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Weight loss surgery is becoming increasingly common to treat children with obesity

AYESHA RASCOE, HOST:

A drastic but very effective weight management treatment is becoming more popular among children and teenagers in the U.S. - bariatric surgery. The procedure on a patient's digestive system limits the amount of food they can consume, helping them lose weight. Sarah Messiah researches pediatric obesity at UTHealth Houston School of Public Health. Thanks so much for joining us.

SARAH MESSIAH: Thanks for having me.

RASCOE: So first, can you describe how bariatric surgery works?

MESSIAH: Sure. The most common here in the U.S. now is what we call a sleeve gastrectomy. The procedure is laparoscopic, so everything is done beneath the skin, basically, without having to open it up and suture it after. And the procedure entails reducing the size of the stomach so that it looks sort of like a banana rather than a bigger pouch. Then the stomach obviously is smaller, so less food is consumed and then that leads to the weight loss.

RASCOE: You are the lead author of a new study published in the Journal of the American Medical Association that finds that weight loss surgeries like this among children and teenagers have increased substantially in recent years. Is this a measure of last resort? How do you decide who qualifies for this, and how often is it really being done?

MESSIAH: It is a lengthy process, in fact, and a lot of adolescents, at the end of that process, do not, in fact, qualify. They have to go through pretty substantial psychological clearances, medical clearances and so on. And if the surgical team - if they feel, as a team, that the adolescent is not a good candidate for the surgery, they don't want to set them up to fail. So it's not just about the weight, per se. It's about things like, how much at risk is this adolescent for potentially becoming a diabetic before they're 18? They have a very strong family history for that or heart disease. It isn't simple, and it takes time.

RASCOE: So in a world now where you have this Ozempic, a diabetes drug that people are using for weight loss, would kids be better off using the medication than going under the knife?

MESSIAH: I think it's a family decision. Ozempic, Wegovy - all the new GLP-1 agonists are a weekly injection drug for life. There's also a new frontier coming of combining both two, in that somebody who has surgery - typically, 18 months after the procedure is finished, you'll see a weight plateau. And so that may be a time when a physician may want to talk about also introducing one of these medications so that the weight loss can continue and they don't get discouraged.

RASCOE: What do you say to those people who may be listening to this and think, wow, this is a bad thing that's happening, that so many kids would need surgery?

MESSIAH: Yeah. The United States has been in an obesity epidemic for - now going on four decades. And over time, we've seen that obesity during childhood strongly tracks into adulthood. So if we have safe and effective treatment options where they can be implemented during adolescence so that they can enter adulthood healthier, why wouldn't we offer that? For other chronic diseases, we don't blink at offering the latest treatment.

RASCOE: That's Sarah Messiah of UTHealth Houston School of Public Health. Thank you so much for joining us.

MESSIAH: Thank you for having me. Transcript provided by NPR, Copyright NPR.

NPR transcripts are created on a rush deadline by an NPR contractor. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.

Ayesha Rascoe is a White House correspondent for NPR. She is currently covering her third presidential administration. Rascoe's White House coverage has included a number of high profile foreign trips, including President Trump's 2019 summit with North Korean leader Kim Jong Un in Hanoi, Vietnam, and President Obama's final NATO summit in Warsaw, Poland in 2016. As a part of the White House team, she's also a regular on the NPR Politics Podcast.
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