First Center for Bariatric Surgery in Youngsters

May 31, 2007
Rebekah McCallister

Internal Medicine World Report, April 2007, Volume 0, Issue 0

In an effort to interrupt the progression of obesity from childhood into adulthood, Morgan Stanley Children’s Hospital of New York-Presbyterian in New York City has opened a Center for Adolescent Bariatric Surgery, the first and only children’s hospital in the country now approved to place adjustable gastric bands in patients younger than 18 years. The center will focus on strategies to help obese youngsters lose weight.

Bariatric surgery is only one of the options offered to obese children in this program. Approximately 50 youngsters are currently enrolled.

“Most young patients initially come to the program for treatment of pre-diabetes or insulin resistance, heart problems, joint problems, or other complications associated with their obesity,” says Marc Bessler, MD, of New York-Presbyterian Hospital/ Columbia University Medical Center and Columbia University College of Physicians and Surgeons.

“Like adults who receive treatment for obesity, adolescent patients undergo rigorous education and a lengthy program of multidisciplinary, nonsurgical therapies. Nevertheless, nearly 90% of adolescents with a body mass index greater than 40 are ultimately unable to achieve or maintain adequate weight loss despite intensive medical regimens. For these patients, the new program offers laparoscopic adjustable gastric banding, which studies have shown to be the safest and least traumatic surgical procedure.”

Studies show that in adults, the risks of remaining obese far outweigh the risks of current surgical procedures. Morbid obesity is associated with a reduced lifespan and a host of medical conditions.

“Obesity is often a fatal disease in the long-term. If we can interrupt the progression in young patients before irreversible damage is done, we will have done a very good thing,” says Jeffrey L. Zitsman, MD, of Morgan Stanley Children’s Hospital and Columbia University College of Physicians and Surgeons.

Until now, pediatric laparoscopic adjustable gastric banding was only available to persons aged ≥14 years, in this program as well as in other hospitals. Younger patients enrolled in nonsurgical weight-loss programs.

Over the past 20 years, the proportion of overweight children (aged 6-11) has more than doubled, and the proportion of overweight adolescents (aged 12-19) has tripled.