Surgical Weight Loss Program for Teens

Surgical Weight Loss Program for Teens

Surgical Weight Loss Program for Teens The Surgical Weight Loss Program team understands the impact that being severely overweight can have on your life. Our guiding principle is that weight loss surgery also called bariatric surgery should be considered only after all other established methods of losing weight have failed to achieve a healthy weight. If you have been unsuccessful with other weight loss methods, weight loss surgery can be a safe and effective option for you. But choosing surgery is a life-changing step, and should be made in an environment that understands and addresses your unique physical, medical, social and emotional needs. The Surgical Weight Loss Program for Teens is specifically designed to help you meet those needs, and to guide you through the decisionmaking process. 2

About our Program The Surgical Weight Loss Program for Teens offers you extensive, individualized counseling and assessment before your surgery. Our team of experts works with you and your family to ensure that you have the knowledge and support you need to make the right decision. The care and emotional support we provide continues long after your surgery, helping to ensure that you will have a healthy and successful outcome. Our team of experts has experience, skills and special interest in working with young people. They include surgeons, physicians, nurses, dieticians, a psychologist and an exercise physiologist, all of whom work on staff at our hospital and provide their services in one location, so that your care is convenient and coordinated. Here is a list of the comprehensive services we offer: Surgical consultation and evaluation A range of minimally invasive bariatric surgeries Nutritional counseling Supervised group exercise Psychosocial support and behavioral strategies to help you succeed Support groups for patients who have had gastric bypass surgery, and for those who are considering it Long-term follow-up, including medical, physical, nutritional and metabolic evaluation

Important Things to Consider Before Weight Loss Surgery A successful outcome from bariatric surgery requires that you are wellinformed, and that you have the full support of your family. For this reason, our program requires that you and your family meet and talk with our psychologist. You must be willing to follow the program recommendations both before and after surgery. Finally, you must have realistic expectations about what weight loss surgery will do. It will not eliminate hunger, and it will not result in lasting weight loss without considerable, ongoing effort on your part. How Obesity is Determined Obesity is defined as a generalized accumulation of body fat. It is determined by measuring both height and weight. Individuals with a body mass index (BMI) of 25 to 29.9 are considered overweight, while individuals with a BMI of 30 or more are considered obese. People with a BMI of 40 or more are considered extremely (morbidly) obese. 4

Is Weight Loss Surgery Right for You? You might be a good candidate for bariatric surgery if: You have tried other, formal weight loss attempts without success You are extremely obese (more than 100 pounds overweight or your Body Mass Index [BMI] is 40 kg/m 2 or more), and you have some of the following problems: Type 2 diabetes Sleep apnea High blood pressure High cholesterol /triglycerides High insulin levels (pre-diabetic) Asthma Fatty liver disease Joint and back pain Gastroesophageal reflux disease (heartburn) Unable to participate in daily activities Sleep disorders Irregular/absent menstrual cycles Urinary incontinence (weak bladder) Poor quality of life related to your weight You are willing to follow the nutritional guidelines given to you after your surgery. You demonstrate that you understand the risks of the surgery, and are willing to make a lifelong commitment to following nutritional guidelines and adopting healthy habits after surgery. Weight Loss Surgery Might Not Be Right for You If: Your obesity can be corrected medically (without surgery). You have had a problem with substance abuse within the past year. You have a medical, psychiatric or learning condition that would significantly impair your ability to adhere to diet, exercise or medication regimens after surgery. You are pregnant, currently breast-feeding, or are planning to become pregnant within two years of surgery. 5

Our Staff The Surgical Weight Loss Center for Teens staff is especially skilled, interested and experienced in caring for young people. Our surgical director is Thomas Inge, MD, PhD, our medical director is Stavra A. Xanthakos, MD, MS, and our clinical coordinator is Jenny Sweeney, RN, MSN. About Weight Loss Surgery Our bariatric surgeons are expert at performing several minimally invasive operations for obesity. We help you decide which surgical procedure is right for you only after a thorough medical assessment, and after discussion of your, and your family s, wishes. We currently offer three surgical options, all of them performed laparoscopically, which means a smaller incision, less scarring and faster recovery: Roux-en-Y gastric bypass Gastric banding Laparoscopic vertical sleeve gastrectomy. Each of these operations helps with portion control by creating a much smaller stomach pouch. As a result, the amount of food that you can eat in a single setting is dramatically reduced. 6

