think someone should be 18 and legally an adult before having someone else make this decision for them which will affect the rest of their lives. I dont see it working. If a child has health issues or genetic issues causing weight, WLS wont work in the long run. Overeating, that will be better dealt with by helping child change diet, otherwise they can outeat the surgery---which is something surgeons dont talk about. The long term nutritional affects will be bad.

The diabetes epidemic is happening due to sugar and corn syrup literally being poured into our food. I am having a hard time finding food withOUT it. When I buy a box of low-fat mac and cheese and see it has 9 grams of added sugar in it per serving, theres a problem. Stress is the second factor in the diabetes epidemic and relates to obesity one. Read my essay:)---The Real Causes of the Obesity Epidemic http://victoria682.tripod.com/thelargestofall/id1.html

Paul wrote: "But it has been established in prior research that diabetes and obesity are not necessarily linked." Well, I'm not sure what to make of this comment. I've seen some pretty convincing evidence that the two are causally linked...namely, if you take two random populations of monkeys and separate them, allow one population to become obese by free-feeding while keeping one population lean, the fat population has a much higher incidence of Type II diabetes. Granted, there are variables like amount of exercise, amt of sugars ingested, etc, but certainly obesity at least partially contributes to (and certainly exacerbates) diabetes. Paul also wrote: "At least some doctors in the article talk sense. But it sounds like this is being done primarily to make things easier for the kids; parents believe that if they just look like everyone else, their lives will be fine. Know what? The world doesn't work that way..." The more I think about this, the more it occurs to me that this statement contradicts just about everything else I've seen on Big Fat Blog. Being fat in modern-day America is a liability, especially for fat women -- something that all the articles posted on this site underscore again and again. Being fat means suffering from discrimination in employment, lower earnings, reduced romantic opportunities, a lower likelihood of marrying, and even limited access to parentally funded college education (for fat girls). Formerly fat people, when interviewed, say that they would rather lose a limb or go blind than ever be fat again. For fat kids, there's no question that the chance to shed their fatness and "look like everyone else" isn't merely a matter of "f***ing vanity"; it means getting access to all of the opportunities and goodies denied to fat people in modern-day America. I know that the "noble" and morally correct answer is to work on conquering America's virulent and disproportionate hatred of fat rather than resorting to drastic surgery (when not warranted for health reasons) in order to get thin. But if you were a teen, especially a teen girl, and some doctor was dangling the carrot of thinness in front of you....well, that would be a pretty strong temptation to resist, even if it meant going under the knife.

Adrienne: For fat kids, there's no question that the chance to shed their fatness and "look like everyone else" isn't merely a matter of "f***ing vanity"; it means getting access to all of the opportunities and goodies denied to fat people in modern-day America. It means getting access at the cost of diversity and uniqueness. BFB's many articles can and do point out discriminations that fat people face, but I strongly believe that getting rid of fat people (or fat kids) is not the solution. That's not even something that should be considered. Growing up is difficult for anyone and everyone, and yes, the idea of being "normal" would be mighty tempting to most young people (especially women.) But this is where our opinions differ. I think that our differences need to be respected and even celebrated. Being fat in and of itself isn't necessarily a liability; being fat in this society is seen as one, however. People should not be admonished for being fat, and the possibility of being fat should not be eliminated. It's the same as saying that "they" have found a "cure" for homosexuality - offer a surgery to kids and manipulate their sexual preferences. Finally, all of those AIDS cases will go away. Yes, I know this is playing on stereotypes. Gastric bypass surgery done on kids primarily for the sake of "fitting in" is the logical conclusion of our severely messed-up, collective self-image. It's a far better option to actually spend money teaching kids to love their bodies, no matter what shape they are. The follow-through is to encourage size diversity in adults, and equal access for people of all sizes. The answer isn't to eliminate some sizes and keep others.

I don't disagree that the "answer" to fat discrimination is getting rid of fat people (not that something like that is even remotely possible). And yes, of course, the answer lies in overcoming the ridiculous fear American society has of being fat. But what I am saying is that being fat is not a "trivial" matter of vanity; there are very real and significant disadvantages to being fat. Hence, the stampede towards bariatric sugery. And I am also saying that in light of these disadvantages, we shouldn't judge the teens who want this surgery (or their parents) too harshly. "But for the grace of God, there go I," and all that. Adrienne

Oops, the first sentence of my last comment needs a "not" before the word "getting".

