Sunday, April 24, 2011


Thanks @DrFlicker for the Twitter invite on the conversation about Promoting bariatric surgery for teenagers

(@ @ @ Thoughts? RT @ Doctors selling weight loss to teens:

The beef with crass advertising is understandable.  As we learned from the Save the Boobies campaign, eye-catching language succeeds in creating awareness, even enthusiasm.  But do health care providers lose trust through such levity?  The public likes to think serious-minded adults rank higher than Beavis and Butthead in the public health hierarchy.  Billboards reading Dieting Sucks and 1-800-GET-SLIM smack of adolescence and aggressive salesmanship, not quality health care from earnest professionals.  

I support tasteful promotion of bariatric surgery for teenagers as part of the Teen-Longitudinal Assessment of Bariatric Surgery (LABS) ongoing at several excellent pediatric hospitals.  (Here’s a promotion from Cincinnati Children's Hospital)  Outside of that setting, I’m uneasy with the operation and the promotion.  Operating on teens exposes minors to unknown long-term risks and opens up the question of by-proxy consent.  In my opinion, such negatives in individual patients are offset when clinical trials yield answers (and ease suffering) for the population at large.

I suspect we’ll learn that well-selected teenagers benefit a great deal from bariatric surgery.  Compared to a middle-aged patients, young ones with successful surgery should enjoy twice as many years free of weight-related diseases and their cost, plus improved social and work function.

In Promoting bariatric surgery for teenagers, Carolyn Thomas seems uncomfortable with bariatric surgery on the whole, focusing on uncertain outcomes, on cost in the short run, and on growing popularity of the procedure.  In her blog post, expert majority opinions are overshadowed by the minority opinion of nay-sayer providers.  Let's see outcomes data from a large sample, and hear from the happy patients too!

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