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New AAP Obesity Guidelines



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If you’ve seen today’s news, the American Academy of Pediatrics is recommending WLS as an option for teens who have struggled with obesity. The comments online are mostly negative.

If you were obese as a teen, and surgery had been an option for you as a teen (money is a whole other story…), would you have taken it?

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This is hard. I weighed in the 160's in middle school & was dealing with undiagnosed PCOS & thyroid issues (& I played sports) - By high school I was in the 180-190's. I would have LOVED the help, those years were so hard & being obese only amplified that.

But at the same time, I think dealing with SUCH a strict diet at that age could be risky. I feel like going from a regular teenage diet, to one of the most strict diets out there could maybe have a negative impact psychologically, I've read stories about ED's developing from less. I personally don't think I would have been able to handle such a drastic change during those years.

If anything, I HOPE there is a larger emphasis on psych care for younger patients. It's such a huge & permanent life decision & I'd want this to go as smooth as possible for them. But in the end I think with proper care & proper education it could go well. It'd be nice to read a story of a teen with a happy ending 😌

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Ok, so I have been obese just about my entire life.

Here is my take, obesity is a problem at all ages and comes with a plethora of other issues. (mental and physical) But, lets think about us as adults for a minute, how much there is to understand. The rules, the regulations, the understanding of nutrition, counting calories, monitoring Protein and Fluid intakes, being sure to take all our vitamins... etc!

Now, as a child do you think you could keep up with that? Do you think we could have even understood the seriousness of all of it? Of what could happen if we don't take Vitamins and become deficient in something? Even, the potential complications from surgery short term or life long?

As a child, I feel like it would be up to the parents to monitor and regulate foods, vitamins and comprehend everything that the child would have to maintain.

So, why doesn't the parent just do that before surgery is required? If the parent is prepared to do that after surgery than why haven't they before surgery is even needed? If healthy habits are established at the parenting level then they (parents) already understand healthy diets and regulation of calories etc. Which in turn would naturally be passed down to their children.

I am not saying this is perfect and some kids refuse to eat anything but mac n cheese.. but those kids aren't going to succeed with WLS anyway if that is the case so why?

If the parents do NOT understand healthy eating habits, then how are they prepared to help their child any differently after surgery?

As adults, we fail and we have the capacity to understand why.

I just don't believe a child is able to maintain this lifestyle without a parents who are prepared to basically do the same exact thing.

Although, I do believe some children may really need the help of WLS I just do not believe they can maintain it without the parent taking complete control (up to a certain age).

Me as a child or teen I really don't think so. When WLS first became a thing, my best friends dad had bypass and it damn near killed him. He went from 700 lbs to around 100 and in a wheel chair in less than a year. Everything that could have went wrong did. Life long complications. I remember it scared the **** out of me! I remember it was a sole reason I waited so long to have surgery myself. Every time I considered it, he crossed my mind. He was the only person I knew for years that had it and it destroyed him.

Then, as time went on I knew other people but literally NONE of them were successful. For whatever reason, lost and gained it all back, didn't loose, didn't follow the plan, didn't understand. I don't know but I know that every story I was aware of was not a positive one.

Then my doctor actually suggested it, I started looking into it again. Researched the best surgeon around, researched every potential risk, benefit. Read for months on these forums and every article I could find online. Talked to people I knew, and had very transparent conversations about why they didn't succeed. I learned, and realized that I wasn't those people and decided to move forward.

Here I am, 9.5 months later. Kicking a**.

But me as a teen, I don't think so. I don't think teens are mature enough(and I was a VERY mature teen) to deal with all the changes and I don't think the parents are prepared to take control or they already would have.

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back then, no. I was "overweight" as a teen, not obese, and the surgeries back in those days weren't nearly as safe as they are today. If I was a teen NOW, with the safer surgeries, I probably still wouldn't since I wasn't all that overweight. If on the other hand, I was really obese (and we're talking really obese - not 20 or 30 lbs) - not sure. I doubt I would have had the discipline to stick to the rules and guidelines at that age, so maybe not.