Some current research (no link, sorry!) shows that Gastric Bypass may cause weight loss because the glandular portion of the stomach is affected, not because of the smaller size! The body sends out a different level of hormones after the surgery, people 'feel full' quicker. It's possible (preliminary hypothesis, no research) that regulating this hormone may have identical effects to the bypass surgery, without the physical side affects.

As an individual who resorted to extreme measures as a teenager (bulimia and anorexia) to lose weight, I can say that weighing 100 pounds less than before did not make me feel "normal." Granted, having an eating disorder makes you feel worse than you would if you lost weight in a healthy way, but to most people it doesn't matter how you lost the weight. They treat you like you're a better person just because you're thinner. But I knew that I hadn't changed on the inside at all. The only thing that changed was that I realized how stupid and shallow people are and I became incredibly cynical as a result.

I got told by my docotor that i have to loose 15 stone (not sure how much that is in pounds) to just be classed as overwaight!! I've been fat since I was born and I know I'll never ever be stick thin but this sort of thing makes me think that this is such a easy way out of loosing waigh the right way!! I'm not agenst this sort of surgery on adults who have tried to loose waight and is recomended by a doctor but I think that the money spent or these operations should be use to help educate the child on healthy eating! Plus is one cup of food a day plus no sugar?? Where will she get the energy to do things?? I think it's a shame that people are letting their kids go thru this a REALL shame!!

ALSO I think that it's avoiding the problem that kids are overwaight and fat more these days. It's like plastic surgery get rid of the bump in your nose and it will be better!! I'd like to see how eating a cup of food a day affects her mentaly as well!!

How can any sane, rational person believe it's okay to do this surgery on children and adolescents? This isn't some little thing...it's major body-altering surgery! Not only does it alter your body function for LIFE, but it's life-threatening...about one in a hundred people DIE from the procedure or complications. If I told you there was a one in a hundred chance your child would die riding the school bus today, you'd drive him/her to school. It boggles my mind that people would agree to having this done to their children. No, diets and exercise oftentimes don't "work," however this is extreme and does not address the cause of a child's obesity. Find the cause, then work on a viable solution instead of seeking the medical "quick fix." I remember when my pediatrician put me on weight-loss drugs when I was 11. These pills made me insane...and sick and dizzy. I would NEVER EVER have pills such as these prescribed to my daughter, no matter how fat she became! It's abusive! I feel this bariatric surgery is worse. As for obesity being the cause of every health issue known to man, unless I see a conclusive correlation, I'll remain skeptical. I know several skinny people who are diabetics, one of whom this past weekend had emergency gallbladder surgery, and has had bypass surgery earlier this year. This man weighs about 150 pounds soaking wet---to what do we blame his health woes? Parents, instead of permanently mutilating your children, encourage them to eat a variety of foods and to get off their behinds each day. It's not about dieting, it's not about pills, it's not about surgery. It's about offering a wider range of food choices and riding bikes with your kids.

my god... i would never do that ! " Courtney is now required to eat no more than a cup of food a few times daily, but must avoid sugar, which can cause symptoms including nausea, rapid heartbeat and stomach bleeding after the surgery. " it's about losing the taste of world, so i think i'd rather enjoy how the world goes... it's beautiful isn't it ?

What saddens me the most is that if we could get rid of the predjudice against fat and fat people there would be more of us at our natural weights and less of us overly fat because we dieted our way up the scale... How many of these children whose parents are authorising dangerous elective whole life altering surgery on them would be abit fatter than average, but ok for their body if they hadn't been put on diets, as I'm sure most if not all were, at age 10? If instead of the "thin at all costs" we talked about "healthy at all costs" and left our bodies to take their very own size. Some of us would be bigger than average, some would be smaller but all would be at a healthy weight.

This strikes me as being very close to child-abuse. I'm amazed the AMA is allowing this to be done on children, when it's still considered to be controversial with adults. I agree with the "healthy at all costs." We must not let our ideals of beauty conflict with our ideals of health, which is what we're currently doing. In times past, being plump was actually considered beautiful for a woman. So why is it now so terrible and horrible for a child to be 10, 15, 20 pounds overweight? Why can parents not love their children, no matter what? It surely is not a sign of love to torture a child so much. I cannot fathom what type of parent would abuse a child like that. Actions speak louder than words. Why are these people allowed to even have kids? There are plenty of would-be adoptive parents who want kids and would give them a loving home, if they could. It makes me cry inside whenever I hear things like this. Parents need to accept their kids for who they are, and get over the fact that their kids will not look like supermodels when they grow up.

