Obese teens and surgery

Great Debates
1

I’ve been reading this ongoing feature at Newsweek.com. It’s a series of articles written by a 16-year-old who’s decided to have laparoscopic gastric banding surgery - a type of weight-loss surgery where they slap a band around your stomach to make it smaller. He’s 6’1, nearly 600 pounds, and has a BMI of 77.

According to him, he’s only made one “concentrated effort” to lose weight, which he did by working with a personal trainer for three months. He’s not currently enrolled in school, and by his own admission, spends almost all his time in front of his computer. He apparently needs to lose a couple pounds in order to make his liver smaller before the operation, and is doing so simply by not eating as much.

I’m torn on what to think about this. On the one hand, it’s none of my business. Obviously, obesity like that is a serious health hazard, and it’s his choice how to deal with it.

On the other hand, I first want to throttle his parents, then him. What are his parents thinking? They allow him to sit in front of the computer all day, eat as much as he’d like, and ignore the very obvious health problem it’s leading to? And they’re then willing to allow a risky invasive procedure to fix it, rather than forcing him to make some effort on his own? To him: obviously, he wants to change himself. Isn’t that enough motivation to exercise a bit?

My main ponderance, though, is the ethical situation this places his doctors in. IANAD, but I’m willing to bet that losing weight because someone slices you open and wraps a rubber band around your stomach is not as healthy as losing weight through diet and exercise. In my opinion, these doctors who will be doing this surgery are basically saying: “It’s OK if you mess up your body and can’t summon the willpower to fix it on your own. We’ll do it for you.”

On the other hand, if they don’t do what they’re capable to in order to help him, that’s not ethical either. If they said “Sorry, we can only tell you to go on a diet and work out every day,” knowing he wasn’t likely to do that, that seems it would be just as unethical.

So. Thoughts? Comments? Opinions?

2

My first thought is your comment about the parents. I know if I was grossly overweight and had my parents harping on me to go out and get excercise, that would decrease my motivation. I know, it’s completely stupid, but I get stubborn like that with my parents for reasons best left undiscussed. So, I would lend no weight (no pun intended) to your argument about the parents.

As for the whole idea, I support him. Sure, it’s not the ‘best’, most natural way to lose weight, but hey, it’s his life and if he’s willing to risk it to lose weight, who am I to argue?

Of course, I think that people should be allowed to do pretty much anything they want provided that what they do does not affect other people. (there are some conditions to that last sentence, but for the purposes of this discussion they are not important)

3

NinjaChick, would you be able to move from your chair with 300 pounds strapped to your front and 300 more strapped to your back? Since he’s taller, take that down to 250 front and back.

At 600 pounds, he would probably be risking his life more by waiting to take off the weight slowly.

Most surgeons who perform gastric bypass surgery require you to have tried several other means of weight loss, and they wouldn’t be doing the surgery on someone so young. But this situation became life-threatening several hundred pounds ago. Now it is crucial.

For some people, food consumption is not a matter of will power. I stayed on nothing but liquids for six months and would have stayed on them forever if the doctor had allowed it. That was about 400 calories a day. But once I was forced to eat regular food again, I regained everything I had lost and more. I could not think about anything but food.

My own surgeon was quite reputable before he learned to do the bypass. I don’t know why you would think that these surgeons would have such a careless attitude toward their patients. Mine screened very carefully.

I had my surgery on Mardi Gras – Fat Tuesday – seven years ago. Half of me survives. :slight_smile:

I lost 150 pounds after a gastric bypass. Even then, I had begun to regain a little. Another physician put me on a medication that controls compulsive behaviors. The same meds that cut back on my shopping sprees and pack a day smoking habit also started taking the pounds off slowly and naturally. They allowed me not to think about eating.

It’s never a good thing to judge someone else’s situation by our own abilities and circumstances.

4

Having once been obese, I have a great deal of sympathy for this boy. But it alarms me that drastic surgical measures are being peddled these days as a panacea for obesity.

A friend of mine died shortly after a gastric bypass procedure. This isn’t like having a hangnail removed. It should be viewed as a last resort, not a quick fix.

5

If this was a situation where the young man was 350 pounds, I would agree that surgery was not the way to go. But you’ve got obese, and then you’ve got fucking obese. SIX HUNDRED POUNDS is a staggering weight; the boy is literally bigger than a Siberian tiger.

I have a weight problem, which I’ve had for ten years. I am what I consider to be absurdly overweight and it’ll take me at least another year, probably two, to get down to an acceptable weight. I’m the same height as this guy, and I weigh… 265 pounds. He’s as heavy as two of me carrying a big television.

I’m sure the kid has been overeating and I am sure his parents are partly to blame, but

A) You can’t get to 600 pounds unless you’re predisposed to it. I couldn’t get that fat if I TRIED, and

B) At 600 pounds you’re basically twenty minutes from death all the time. Begrudging surgery in this case is like begrudging emergency treatment to someone who was in a car accident because they weren’t driving very safely. Yeah, we need to amend our behaviours sometimes, but for Christ’s sake, let’s save the kid’s life, huh?

