Adult options for childhood obesity?

Doctors say the high number of extremely overweight young people is serious enough to consider radical interventions.

By Victoria Stagg Elliott, AMNews staff. May 27, 2002.

More than a decade ago, William Cochran, MD, a pediatric gastroenterologist and nutritionist, referred one of his morbidly obese adolescent patients for bariatric surgery. The patient died of complications from the operation, and Dr. Cochran hasn't contemplated the possibility since. Until now.

"We had attempted everything we had -- behavior modification, exercise, lifestyle, protein sparing fast -- with that child, but he had severe obstructive sleep apnea. We felt he was very much at risk for dying from that," said Dr. Cochran, who works at the Geisinger Health System in Danville, Pa.

"When he died from the surgery, we said that's it. We're never doing it again. But now we're contemplating it again because I hadn't seen other kids with that degree of obesity until the last several years," he said.

Until a few years ago, most doctors say surgery or medications traditionally reserved for adults was something they would have never considered for their pediatric patients. But with childhood obesity growing in both rate and severity, they say those measures are now on the table.

"In pediatrics, physicians are asking: 'Should these kids at some point be referred for surgery?' " said Andy Muir, MD, associate professor in pediatric endocrinology at the University of Florida College of Medicine, in Gainesville. "In the past, it was always: 'No.' You'd wait until they were finished growing and then consider it." But, he said, the obesity problem is becoming serious enough that doctors "are going to have to ask those questions and examine them carefully in a controlled fashion." [...]