Canadian teens who are severely obese because of medical conditions will be offered weight-loss surgery as part of a new program. Some children aged 12 to 17 who are obese because of brain tumours or other conditions such as complications from Type 2 diabetes will be offered a minimally invasive type of weight-loss surgery at the Hospital for Sick Children in Toronto.

The hospital announced Friday it will be the first centre in Canada to offer the surgical approach to pediatric patients who meet certain criteria for complex severe obesity.

It is estimated about three per cent of Canadian children have the condition, which involves having a body mass index or BMI of greater than the 95th percentile for their age and gender.

The surgery involves shrinking the stomach to reduce food intake, after people have unsuccessfully tried to lose weight through diet, physical activity and anti-obesity drugs.

The surgery is one part of the program, known as the SickKids Team Obesity Management Program, or STOMP. It involves an intensive behaviour management program to determine if the procedure, laparoscopic gastric banding surgery, is appropriate, alongside diet changes and medication in some cases.

Surgery a tool
The program includes doctors, a nurse practitioner, a dietitian, a psychologist and an exercise therapist who will help patients develop healthy eating habits, create exercise routines and learn new coping techniques. Teens and their parents will have support groups to teach them how to succeed, and researchers will monitor progress.

Sick Kids expects to admit 50 patients this year in the program, and up to 15 of them may undergo the adjustable and reversible surgery, said program director Dr. Jill Hamilton, an endocrinologist and associate scientist at the hospital.

"We're really offering treatment not just about the weight but around the complications, the health consequences and complications related to the overweight," Hamilton said. "It can be life saving."

Katie Lougheed went to Michigan for the surgery when she was 20, which she called the right time of maturity in her case. She wishes she had known about the option as a teenager.

"I decided to get the surgery because when I was only 20 years old and feeling the pain when I walked," Lougheed said. She was suffering tension headaches and didn't want to face worse problems as she aged.

Lougheed and Hamilton call the surgery a tool for becoming healthier.
"The surgery has definitely given me almost a sense of freedom," Lougheed said. "I'm not afraid to go out and go for that hike."
Socially, Lougheed said, she now feels more open with people.
Dr. Yoni Freedhoff, medical director of the Bariatric Medical Institute in Ottawa, welcomed the announcement that Ontario now has such a program. He called it an "absolute necessity" for a small subset of teens whose quality of life would suffer tremendously otherwise.

"The biggest thing for us and for a lot of people who do this work is not necessarily the pounds," said Geoff Ball, a professor of pediatrics at the University of Alberta in Edmonton.

"But it's the reduction of the risks that really have a strong impact on the morbidity and potentially mortality in these boys and girls who can't breathe, can't sleep, they can't move."

The program is funded by the Ontario Ministry of Health and Long-Term Care and Sick Kids Foundation.
From cbc