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For Severely Obese Teens, Surgery

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The teens have been monitored for at least one year and as long as 10 years. All of the surgeries went well. Nine of the 10 teens had persistent weight loss -- nearly 118 pounds on average and almost two-thirds of their excess weight. The 392-pound boy lost 183 pounds and was able to go back to school. The patients with breathing problems and high blood pressure got better. And three of the girls -- including one who did not lose weight -- had normal pregnancies.

Yet, there were some problems. One girl developed malnutrition and had to be treated in the hospital. Two other patients had gallstone surgeries, and one patient required surgery to correct a small-bowel obstruction 10 years after the stomach surgery.

Patients who undergo stomach surgery for obesity must remain under a doctor's care for the rest of their lives -- a huge commitment for a young person to make.

Kenneth B. Jones Jr., MD, is president-elect of the American Society for Bariatric Surgery. Over the course of his career he has performed the operation on fewer than 25 teens. He attributes his high success rate to careful patient selection.

"Most of these [teens] have done quite well," Jones tells WebMD. "In general, my impression is they have done as well as or even better than my adult patients."

Jones says that he will consider the surgery only for teens who have reached their full height and no longer have the nutritional needs of a child.

And he has one other requirement for these young patients.

"I think you have to seriously consider the motivation of the patient and how much they are being pushed into this by their parents," Jones tells WebMD. "You also have to evaluate how much they are going to be able to comply with the very intense dietary restrictions this requires -- and this can be particularly difficult for teens who eat so much junk food and drink so many sodas."

Jones stresses that the surgery is not in itself a cure for obesity.

"You can use this operation as a crutch or as a tool," Jones says. "The operation will almost automatically take a lot of weight off. But the ones that use it as a tool to go further, to get involved in regular exercise and a strict dietary program, will do a lot better."

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