P.S. I was overweight as a child and would still not have done this, if given the option. I'd rather be overweight, happy, and healthy than thin, unhappy and depressed. Being thin does not always equal health, despite what the popular media says. Perhaps "conflict" was not the right word above...but society in general is getting beauty and health mixed up, which isn't a good thing.

If parents and teachers alike would take the time to teach kids that teasing others about their size, ethnicity, etc., is WRONG and could be harmful, this would be a much better world to live in. Diets and WLS would become a thing of the past and everyone would be happy with themselves. Why can't it be like that? What are these so-called "adults" afraid of?

This IS child abuse and I bet in 10 years times there will be a lawsuit from a child having gone through this unecessary surgery. There are some good points above and one is that it is too difficult to find healthy snacks. Food manufacturers have a social responsibility. It's all very well saying that people have the choice not to eat junk food but when you buy a lower fat version of a product and find it is loaded with sugar it doesn't help. Sugar has a pleasing taste and it is cheap, these are the only reasons our food contains so much of it. Think of the food manufacturing process, if you're making chocolate it makes economic sense to use more sugar and less cocoa. In the meantime something parents can do is teach their kids how to cook. It's amazing how few adults can cook even simple meals these days. When you cook your meals from scratch you can see what quantities of fat and sugar go in them. I have cooked cakes with little kids and they were shocked to see the amount of sugar and butter used. And my cakes contain a lot less than shop-bought versions. This shows the kids than making and eating a cake is fun but that you need to eat a balanced diet too. It's very hard for kids not to give in to social pressure. Even if you feed your child healthy meals chances are they'll eat junk food at school or with their friends. Have you ever watched kids TV on a Saturday morning? I don't know how it works in the states but here in the UK it's one ad for junk food, one for toys, one for more junk food and so on. Research has shown younger children are not able to tell the difference between ads and programming. We need legislation to stop our kids being brainwashed.

Actually, sugar doesn't directly cause diabetes, but it can lead to conditions that cause it. Blood sugar levels can be raised by healthy foods as well as sugary foods. The myth that sugar is directly responsible for diabetes is probably one of the factors that causes everyone to mistakently think that: 1.. All overweight people eat too much junk food, and therefore: 2. All overweight people will eventually get diabetes. Neither of those myths is true. There are many good web sites which debunk diabetes myths and misinformation out there.

"America has lost its soul. Now it's trying to save its body." -George Carlin

As an over-weight teenager (I will be 18 in January), my family has been pushing me to consider having a gastric bypass for the past year and a half. While I realize something has to be done about my weight, I'm not willing to buy into the supposed 'quick fix' of my body. If these parents cared so much about their children, enough to endanger their lives to save their lives (makes so much sense...), you would think they would take the time to change their entire household ways. While we all know genetics play a huge role in 'fat people having fat kids', the most important part is fat is a way of life for many people. No excersize, fast food, television five hours a day, etc. It honestly sickens me to think that we live in a world were mutiliating ones child is thought of as "okay" because it's easier that eating right and working out.

I'd just like to add a little something. I'm a nutrition student...at school I am learning about how people process the food they eat. I can say with authority to back me up, that 1 cup of food is not enough to sustain a child. Children are more metabolically active, gram for gram, than adults. They are the most metabolically active group of people. This fact makes it difficult for children with normal-sized stomachs to eat enough to meet their huge energy needs in relation to size. In plain words, kids' stomachs are often too small (because they're little kids) to hold all the food they require for energy. That means that further altering a child's stomach to be even SMALLER, is incredibly stupid. Not only that, but lately we have been studying various vitamins (especially the B vitamins, which are particularly important in growth) and how they are absorbed. It is a consistent finding that people missing certain parts of their small intestines (as certain patients of bariatric surgery will be missing) have vast troubles absorbing vital nutrients and can suffer from deficiencies. This applies even more dramatically to children. I don't care about the argument of the health risks of obesity...the risks of not being able to meet the body's energy requirements COME BEFORE ANYTHING ELSE. Until a person can get the nutrients they require to SURVIVE, we have no business trying to alter their size. Survival comes first, even before thinness.

