As the popularity of stomach surgery has risen among obese adults, a growing number of doctors are asking, "Why not children, too?"
For decades, the number of kids trying weight-loss surgery has been tiny. The operations were risky, with a death rate of about 1 in 50. Children rarely got that fat, and when they did, pediatricians hesitated to put their developing bodies under the knife. Only 350 US kids had such an operation in 2004, according to federal statistics.
But improvements in surgical techniques and huge increases in the number of dangerously obese children have begun to lead to a change.
A group of four hospitals are starting a large-scale study this spring examining how children respond to various types of weight-loss surgery, including the gastric bypass, in which a pouch is stapled off from the rest of the stomach and connected to the small intestine.
Three more hospitals have approval from the US Food and Drug Administration (FDA) to test how teens fare with a procedure called laparoscopic gastric banding, where an elastic collar installed around the stomach limits how much someone can eat.
The FDA has hesitated to approve the gastric band for children, but surgeons at New York University Medical Center reported in the Journal of Pediatric Surgery this month that the device holds promise.
The 53 boys and girls, aged 13 to 17, who participated in NYU's study shed nearly half their excess weight over 18 months, while suffering relatively minor complications.
Crystal Kasprowicz said she lost 45kg from her 112.5kg frame after having the band installed at age 17. Before the procedure, Kasprowicz said she took medication for a rapid heartbeat and was showing signs of developing diabetes.
"I'm a totally different person," she said.
The studies have followed a huge surge in the popularity of obesity surgeries among adults. The American Society for Bariatric Surgery estimates that more than 177,000 Americans had weight-loss surgery last year, up from 47,000 in 2001.
Not everyone is pleased that kids might be next.
"I don't think altering the human digestive tract is a solution to the problem of excess weight," said Joanne Ikeda, a nutritionist emeritus at the University of California, Berkeley.
Doctors still know relatively little about the long-term effects of such operations on the very young, she said.
The US Agency for Healthcare Research and Quality released a study in July that said four in 10 weight-loss surgery patients develop complications within six months.
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