Weight-loss surgery is becoming more common among US teens

More teens with obesity are getting weight-loss surgeries year over year in the U.S., a new analysis suggests.

The study, published Tuesday (May 30) in the journal JAMA Pediatrics, focused on a time period before and after the American Academy of Pediatrics (AAP) issued a 2019 policy statement saying that teens with severe obesity needed better access to weight-loss surgeries because lifestyle interventions aren't very successful in helping this group lose and keep weight off in the long-term. 

Just this year, the AAP released more detailed guidelines for treating children and teens with obesity. These new guidelines also emphasized surgeries as a treatment option to consider for teens with severe obesity, meaning those with a body mass index (BMI) equal to or greater than 120% of the 95th percentile for their age and sex. (BMI is a rough estimate of body fat calculated using a person's weight and height.) 

The guidelines issued this year framed weight-loss surgeries and weight-loss drugs (a treatment option for children ages 12 and up) as adjunct therapies to "intensive health behavior and lifestyle treatment," programs focused on introducing sustainable weight-loss-promoting lifestyle changes.

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Despite barriers to accessing weight-loss surgery — "including low referral rates, limited access, and poor insurance coverage" — the number of young people undergoing the procedures has still increased in recent years, the authors of the JAMA Pediatrics analysis wrote.

The analysis pulled data from patients ages 10 and up from the national accreditation program for bariatric surgery centers, called the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program. The analysis included data collected between 2015 and 2021 from more than 1.3 million patients, in total. 

In each year assessed, far more adults than youth got weight-loss surgery — the annual rate of metabolic and bariatric surgeries in adults ranged from roughly 160,000 to just over 200,000, while the rate in youth ranged from about 700 to 1,400.

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However, the data revealed an interesting trend among U.S. youth: After dipping between 2015 and 2016, the rate of weight-loss surgeries increased steadily between 2016 and 2021, both overall and in each racial and ethnic subgroup analyzed. This upward trend even continued through 2020 and 2021, the first years of the COVID-19 pandemic, when the rate of adult surgeries briefly declined. Among young patients, surgery rates increased about 19% between 2020 and 2021.

"This data shows us that adolescents and their families are indeed interested in pursuing surgery as a treatment option if they are given access and a good candidate," study co-author Sarah Messiah, a professor and pediatric obesity researcher at UTHealth Houston School of Public Health, told CNN. 

Evidence suggests that weight-loss surgeries help teens with obesity lose and keep off weight and counter conditions linked to obesity, such as diabetes and high blood pressure, according to the AAP. However, patients must follow a restrictive diet plan following surgery, and eating disorder experts have raised concerns about how this might impact teens' long-term relationship with food. Other medical experts worry that, now that surgeries are being emphasized in official recommendations, doctors might push the procedures without first exhausting other weight-loss options.