Growing Demand for Adolescent Bariatric Surgery Brings Risk Management Concerns

April 1, 2004 | Health System Risk Management


"Hospitals should expect to see many more parents pushing their seriously overweight children to investigate having their obesity treated surgically."1

Since its days of infancy in the 1950s,2 bariatric surgery has continuously evolved from a complication-fraught procedure with minimal patient success to a procedure that many health experts now view as a lifesaving intervention for the morbidly obese. However, as bariatric surgery gains approval and popularity, controversy has emerged regarding a new patient population seeking the procedure in growing numbers: children 18 years of age and younger.

A reported 150 adolescents underwent some form of bariatric surgery from 2001 to 2003, according to an October 7, 2003, report in the Wall Street Journal. The number of U.S. children from 6 to 19 years of age who are considered overweight has surged to 15% and shows no sign of abating, according to the Centers for Disease Control and Prevention (CDC). Although experts agree that the best way to curtail the national obesity epidemic is prevention by promoting healthier eating habits and a more active lifestyle, these measures often fail for many morbidly obese adolescents who are now viewing bariatric surgery as a viable weight loss option. This presents a conundrum for healthcare providers that exudes questions related to unknown long term risks, whether it is ethical to permanently alter an adolescent's body, and whether teenagers are mature enough to make the decision to undergo a procedure that requires significant changes in their activities of daily living.

Earlier this year, Healthcare Risk Control (HRC) conducted a member survey to get an idea of the current status of adolescent bariatric surgery. Of responding facilities, 5.6% said they currently offer the procedure to children 18 years of age or younger, and another 1.8% report that offering adolescent bariatric surgery is being planned for the future. Survey results are explained in further...

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