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Sunday, November 08, 2015

Like A New Life

"I feel awesome. It's like a new life."
"I knew that this might not get me down to like model-size, which I wasn't concerned about. I just wanted to be able to fit into a healthy size."
Miranda Taylor, 20, Cincinnati nursing student
 Miranda Taylor poses for a photo outside Christ College of Nursing and Health Science in Cincinnati. Taylor, a student at the college, was part of a study of teen obesity surgery at the Children's Hospital Medical Center.
Miranda Taylor poses for a photo outside Christ College of Nursing and Health Science in Cincinnati. Taylor, a student at the college, was part of a study of teen obesity surgery at the Children's Hospital Medical Center.    Michael Conroy/AP

"We documented the durability of clinically meaningful weight loss and improvements in key health conditions and weight-related quality of life among adolescents who underwent gastric bypass surgery or sleeve gastrectomy."
"These benefits must be viewed in the context of the risks of micronutrient deficiencies and the possibility that future abdominal procedures will be needed in some patients."
Study, The New England Journal of Medicine
For decades the rates of obesity among American children have kept pace with those of adults, with the percentage of obese teens from the age of twelve to nineteen having increased from five percent to 18 percent. A young body burdened with obesity faces the potential of acquiring Type 2 diabetes, high blood pressure, heart disease, cancer and stroke. The childhood obesity epidemic is of primary concern to health professionals for its short- and long-range consequences.

With this in mind a study was undertaken by researchers among 228 American teens each of whom weighed close to 330 pounds on average. That colossal weight led to their having obesity surgery, in an attempt to bring their weight closer to a normal range, and bringing them away from the sphere of candidates for serious health conditions in their future lives, let alone their current health struggles.

The average weight loss between all the individuals studied was over 90 pounds. Many of the teens realized immediate relief in that obesity-related health problems evaporated soon after surgery, and they were free of those complications three years after surgery. Miranda Taylor underwent surgery at age 16 when she weighed 265 pounds. Post-surgery she lost over 100 pounds. With that weight loss went severe depression, pre-diabetes and a hormonal condition linked to obesity.

Of the total number of teens studied most were still in the obese range three years following their surgery, while five percent of those studied managed to achieve a normal weight. About half of the studied teens developed low levels of iron, which may lead to anemia, and some of them exhibited vitamin deficiencies. Additional operations were required for about 13 percent of the studied teens; mostly for gallstones, related to obesity.

One death occurred,  unrelated to surgery. And there were some surgical followups for bowel obstructions or surgery-related hernias. Adult studies for weight-loss surgery have achieved similar results. But it was not until the study was published in The New England Journal of Medicine, and presented at the Obesity Society annual meeting in Los Angeles that long-term effects in a group of young patients have been presented for consideration in an atmosphere reluctant to submit teens to such surgery.

According to the study results, teen surgery is capable of reversing obesity-related complications whose results can dramatically shorten life-expectancy. "And that ultimately is more important than actual pounds lost", stated Dr. David Ludwig, obesity expert at Boston Children's Hospital. Guidelines state that surgery should be resorted to for extremely heavy teens with obesity-related health problems, where other weight-loss methods have failed.

Teens from the age of 13 to 19 treated at five centres formed the study participant-group. Most of them had undergone gastric bypass surgery -- a stomach-stapling procedure reducing the stomach to the size of a small pouch. Close to a third of the study group were given a less dramatic stomach-reducing operation named sleeve gastrectomy.

According to the study's lead author, Dr. Thomas Inge, who is director of an obesity surgery program at Cincinnati Children's Hospital Medical Centre, the reduction in diabetes and other obesity-related health problems presented a gratifying realization and encouragement toward using these surgeries for  young people with imperilled health due to obesity. It is the health improvement effects of the surgery that is remarkable, without expectations that patients will lose additional weight.
  • 75 percent of study participants had unhealthy blood fat levels including high triglycerides and too little 'good' cholesterol: in two-thirds, those impediments to good health dissipated;
  • 40 percent exhibited elevated blood pressure, which returned to normal in three-quarters of the study participants post-surgery;
  • Almost 20 percent of study participants had abnormal kidney function, which also disappeared in over 80 percent of those studied;
  • 13 percent had contracted Type 2 diabetes which then disappeared in over 90 percent of the study participants.

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