Hollister, I'm so glad you posted. Bless your heart! I hope you can find the strength to resist the pressure from your family to conform to a societal ideal (or head in that direction anyway) and the possible cost of your health and well being. I don't know what size you are, but no matter how big your body may be it's not a foregone conclusion that something "needs to be done about your weight." Everyone has a different weight at which they can be healthy and happy. Being a large person does not necessarily preclude those things. Best wishes to you, and good luck. Peggy, you said it well. This is an awful thing to do to a child, a growing human being. It's scary and it must be stopped.

Hey Hollister Just do and be who you wanna be at the end of the day a gastric bypass may change the way you look but it will never EVER change the person you are inside and that's the most important thing!! Much love Claire

What scared me about this the first time I saw it (on television, I think) was the thought that GBS is not reversable. So, if you did put your child under the knife for something like this and they chose not to have a stomach the size of an egg when they got older...what would be their choices? It's almost like giving your child a vasectomy when they are 10.

Mmmm. My first reaction to this article is personal: I struggled with weight problems as a child and my parents were shocked that I was heavy (the only one in the family). They put me on juice fasts. Imagine being 8 years old and only allowed to drink V8 and water for 7 days! I get the same feeling about these kids whose parents pursue gastric bypass. It's child abuse. My second reaction is professional - I'm a doctor. Elective surgery of this nature is child abuse. The complications from gastric bypass or gastric banding surgery start at 20% and go up to 80% of all surgeries performed. Are these doctors who perform the surgery pediatric surgeons? Children are not miniature adults - they are physically different than adults. Their hearts are stronger but their lungs are weaker and more prone to post-surgical complications. Complications Include - inability to eat solid foods (forever) - dumping (throwing up after eating sugar) - anorexia (unable to eat enough food to survive) - gastric bleeding - infection (this risk is very large) and many more.... This is a very dramatic step to take for an obese person and should not be attempted unless someone's life is at near-term risk due to excessive weight.

This is so sad! It makes me absolutely sick that people would even consider this. This is why, every year, I become more anti-media, because most news sources skew truth. And the average American doesn't have time or desire to research something to make sure it's true. So many lies are put forth as truth, and it almost seems like actual, objective journalism is dead. The comments on diabetes caught my eye. Sugar occurs naturally, in fairly high amounts, in most fruits. So avoiding sugar completely means avoiding all fruit, which denies the body of many of the vitamins it needs that come from fruit. Granted, the snacks out there are awful, and in desperate need of overhaul, but eliminating sugar from a diet can be dangerous. Also, another thing: what if some of these kids have been told to diet, and because of the way metabolism changes on a starvation diet (metabolism slows way down to conserve energy) what is that is causing more of the weight gain than actual overeating? I never had big problems as a kid, I was a picky eater and very skinny, but at adolescence I got hips and a waist and for many years felt bad and dieted. It's horrible. I do continue to exercise and eat fairly healthily (difficult with my dorm meal plan) and my weight does not fluctuate. Starvation diets are dangerous, and these surgeries are permanent and also dangerous.

did anyone else catch the insanely innapropriate joke on this subject in the weekend update portion of the last saturday night live? it was in such poor taste, i was so shocked...

I watched SNL but don't remember the reference. What was it?

I, too, watch SNL, and vaguely remember some reference to it, but don't remember *exactly* what it was...

I don't agree with this either, I think that kids should wait til their 18, and then make the decision to have this surgery. I was a "plump" child, it's amazing how perceptions of adults around me shifted from the baby fat cuteness, to outright comments about exercising and eating less... In turn I became much more self-counscious, and thought my body was huge, when in fact I was like a size 10 at ages 12-15! After this my weight did fluctuate a bit, plus or minus 10 pounds, til I reached size 12-14 at 18 years old, and even this wasn't such a big size, it's apparently the average size as I've found out. Now I'm 25 years old and a size 16-18, and I'm more content with my body image than I've ever been. It's soo true, there will always be those people who will tease and torture you for whatever reason, if it's not weight it will be something else, your style, or your opinions. In everyday life I've come across these vulture-type people who feed off of making other people feel bad about themselves, but you know what, only I can make myself feel bad about myself. As for weight, it's become one of those issues that are front and centre in society, fat = negative impressions, and I feel really bad for kids growing up in this environment, how can you have a good self-image/self-esteem if it's not only mean people but everyone belittling you about your weight?? Instead of promoting drastic surgery, I think that there should be an organization set up that helps kids become more active, I myself hated gym class, and by extension exercise, but I think kids need to be introducted to the many fun physical activites such as dancing, skiing etc. and I think having a forum to discuss issues like body image, and teasing will also help kids more than a band-aid surgery. Kids need the space to learn to express themselves, to find out their talents, and who they are, focussing on such a small aspect of themselves, their weight, and equating skinny with happiness is ultimatly destructive in my opinion. Further, I think that the concept of happiness itself has been taken over and manipulated by advertisers, they promise us happiness just around the bend, after you lose weight, after you're married, after you have kids, after you retire etc. it's lies. Happiness should lie in the present moment. There almost seems to be a war of sorts between the fats and the thins, and a socially sanctioned hate directed towards the overweight. We've become the nightmare of the thins, there are soo many people who want to become thin at any cost, unfortunatly these people might be the parents of the kids who are now being encourged to undergo a potentially life-threatening surgery all for vanity's sake.

