CHICAGO - The number of U.S. children having obesity surgery has tripled in recent years, surging at a pace that could mean more than 1,000 such operations this year, new research suggests. While the procedure is still far more common in adults, it appears to be slightly less risky in teens, according to an analysis of data on 12- to 19-year-olds who had obesity surgery from 1996 through 2003.
During that time, an estimated 2,744 youngsters nationwide had the operations. The pace tripled between 2000 and 2003, reaching 771 surgeries that year, the study found.
Youngsters had slightly shorter hospital stays than adults and none died in the hospital during the study period. By contrast, there were 212 in-hospital deaths out of an estimated 104,702 adults who underwent obesity surgery in 2003, or a rate of 0.2 percent, the study found.
Researchers at Robert Wood Johnson Medical School in New Brunswick, N.J., and Cincinnati Children's Hospital Medical Center analyzed a database of U.S. hospital patients. Obesity surgeries in children during the eight-year period and adults in 2003 were included in the analysis.
The study appears in Monday's Archives of Pediatrics & Adolescent Medicine.
About 5 percent of children and adults had major complications, mostly respiratory problems. Children spent an average of about 3.2 days in the hospital in 2003, versus 3.5 days for adults. Total hospital charges also were lower for pediatric patients, $30,804 per patient versus $36,056 for adults.
The youngest patients were age 12, but most were older teens. Eric Decker was one of them. In 2003, at age 17, he had gastric bypass surgery, the most common obesity operation in teens and adults.
"I was 5-foot-8 and 385 pounds," Decker said.
He had struggled with his weight since he was 11, and said he had tried just about every diet, but nothing worked.
Obesity surgery was a last resort for Decker, and doctors say it should be for overweight teens.
Decker had no major surgery complications. A year and a half later, he was down to 185 and says he has stayed there through diet and exercise.
"It's definitely a painful surgery," said Decker, a student at the University of South Carolina. It also requires drastic changes in eating habits, he said. "I don't regret it because it's something that I felt needed to be done for my health."
Study co-author Dr. Thomas Inge attributed the surge in teen operations to publicity about celebrities having obesity surgery, including pop singer Carnie Wilson and broadcaster Al Roker.
The numbers contrast with an estimate in January from the Agency for Healthcare Research and Quality, which reported that 349 youngsters aged 12 to 17 had obesity surgery in 2004.
The new study included children up to age 19, which accounts for the higher number, said lead author Dr. Randall Burd of Robert Wood Johnson Medical School.
Burd said the numbers of youngsters undergoing obesity surgery likely has continued to rise along with adults having the surgery.
The American Society for Bariatric Surgery estimates that last year, there were 177,600 obesity surgeries, up from 20,500 a decade ago and 103,200 in 2003. (That 2003 estimate is lower than the new study's figure because the bariatric society bases its estimate only on reports from its members, not all doctors.) The organization doesn't have a breakdown on the number of pediatric operations. If it has kept pace with adults, the number of obesity surgeries in teens likely would climb well past 1,000 this year.
Inge, of Cincinnati Children's, said the new study suggests the benefits outweigh the risks for most patients. But it also left many unanswered questions, including how teens fared after leaving the hospital.
Obesity surgery during the teen years poses different psychological risks than for adults, Inge said. Many teens already are struggling with identity issues, and rapid weight loss after surgery can catapult them "into situations that they didn't really imagine before," he said.
His center is taking part in a five-year study to examine the medical and psychological results of obesity surgery among teens.
"It's critically important that the short-term and long-term outcome of these kids is studied" because of the potential health implications, Burd said.