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A teen would not have the slightest issue following my surgeon's plan. Heck a grade schooler could handle it.

Having been a precocious teen I tend to believe teens are generally able to handle themselves as much as adults generally. If I had really wanted such a surgery and made a good case demonstrating I understood the impacts my parents would have supported me.

My greater worry would be parents. The overbearing parents that push their kids into things they don't want or require and the Milquetoast parents that give their kids every whim. Neither situation is healthy for kids.

All this really depends on the individuals and family dynamics. Should we really stop the people that can deal with this stuff rationally because some people can't? As with other controversial teen surgeries it seems thorough psychological evaluation should be part of the process.

There is no one size fits all answer to these things.

But I am long past having to worry about this for me and my kids. I'm in the peanut gallery for everyone else.

Good luck,

Tek

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Here's my two cents:

Obesity is a medical condition and bariatric surgery has proven to be the most successful long-term treatment option. I'm surprised that even among those of us that have had WLS, we sometimes still act like it was needed due to a lack of willpower or some sort of moral failure. We really have to get over that and acknowledge obesity as a disease state that sometimes requires surgical treatment.

To me, it follows that many children also suffer from obesity and that it would be morally wrong to withhold effective treatments options. I wouldn't withhold cancer treatments from a child, so why would it be okay to withhold WLS from children if we know that it can effectively treat their disease state?

Regarding all the comments about can a child understand the need or what's required long-term, that really feels like a red herring. Just like we all had to show that we were ready for surgery by jumping through various hoops like psych evals, nutrition visits, & documentation of past diet failures, I would expect the same to be true for children. Those children or parents that aren't ready would be disqualified, just like some people can't or won't complete all the requirements as adults.

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I wasn't obese as a teen and hardly overweight either. so I personally would not have qualified or wanted to have surgery. I think the recovery would be hard on a teen and that bariatric surgery is not a good option for teens unless they are severely obese. Children should not be on diets either, in my opinion. I think a lot of my weight problems stem from going on a diet as a teen, even though I was not technically overweight. I developed an unhealthy relationship with food and started binge eating.

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I'm not sure being an "adult" has the monopoly on making good choices or being able to "stick to plan" or even understanding consequences. The thousands of posts on this forum alone is a testament to that.

Its a very individual thing, though i do agree that for children/teens to have surgery available to them, there needs to be the buy in of the parents or guardians, unless of course the child/teen has the resources to buy their own groceries, cook their own food, transport themselves to appts etc (which more often than not, the probably don't).

i always lean on not having a hard line to things, and mostly take things on a case by case basis. Of course there will be instances where in hindsight one would rethink their decisions, but that's life i guess.

Now, would i have wanted surgery available to me as teen? It's a non-issue (for ME), as i didn't join the obesity club until my 30's. Would my mother wanted it for me? No. Would she have wanted it for my sister (who was overweight all her life and obese by her 20's?). Knowing my mother, who is/was always about looks and weight, probably. But would my sister have wanted it? Would she have been able to say no to my mother if she didn't?

Tough call.

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If it's accompanied by extensive conversations with a psychiatrist to ensure this is the patient's own decision and not their parents forcing them into it, I don't see a problem with an older teen having the surgery. I would be concerned that a child who has not yet reached their adult height/puberty yet might experience undesirable side effects like stunted growth.

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Great discussion.

When I was a teen with a BMI of 33, I would have been on the borderline. I ended up getting down to a slightly-over-normal body weight by age 21, but spent years after that going up and down, never able to get low enough (for long enough). So in retrospect, I would not have been a good candidate yet as a teen.

However, I wish I had done the surgery 10 to 15 years earlier. My own children are obese, even after our family has changed so much nutritionally (due to my changing first). I am willing to pay for my own children to have it if/when they are good candidates, and want it, when they are young adults.

If they were more obese, I might feel differently about getting them considered for surgery earlier. But I wonder what the qualifications are for teens to be recommended for WLS, and if they are different than for adults. There have to be some good reasons why the AAP would recommend this for some teens, that the pros outweigh the cons.

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