A study of bariatric surgery on California adolescents shows that growing numbers of families are opting for a surgical solution to their children's obesity. But a study on trends in bariatric surgery among those under 21 shows that, in this population, the surgical weight-loss technique is disproportionately embraced by girls, and by white adolescents in general.
The study, published this week in the journal Pediatrics, tallies a dramatic increase in weight-loss surgery between 2005 and 2007, with a surgical procedure not yet approved by the FDA for use on children showing the steepest rise.
In all, 590 adolescents between 13 and 20 underwent bariatric surgery in California between 2005 and 2007. Overweight white adolescents were far more likely than their African-American peers to get such surgery: If all overweight children had equal access to such surgery, 165 of those procedures would have been on white adolescents and 425 would have been performed on young African-American patients. But researchers found that 384 adolescents getting the procedures during the study period were white.
Laparoscopic adjustible gastric banding -- a procedure that can be altered or even reversed post-operatively -- showed an almost seven-fold increase in use on this population. In adolescents, the use adjustible gastric banding overtook the older procedure associated with the steepest rates of weight-loss -- Roux-en-Y gastric bypass. Considered the more tested procedure, Roux-en-Y gastric bypass use declined almost 30% in the study's timeframe.
Patients with private insurance were more likely to get the Roux-en-Y gastric bypass procedure, while self-payers were more likely to opt for the adjustible gastric banding procedure. Led by UCLA pediatric surgeon Daniel A. DeUgarte, researchers concluded that there was a relatively low rate of complications from the surgery in the populations studied, with no deaths and roughly one-in-a-100 patients experiencing postoperative complications while still in the hospital.
-- Melissa Healy / Los Angeles Times