May 7, 2010

Surgery Not A Good Fix For Childhood Obesity

Medical experts warned on Thursday that weight-loss surgery should only be used in the most severe of cases in children, and then only with extreme caution due to potential risks and the fact the effectiveness of such procedures remains unknown.

Scientists from the United States and Britain reviewed past studies on the obesity epidemic, and expressed that lifestyle changes such as better diets and increased exercise should always be the first option in weight-loss. Treatments including drugs should be used rarely.

Bariatric surgery, and other weight-loss surgeries that are used to help severely obese people lose weight, should be a last resort. "The risks of bariatric surgery are substantial, and long-term safety and effectiveness in children remain largely unknown," Sue Kimm of the University of New Mexico, Debbie Lawlor of Britain's Bristol University and Joan Han of the U.S. National Institutes of Health, wrote in The Lancet journal.

They said that only the most severely obese children should have the option available for surgery. Those with a body mass index (BMI) over 50, or those with a BMI over 40 with other health risk factors should be the only ones considered for weight-loss surgery, and "even then considered with extreme caution."

A BMI score of 30 is considered to be obese, and a BMI over 40 signals morbid obesity. BMI is measured by taking the weight in kilograms and dividing it by the height in meters squared, according to Reuters.

The Lancet review emphasized data up to 2006 showing that prevalence of childhood obesity either doubled or tripled from the 1970s to the late 1990s in Australia, Brazil, Canada, Chile, Finland, France, Germany, Greece, Japan, Britain and the United States.

A more sedentary lifestyle and consumption of foods with higher caloric content are the main attributions for the rise in obesity. Obesity can affect almost every organ in a harmful way. Some serious consequences of childhood obesity include: high blood pressure, abnormal blood fats, insulin resistance or diabetes, fatty liver disease, and psychosocial complications.

The World Health Organization predicts that as much as 40 percent of North American and Mediterranean children, 38 percent of European children, and 22 percent of southeast Asian children are overweight or obese.

Weight-loss surgery in adults has been studied immensely, but in children there is little evidence about safety and effectiveness.

One study published in February found that obese teenagers who had weight-loss surgery to limit their food intake lost more weight and enjoyed more health benefits than those who stuck to an intensive diet and exercise regime.

Lawlor said assessments of drugs for obese children had found they produced improvements compared solely to lifestyle changes alone, but also had increased side effects.

As a result, suggestions were made to doctors saying they should take "a very conservative approach to drug therapy" and use weight-loss drugs only for children in the highest five percent of BMI.

Experts said obesity prevention, especially in children, is the most effective approach to curbing the rising global obesity epidemic.

Schools, communities and households should be introduced to policies that help encourage children to eat healthier food, boost physical activity and reduce sedentary lifestyles to help reduce and eliminate child obesity.


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