In its latest incarnation... And being 300 pounds is the determining factor??? And those side effects, as someone said about a "wonder drug" in a previous thread and entry, will really make young people who get BLS popular, especially the vomiting and dumping... When does the merry-go-round of idiocy stop? Here is the article. medical examiner Radical Reduction The benefits of stomach stapling for teenagers. By Amanda Schaffer Posted Tuesday, Aug. 22, 2006, at 7:27 AM ET Last month, the already grim prognosis for heavy kids took a turn for the even worse. A study of more than 100,000 women, published in the Annals of Internal Medicine, found that those who were overweight at age 18 were more likely to die prematurely in middle age. And research published in the Journal of the American Medical Association showed that people who develop type 2 diabetes—a condition associated with obesity—before the age of 20, as opposed to later, are at greater risk of end-stage kidney disease and death before the age of 55. Obesity at any age is associated with health woes like sleep apnea, fatty liver disease, atherosclerosis, loss of vision, and some types of cancer, in addition to diabetes. But when these conditions appear in the young obese, the long-term ramifications are just scary. How about a radical solution—stomach stapling for teenagers? It may sound crazy and desperate, but several major children's hospitals, including Cincinnati Children's Hospital Medical Center, Texas Children's Hospital, and Lucile Packard Children's Hospital at Stanford, have started offering obesity surgery in recent years. Nightline recently followed a 16-year-old Texas girl who underwent stomach stapling and lost 129 pounds in six months, down from a starting weight of 368. The worry is that such stories distract from workaday efforts to improve school lunches, promote exercise, and establish good eating habits for kids. Critics also point out that stomach stapling is expensive and can cause serious complications, like intestinal leakage, bowel obstruction, and nutritional deficiencies. But for extremely obese teens—especially those who already have a related health problem—less radical treatment options may not work, or at least not work fast enough. Surgery, by contrast, can not only lead to dramatic weight loss but also improve or reverse conditions like sleep apnea and diabetes. Only a small group of kids should be eligible for the surgery, but for these few, it can be a very good thing. In a stomach-stapling operation (the medical term is gastric bypass), a small pouch is created in the upper portion of the stomach, and the small intestine is rerouted to connect with it. The benefit is that a downsized stomach will hold less food and may release fewer hunger-inducing hormones, causing patients to feel full more quickly and stop eating. To be sure, obesity surgery is a risky proposition. One small study, published earlier this year in the Journal of Pediatric Surgery, found that roughly 40 percent of kids who underwent gastric bypass experienced some kind of complication, such as intestinal leakage, dumping syndrome, bowel obstruction, wound infection, or a nutritional deficiency. (A similar complication rate has been found in adults.) Nutritional deficiencies, especially of calcium, iron, vitamin B-1 and vitamin B-12, may occur partly because patients are eating less and partly because the operation bypasses a portion of the digestive tract that efficiently absorbs many vitamins and minerals. The potential for deficiencies means that patients must adhere to strict guidelines. All patients must eat more lean, high-quality protein; exercise; and take vitamins and minerals for the rest of their lives. Teenage girls must take additional calcium and iron. Critics argue that teens are less likely than adults to follow these rules and are too young to make a decision to undergo major elective surgery. They also argue that the surgery takes on a different social meaning when performed on young people: It seems like giving up and is hard to reconcile with the cherished notion that kids can always grow and change. There's no sense in soft-pedaling these issues. But Thomas Inge, co-founder of the obesity surgery program at Cincinnati Children's Hospital, points out that when teens are more than 100 pounds overweight, the chances are vanishingly small that they will shed the necessary pounds on their own and keep them off. Programs that focus on changing diet and behavior may work for younger children whose eating habits and behavioral patterns are less ingrained; for teenagers, though, the results are often disappointing. Inge has developed guidelines to identify the small group of teens he and other doctors think should be eligible for stomach stapling. (Here's a brief summary.) Preliminary data show that surgery can really help these adolescents. In one study, teens who underwent gastric bypass lost an average of 37 percent of their body mass index by the end of the first year. Other research suggests that the procedure can reverse or improve sleep apnea and type 2 diabetes. Similar health gains have been noted in adults. But that's not necessarily a reason to delay the surgery. Inge points out that the longer a patient has had diabetes, the harder it may be to reverse the condition. The same may turn out to be true for cardiovascular disease, though the data on this are not well-established. Stomach stapling also seems to get riskier the more obese a patient is. So, an extremely heavy teen who is likely to grow into an even heavier adult might be better off opting for surgery sooner rather than later. A procedure that's less risky than stapling, known as adjustable gastric banding, may also soon make surgery a better option. During this procedure, a flexible silicone band is placed, inside the body, around the upper part of the stomach. At follow-up office visits, the band is progressively tightened (here's how). This appears to suppress appetite (perhaps by stimulating stomach fibers associated with feeling full). Gastric banding seems to cause adults to lose weight more gradually on average than gastric bypass. But it has a lower rate of complications. And it's reversible. In 2001, the Food and Drug Administration approved adjustable gastric banding for people over 18. Now a small number of researchers have received permission from the FDA to study it in teens. At NYU Medical Center, about 100 teens have undergone the procedure. About 5 percent have required a second operation because the band slipped out of position. But according to NYU lead surgeon Christine Ren, that's the most frequent complication. To date, there have been no deaths and no hospital readmissions for acute complications. Patients, who weighed 300 pounds on average before surgery, report a decrease in appetite. And they appear to be losing a lot of weight—an average of 95 pounds in the first year. Ren says that adolescents who undergo gastric banding seem to lose weight faster than adults do, perhaps because of differences in metabolism or because they're more, not less, diligent about following the post-surgery rules. There's a lot we still don't know about stomach surgery and its long-term effects when performed on young people. But for kids whose obesity is likely to be life-shortening, not to mention a source of diminished self-confidence and opportunity, the benefits may well outweigh the risks. It's heartening to have a possible life raft to offer them, however bizarre it seems. sidebar Return to article According to Inge's guidelines, teens should have a body mass index of more than 50 kilograms per meter squared or a BMI of more than 40 kg/m2 along with a major medical condition, like type 2 diabetes, sleep apnea, or pseudotumor cerebri, which can cause progressive loss of vision. For a typical obese teen who has stopped growing, a BMI of 50 corresponds roughly to a weight of 300 pounds for girls and 335 pounds for boys. A BMI of 40 corresponds to 250 pounds for girls and 275 pounds for boys. sidebar Return to article During surgery, the band is connected to a small reservoir placed deep under the skin. At follow-up visits, saline solution is injected through the skin and into the reservoir, which causes the band to inflate and tighten around the stomach. (Think of a blood pressure cuff being tightened around the arm.) Amanda Schaffer is a frequent contributor to Slate. Article Copyright 2006 Washingtonpost.Newsweek Interactive Co. LLC