Roux en Y Gastric Bypass In this procedure, a small pouch of stomach is created. The larger stomach remains inside the body, but is no longer used for digestion. The small, proximal pouch of stomach empties into a short, intestinal roux limb as shown in the diagram. The Roux-en-Y gastric bypass has been performed and perfected over a 30-year period. 7

Adjustable Gastric Band: Lap Band Procedure This procedure places an adjustable band around the upper portion of the stomach to restrict the amount of food that can be eaten at one time. It does not require stomach stapling or bypassing normal digestive processes. Since 2001, the Adjustable Gastric Band has been approved for use in people who are more than 18 years of age in the U.S. 8

Vertical Sleeve Gastrectomy (VSG) This procedure removes 85% or more of the stomach without bypassing the intestines or using a restriction device. The stomach is stapled and divided vertically, significantly reducing its size. The portion of stomach that remains is shaped like a very slim banana and measures only a few ounces. This surgery is not reversible. Although it has not been as widely performed, early results have shown that it is safe and effective.

Join Us in a Study of Teens After Weight Loss Surgery The Teen-LABS Study If you are interested in participating in a study that will provide helpful information about your experience with weight loss surgery and will benefit overweight teens and adults in the future, we invite you to join in the Teen-LABS Study. The Teen-LABS Study is sponsored by the National Institutes of Health-National Institute of Diabetes & Digestive, and Kidney Diseases, and is being conducted at 8 medical centers across the United States, including Cincinnati Children s Hospital Medical Center. The study will allow us to look at the differences between adults and teens who have weight loss surgery, helping us to better understand how obesity and weight loss affect health over time. The Teen-LABS study is directed by Dr. Thomas Inge, a researcher and bariatric surgeon at Cincinnati Children s Hospital Medical Center. What is Required To Participate If you choose to participate in the Teen-LABS Study, you will be asked to take part in four visits over a 2-year period: before surgery 12 months after surgery 6 months after surgery 24 months after surgery Because we know your time is valuable to you, you will be compensated for your time for each of your study visits. What Happens During a Study Visit During your study visits, we will look at how your body changes following weight loss surgery, and how those changes may affect your heart, lungs, metabolism, liver, and kidneys. We might collect some of your blood, tissue and DNA samples for use in future research. Following surgery, you will need to take daily vitamin supplements to make sure your body gets the nutrients it needs. We will look at how often you are able to take your vitamins and what things may prevent you from taking your vitamins after surgery. We will talk with you about how you feel about yourself and your quality of life, and how that may change following surgery. 10

Here are the specific things you will be asked to do if you participate in this study: You will take a walk test We will measure your neck and waist with a tape measure. We will measure your weight and percent body fat on a special scale. We will take a blood and urine sample. You will fill out questionnaires about your health and medications. You will fill out questionnaires about your mood, your daily life, your eating, and how your surgery has affected your psychological health. You will wear a small physical activity monitor (the size of a pager) around your ankle for one week and then send it back to us. We will ask your parent or guardian to provide some basic contact and demographic information. If you wish to participate in the Teen LABS study, or would like more information, contact: Cynthia Spikes, Study Coordinator Phone: 513-636-7932 Email: Cynthia.Spikes@cchmc.org Or visit us on the web at www.cincinnatichildrens.org/teen-labs Contact Us For more information about the Surgical Weight Loss Program for Teens, to request a bariatric surgery consultation and evaluation, or to refer a patient for a review, please contact: Cassandra McDaniel, Program Coordinator Phone: 513-636-4453 Fax: 513-636-7657 Email: cwmc@cchmc.org Or visit us on the web at: www.cincinnatichildrens.org/weight 11

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