6

It’s not about their harping on him, though. It’s about their having allowed and enabled the situation to reach this point. It didn’t happen overnight, and saying “well, he’s just willful and stubborn” is not a valid excuse for the people who are responsible for the child’s welfare. IMNSHO, it’s irresponsible parenting.

7

I don’t get that. Bypass surgery won’t make him lose weight overnight. It only will result in him eating less hence losing weight. A diet would also result in him eating less hence losing weight. I can’t see a difference. It might be easier with surgery, but you can’t say that surgery in itself results in a miraculous and immediate weight loss.
And yes, I do blame the parents. I mean : he didn’t suddenly gain 400 pounds. Before reaching 600, he had to be 200 then 300 then 400, etc… They could have reacted strongly way earlier. Even if he’s predisposed, he still had to eat all the calories needed to reach such a weight. And last I knew, parents have some control on their children, including on their eating habbits. I doubt he secretely stole food at night from neighbor’s garbage cans while his parents were making their best to feed him a balanced diet. I doubt they just didn’t notice he was overweight until he reached the 600 pounds mark, either.

8

I found this quote:

to be troubling, if it is true. If my kid weighed more than 300 pounds, he’d never get a Big Mac from me. Also, if he were mine I would certainly insist he do something all day besides play on the computer. In his circumstances, he probably can’t go to school, but that doesn’t mean he should just have the whole day to do nothing at all constructive.

All that said, I can’t help but think that, in his circumstances, the surgery is a good idea – the kid has to get that weight off pronto. I just wish I felt better about his long-term chances for keeping it off. Judging from the diary he doesn’t seem able to accept his own culpability in his weight and health problems.

9

There is some reasonable doubt as to how culpable this kid is for his situation. There’s no way he got up to 600 lbs. without a lifetime of bad habits, most of which had to be introduced when he was very young. His parents are most likely enablers, and that complicates things.

With a BMI of 77, it would be unethical to deny him the surgery, but he needs to put some serious effort into taking care of himself.

10

Did most of you even read the article? The kid’s not getting gastric bypass surgery!

Gastric banding is reversible and its mortality rate is practically nil. At 600 pounds, something’s gotta be done quick, and I’d much rather see a 16 year old have this kind of surgery than gastric bypass.

Hopefully the eating habits he’ll be forced to have after the banding will stick.

I’ll refrain from assigning blame. Let’s just hope that the kid makes it and finds a better life, k?

11

He’s only 16 and already weighs in at 600 pounds??? I have to go along with those who say get the rubber band surgery now. The kid is a massive heart attack looking for a place to happen. At that weight, making him work out might just kill him. After he has lost some weight they can try to get him on a reasonable program of diet and exercise. Right now, the main thing is to keep him alive.

12

Totally agree. Especially about the parents – I wonder if they are also obese? But at 16, the boy’s getting old enough to start accepting some responsibility – at least, if he wants to see genuine improvement. My concern upon reading his journal was the number of times he made comments like, “My eating habits aren’t that bad. I just eat too much.” and similar, even after admitting to snacking and fast food. He also seemed to make frequent use of the good, old “I have a gland problem” excuse. And I’m not comforted by the fact that he’s only lost 19 pounds while waiting for the surgery. I have a dear friend who had weight loss surgery last year – she made major changes in her life before the actual surgery and lost 60 or so pounds. She also (difficult for her after 35+ years of ignoring and excuses) had to accept responsibility for her size and fitness.

Also totally agreed. And I really hope he does it. But I didn’t get a warm&fuzzy about it from the articles, I’m afraid.

13

I agree the kid needs to learn to take responsibility, but then again… what kind of parents would bring snacks and fast food into the house when they have a morbidly obese son??? Sure, the kid is choosing to eat it, but if it wasn’t there, he wouldn’t be able to get it; it’s not like he can take a jaunt down to McDonald’s if he doesn’t like what his mom is serving. I figure that at this point he’s pretty much immobile (actually, I reckon he’s probably been bed-bound since 400 pounds), so it has to be the parents who are actually giving him the food and bringing it into the house. Do they think it’s “punishing” the other children if they don’t bring in snacks and fast food? When I was growing up those things were treats, not part of a regular diet. So I don’t think it’s all the kid’s fault–if it wasn’t there, he couldn’t get it, and it’s the parents that are bringing it in.

14

I agree with everything you’ve just said, because I’ve also had gastric bypass (100 pounds lost). It was about a year and a half ago and I still have food issues. My weight fluctuates about 10 pounds up or down.

If you don’t want to say in this open forum what medication you are on, would you mind emailing me? I’m also still eating bad foods once in a while and when I get a handle on that, I replace it with shopping, smoking, etc. I live near Saratoga and they have slot machines at the harness track, so I guess I’d better stay away or I’ll get hooked on those, too!

15

The difference is that after my surgery, I lost weight at a rate of approximately 1-2 pounds per day. I lost over 30 pounds in the first month and lost the whole 100 in 5 months. Dieting would take at least a year or two. And I suspect that this boy doesn’t have a year or two.