'Last Resort' for Overweight Teenagers

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Tuesday, March 3, 2009

The Feb. 24 Health article "Extreme Measures" was timely as our nation struggles to address the increasing prevalence of obesity and its health consequences. In December, the Endocrine Society published clinical guidelines for the prevention and treatment of pediatric obesity. These guidelines emphasize lifestyle modification -- reducing calorie intake and increasing physical activity -- as the cornerstone to the treatment and prevention of obesity. Bariatric surgery should be used only as an adjunct to a commitment to a long-term program of lifestyle modification.

We must keep in mind that teenagers and adults do not have the same nutritional requirements and metabolisms. In addition, postoperative endocrine care has yet to be standardized for adolescent patients who have undergone bariatric surgery. To date, not enough outcome data are available to know whether teenagers are affected in the same way as adults.

Bariatric surgery is an expensive procedure that could balloon into spending billions of unnecessary dollars a year if unmonitored. Until more data become available, bariatric surgery for teenagers should be a last resort, restricted to those with a long-term commitment to nutritional and lifestyle changes.

ROBERT M. CAREY

President

The Endocrine Society

Bethesda