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Washington University School of Medicine and Barnes-Jewish Hospital have partnered with St. Louis Children’s Hospital to open the first bariatric surgery program in the St. Louis area for obese adolescents. 

“Obese adolescents face a lifetime of long-term health problems related to their weight,” says Washington University bariatric surgeon Esteban Varela, MD, who directs the program. “Bariatric surgery increasingly has become a viable treatment option for extremely obese teens who can’t lose weight by other methods.” 

The rate of obesity among teens has more than tripled in the past 30 years. Today, 18 percent are obese, which increases their risk of heart disease, diabetes, stroke and dying young. 

Barnes-Jewish Hospital is designated as a Bariatric Surgery Center of Excellence by the American Society of Bariatric Surgery. Washington University’s adolescent bariatric surgery program is comprehensive in nature. Adolescents ages 14-19 may be eligible for weight-loss surgery if they are extremely obese, with a body mass index above 40. Teens interested in the procedure must have been unable to lose weight after participation in the Head to Toe weight management program at St. Louis Children’s Hospital. They must also be evaluated by Varela and the adolescent bariatric surgery team, along with pediatric experts at St. Louis Children’s Hospital, including a pediatric endocrinologist and registered dietitian. 

Varela and the bariatric surgery team offer three types of minimally invasive weight-loss surgeries: laparoscopic adjustable gastric banding, laparoscopic sleeve gastrectomy and laparoscopic gastric bypass. The surgery generally lasts one to two hours and patients often stay in the hospital for one to two days afterward. Most patients can return to school or work after two weeks of recovery. 

Varela’s own research before he joined the Washington University faculty has shown that bariatric surgery is as safe in adolescents as in adults and that adolescents have fewer complications. In addition, he says, obese teens often are unable to lose weight without surgery. 

“A recent study in the New England Journal of Medicine offered very good scientific evidence that obese kids often die young,” Varela says. “An intervention like bariatric surgery has the potential to increase their chances of living longer.”
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