Bariatric surgery 101

The Adolescent Bariatric Surgery Program at Texas Children’s Hospital started in 2004 when Dr. Mary Brandt wanted to offer a program with a surgical option to help our teenage patients struggling with their weight and the health problems that usually come along with being obese.

Our program was designed to provide options for patients who have failed medical (non-surgical) weight management and suffer from serious medical conditions that when left untreated, can lead to severe long-term consequences. All surgeries are performed to help patients achieve a healthy weight and a reduction in their associated medical conditions. 

What is bariatric surgery?

Bariatric surgery is a term that encompasses a variety of surgeries to produce weight loss. Here at Texas Children’s, we primarily perform gastric bypass, and in a few special situations, gastric sleeve is considered. Gastric bypass works by reducing the size of the stomach and bypassing a part of the small intestine where the absorption of calories and nutrients take place. This is why a gastric bypass is considered both a restrictive and a malabsorption procedure. This is different from a gastric sleeve in which the stomach size is reduced, but no changes are made to the intestines.

Are there risks involved?

Just like any surgery, there is a potential for complications. Immediately after surgery, patients are at risk for bleeding, infection, intestinal obstruction and a leak anywhere along the staple lines placed in surgery (this is when contents of the stomach and intestines get through the staple line and enter the abdominal cavity internally). 

In the months and years to follow, patients are at risk for malnutrition due to nutrient malabsorption and intestinal obstructions. Patients are followed very closely for the first year, and then annually thereafter, which includes office visits and lab draws to assess for vitamin and mineral deficiencies.  

Is my child a candidate?

In order to qualify for entrance into the program, your child must be between 15 and 18 years old and have insurance coverage for bariatric care or treatment of morbid obesity. Teens must also have associated medical conditions as follows:

  • Type 2 diabetes  with a BMI over 35
  • Hypertension (high blood pressure), hepatic steatosis (fatty liver), type 2 diabetes, pseudotumor cerebri and/or obstructive sleep apnea with a BMI over 40. 

Expected weight loss with surgery

Every teen is different in terms of the weight loss outcomes. Bariatric surgery is considered successful when a patient loses 50 percent of their excess weight during the first 12 months after surgery. So, if a patient needs to lose 100 pounds to be at a healthy BMI (BMI under 25 means the patient is no longer overweight or obese), and they lose at least 50 pounds in the first 12 months, that is successful. Patients can continue to lose weight beyond that first year after surgery by following the bariatric post-surgical diet and exercise regimen. 

Why is bariatric surgery a good option for some adolescents? 

There are many young people struggling with their weight. Surgery becomes a good option when other types of weight loss strategies have failed to produce durable, long-term results and medical problems jeopardize the well-being and health of our patients. Our program and our team is dedicated to helping our patients lose weight safely and effectively in order to become healthy. 

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Post by:

Courtney L. Kassow, MPAS, PA-C

Courtney L. Kassow, MPAS, PA-C is a certified Physician Assistant in the Department of Pediatric Surgery at Texas Children’s Hospital. She is the advanced practice provider for the Adolescent Bariatric Surgery Program. Courtney graduated from Northeastern University in Boston, MA with a...

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