Tuesday, December 18, 2012

What’s working for teens with severe obesity?

A new study online in the Archives of Pediatric and Adolescent Medicine (a JAMA Network publication) finds that although weight-loss surgery for teenagers saw a big jump from 2000 to 2003, after that, the numbers of teens undergoing these procedures plateaued to about 1,000 per year in the United States.

The study, conducted by Children’s National surgeons and experts from several divisions, including lead author and Surgery Research Fellow Deirdre Kelleher, MD, as well as pediatric bariatric surgeon and investigator from the Sheikh Zayed Institute Evan Nadler, MD, and the Chief of the Division of Trauma and Burns at Children’s, Randall Burd, MD, sought to quantify the number of surgeries, the types of surgeries (open vs. minimally invasive), and the demographic of the patients electing to undergo these procedures.

The hard data findings of a plateau in the number of surgical procedures contradicts several high profile commentary pieces citing an increase in the use of bariatric surgery for teens over the last 10 years.

In truth, the data from the Children’s study, which used the AHRQ’s KID database to track inpatient bariatric procedures, finds that, since 2003, the numbers of teens undergoing these procedures has remained static, even while the rate of children with morbid obesity continues to rise.

Interestingly, in the same journal edition, a 3 year longitudinal study out of Sweden found that the more traditional weight-loss interventions involving diet, exercise, and other lifestyle interventions, while successful with teens who have moderate obesity, were not effective at all for adolescents with morbid/severe obesity—the population who has the greatest number of obesity-related comorbidities and would benefit from direct intervention.

“New studies are being published every day, including this one, that show traditional behavioral interventions are not effective for adolescent patients with morbid obesity,” said Dr. Nadler. "If we aren’t treating them successfully with diet and exercise, and they aren’t undergoing surgery, how are we going to help these patients and how will the obesity epidemic end?”

Read the media release at ChildrensNational.org. 

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