Bariatric Surgery in Adolescents

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With an estimated one in three American adolescents being classified as overweight or obese many parents are turning away from traditional lifestyle modification approaches to more radical methods of combating adolescent obesity. Excessive weight at young ages has been linked to a wide range of comorbidities including hypertension, type 2 diabetes, and elevated blood cholesterol which is connected to higher and earlier death rates in adulthood (Kelleher, Merrill, Cottrell, Nadler, & Burd, 2013). Since the early 70’s the prevalence of overweight adolescents has increased from an average of 5% to an alarming 18% with obesity being the number one health concern for parents trumping drug abuse and smoking (www.heart.org).
Lifestyle modification such as diet and exercise has primarily been the treatment option of choice for these overweight adolescents. But in recent years bariatric surgery has become increasingly popular and an acceptable method of treatment. The results, although promising, are scarce, of poor quality, and adolescent patients undergo bariatric surgery without understanding the risks and benefits. Parents and adolescents differ in their views as to how obesity impacts their lives. Parents tend to look at the negative psychosocial and medical impacts of obesity (Hofmann, 2010) whereas the adolescent patient may be motivated by peer relationships that result in weight-based victimization (Browne, 2012) therefore creating a series of moral and ethical challenges regarding this practice.
One of the many ethical and moral challenges presented by bariatric surgery in the adolescent patient is at what age can a child understand the lifelong lifestyle ramifications of such a procedure? When providing health...

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...owne, N. T. (2012, ). Weight bias, stigmatization, and bullying of obese youth. Bariatric Nursing and Surgical Patient Care, 7(3), 107-115. http://dx.doi.org/10.1089/bar.2012.9972
Geelen, S. V., Bolt, L., & Summeren, M. V. (2010, December). Moral aspects of bariatric surgery for obese children and adolescents: The urgent need for empirical-ethical research. The American Journal of Bioethics, 10, 30-32. http://dx.doi.org/
Hofmann, B. (2010, March 11). Stuck in the middle: The many moral challenges with bariatric surgery. The American Journal of Bioethics, 10(12), 3-11. http://dx.doi.org/10.1080/15265161.2010.528509
Kelleher, D. C., Merrill, C. T., Cottrell, L. T., Nadler, E. P., & Burd, R. S. (2013, February 2013). Recent national trends in the use of adolescent inpatient bariatric surgery. Jama Pediatrics, 167, 126-132. http://dx.doi.org/10.1080/15265161.2010.528514

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