Weight Loss (Bariatric) Surgery

Losing weight is a challenge. For some teens and young adults, following through with a medically approved diet and exercise plan is enough to improve their obesity-related illnesses, such as diabetes, heart disease or sleep apnea. For others, these changes are not enough. In these cases, weight loss surgery might be an option.

There are 2 kinds of weight loss surgery:

• Restriction: Limiting the amount of food you can comfortably eat by reducing the size of the stomach.
• Diversion: Letting food “skip” part of the intestinal tract so that fewer calories are absorbed by the body. Diversion also changes the levels of hormones and enzymes in the digestive tract that signal hunger and fullness, so you feel full sooner.

To be eligible for weight loss surgery, you must meet all of the following criteria:

• You must be 15 or older and physically mature and healthy enough for surgery, as determined by a medical provider.
• Your body mass index (BMI) – the number calculated from your height and weight that estimates body fat – must be 40 or higher (35 or higher with diabetes).

A referral to the Endocrinology Insulin Resistance Clinic is the first step. A medical provider will complete an evaluation and refer you and your family to meet our team which includes:

• Registered dietitian
• Social worker
• Athletic trainer

Each team member will recommend follow-up based on the goals you and your family set during the visit. An evaluation by a behavioral health therapist may also be recommended.

Monthly visits with the Insulin Resistance Clinic team that focus on positive lifestyle, including nutrition, exercise, mood and family communication.

• Individual appointments with a medical provider, dietitian, athletic trainer and social worker.

Your team evaluates:

• If you can stick to nutritional and medical guidelines after surgery
• If you can understand and agree to surgery
• If you are ready to make adult decisions to support your health and well-being
• If you have family support that will help you stick to guidelines after surgery

Insurance authorization for surgery is required before we refer you to the UW Weight Loss Management Center. Each insurance carrier has their own set of guidelines to approve surgery. Some insurance companies require teens to lose weight prior to referral to the bariatric surgeon. The team will work with you to meet these.

The Seattle Children's Insulin Resistance team will refer you for evaluation by members of the UW bariatric surgery team which includes:

• A surgeon
• A registered dietitian
• A social worker
• A psychologist
• A care coordinator
• A nurse

Although many teens and family members focus on the immediate improvement of looking better, our main focus is on health benefits of surgery:

• Almost all teens with type 2 diabetes no longer have it after surgery. This is important because people with diabetes have a much higher risk of developing heart disease, kidney disease and may even lose their vision.
• High cholesterol levels usually come back to normal.
• Other serious medical problems, such as high blood pressure, sleep apnea and liver disease, also improve after surgery.

• Pain
• Vomiting
• Diarrhea
• Acid reflux after eating

• Bleeding
• Reaction to anesthesia
• Infection at the incision site
• Leaky stomach or intestine that can lead to an infection of the abdominal cavity (peritonitis)
• Blood clot in the lung
• Bowel obstruction

Weight-loss surgery is not a quick fix or an easy way out. It is not for everyone. There is a lot of hard work involved. You will need to eat differently for the rest of your life. You will need support before, during and after. If your health is compromised and you are able to make the commitment, it may be an option that can change your life.