Oh, this whole subject makes me want to scream. Child abuse, absolutely. One thing, there is some evidence that all of the conditions associated with obesity are more like caused by lack of exercise and/or yo-yoing. How about, we reinstate playgrounds and recess and P.E. in the schools? There was a study that found that the younger you start dieting, the more likely to developing obesity -- with a huge proportion of obese women in that study having begun dieting before they were 18. What does that say about little kids? I know a good number of people who have had WLS. I only know one who had it more than three years ago who isn't fatter than before the surgery, and that one has lost too much weight and is unable to gain any of it back; she spent over two years unable to do much more than move from the bed to the couch and back. So, we mutilate the childs guts and then they regain? When a doctor asked me if I had considered WLS I responded with, "No one is getting me to take a risk of death as high as 1 in 100" and he answered, "1 in 100 is the number who die on the table. 1 in 50 is the number who die within 90 days." And, from what I've read elsewhere, after 90 days, no one keeps count. The lack of a full digestive track means the lack of the ability to digest your food and get all of the necessary nutrients. Children's stomachs are already too small to sustain them through a growth spurt, which is why many of them get a littel chubby right before they go on one, needing to eat a lot before the growth spurt, during the growth spurt, and then after the getting taller part is over, in order to consolidate their growth. How can a child do this if she has had WLS?