Bariatric
Surgery
When it comes
to teens, Texas Children’s is working to make
this innovative procedure an option for a
special group of patients.
Nothing Brittany tried helped her lose
weight. Diets and exercise made no difference
as she crossed the 400-pound mark.
“It was very hard
to see other people in the same weight-loss
program I was in lose weight, while I
continued to remain the same,” says
16-year-old Brittany.
Conditions and criteria
In addition to her weight, Brittany faced
several health problems (called
“co-morbidities”) brought on by her obesity.
She had high blood pressure and developed
insulin resistance, putting her on a path
that would eventually lead to diabetes.
Brittany also
experienced sleep apnea, a condition that
made her stop breathing and wake up in the
middle of the night gasping for air. “I
couldn’t sleep lying flat down. I had to prop
myself up with pillows, or I wouldn’t be able
to breathe at all,”
she recalls.
These or similar
co-morbidities are part of the criteria that
an adolescent must meet before being
considered for
bariatric surgery
at Texas Children’s. The teen also must have
a Body Mass Index (BMI) of 40 or more,
reached maturity, and failed at previous
weight-loss programs.
Knowing that
surgery was her only option and that her
health problems were getting worse, Brittany
had the procedure at Texas Children’s
Hospital in May 2004. She weighed 404 pounds.
Caring for the long-term
The Adolescent Bariatric Surgery Program, is
one of the few in the U.S. that is dedicated
strictly to adolescents. It is taking the
lead in developing safe and effective
surgical programs for morbidly obese
teenagers. A board of medical experts reviews
each individual’s case before deciding
whether to perform the
Roux-en-Y Gastric Bypass, a laparoscopic
technique known for its reliable results and
effectiveness in achieving long-lasting
weight loss.
“The surgery is
effective, but patients must understand that
it is just the first step,” states
Dr. Mary Brandt, Surgical Director of
Adolescent Bariatric Surgery and professor
and vice chair of Surgery at Baylor College
of Medicine. “They must form new eating and
exercise habits, and develop a different
relationship toward food.”
Led by Brandt, the bariatric surgery program is
comprehensive, with support before and after
surgery coordinated by Trish Walters-Salas, a
nurse case manager, and Susanne Trout, a
registered dietitian. Many other medical
professionals are important in addressing the
unique emotional and physical needs of this
special group of patients. This comprehensive
approach supports patients during the many
changes they face after the surgery, with
follow-up that continues as long as 10 years
after the procedure.
In the two years
since her surgery, Brittany has formed a
close bond with the members of the
bariatric team. She has lost more than
half of the pre-surgery weight, and no longer
has any obesity-related conditions. And she
feels like a totally different person: “I can
walk up a flight of stairs now without
getting winded. I have more self-esteem, and
I love what I look like.”
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