- Video Transcript
Visual: Man riding bicycle, Parent walking with child, Woman canoeing on lake, Woman riding on scooter
Narration: At the weight loss surgery and wellness center, prevention of weight gain is always the best strategy to avoid obesity. Unfortunately, this is not always successful and more help is required to reverse the abnormal weight gain. At the Healthy Kids, Healthy Teens Weight Program at St. Christopher’s Hospital for Children, our team is dedicated to your child’s success and includes…
Visual: Illustration of group of doctors, APPs, and nurses
Narration: …Pediatricians, Registered Dietitians, Social Workers, Nurse Practitioners, Psychologists, Pediatric Nurses, and Surgeons.
Visual: Chalkboard with silhouette of person with obesity
On-screen text: Obesity is a Medical Disease
- Diabetes
- Sleep apnea
- High blood pressure
- Abnormal cholesterol
- Liver disease
- Bone/joint abnormalities
- Depression
- Bullying/missed school
Narration: Obesity in children and adolescents is a common medical disease that can lead to other diseases including diabetes, sleep apnea, high blood pressure, abnormal cholesterol, liver disease, and bone and joint abnormalities. Obesity may also contribute to depression and social issues such as bullying and missing school. Usually, this continues into adulthood and is likely to contribute to increased risk of heart disease and cancer and a shorter life span.
On-screen text:
- Heart disease
- Cancer
- Shorter lifespan
Narration: There are many causes, but few effective solutions.
On-screen text: Diet, Exercise, and Behavioral Changes
Narration: Diet, exercise, and behavior changes are important and can work for some and may help a person to lose five percent of their weight, but ultimately it is difficult to maintain. Generally, diet and exercise are not enough for ninety-five percent of children and adolescents struggling with weight.
On-screen text: Medication-based therapy
Narration: In addition to diet, exercise, and lifestyle changes, anti-obesity medications can be included to help children and teens decrease their weight. The American Academy of Pediatrics recommends anti-obesity medications for some children twelve and older struggling with weight. Some medications may be taken by mouth each day. Another option is to receive a weekly injection at home. These medications decrease appetite and food cravings. The medications must be continued, or the weight is likely to recur. Most patients tolerate the medications well, but potential side effects are possible and will be discussed with you by the pediatrician. A person could expect to lose around thirty pounds with the help of anti-obesity medications.
On-screen text: More than 90% are treated with lifestyle changes with or without medications
Narration: More than ninety percent of the individuals that come to the Healthy Kids, Healthy Teens program for care are treated with lifestyle changes -- with or without the assistance of anti-obesity medicines.
On-screen text: Weight-loss Surgery
Narration: However, for some teens over thirteen with more severe weight gain, the American Academy of Pediatrics recommends weight loss surgery as a possible best option. In our program, the teen is evaluated by the entire team and only meets with the surgeon if the family expresses interest in learning more about surgery. The teen is seen in our clinic for six visits or more, each one month apart, before they may qualify for surgery.
Visual: Illustration of abdomens of two individuals with weight loss surgery, one with a straight line going down the middle, and the other with several incision dots
Narration: Like all surgery, there is some surgical risk involved although the risk is much lower in adolescents than adults. Previously, the open-generation surgical procedures were done by creating a large incision in the abdomen, which led to increased complications. Today, laparoscopic-generation surgical procedures use five small incisions, each about one half inch long, which reduces complications significantly. Although there are other operations recommended in adults, we believe that the best procedure for adolescents is usually a gastric sleeve.
On-screen text: Sleeve Gastrectomy or Gastric Sleeve
Visual: Illustration of stomach with dotted line along it, and removing stomach on one side of line
Narration: This operation surgically reduces the size of the stomach from a small watermelon to the size of a banana. This limits the amount of food that can be consumed, as well as reduces the hunger hormone and also reduces food cravings. This is a surgical procedure, not an implant.
Visual: Illustration of female patient
On-screen text: Gastric Sleeve Operation
- Procedure takes 1 hour
- One night in hospital
- Return to school/work in 2 weeks
- Lose average 100 lbs.
Narration: The operation is usually a gastric sleeve operation that is performed laparoscopically and takes about one hour. The teen usually spends one night in the hospital and is discharged to home the following day. They can return to school or work in two weeks. In our program these individuals lose an average of one hundred pounds and resolve many of their obesity related medical problems such as diabetes, sleep apnea, and high blood pressure.
On-screen text: Sleeve Gastrectomy or Gastric Sleeve
Visual: Illustration of scale with advantages appearing in text on left side, and disadvantages appearing in text over the right side
On-screen text: Advantages
- No rerouting of the intestine
- Less short-term, long-term risks
- Resolution of most obesity-related medical problems
- Average of 100 lbs. weight loss
Disadvantages:
- Vitamins are recommended
- May experience acid reflux
- Diabetes
Narration: Advantages of the gastric sleeve procedure is that the intestine is not re-routed, thus eliminating malabsorption. Vitamin and mineral deficiencies are less likely to occur than with other weight loss operations. However, we still recommend some supplemental vitamins and minerals following this operation. There are also lower short-term and long-term risks. Gastric sleeve surgery in adolescents usually resolves diabetes, sleep apnea, and high blood pressure. A disadvantage is that some patients may experience acid reflux. If this occurs, it can be treated with acid-reducing medications.
On-screen text: Overall Risks. Most operative risks are within 3 weeks of surgery.
Visual: Icon visual of gastric sleeve (stomach separated along the middle)
Visual: Meter with colors going from green to red, indicator resting on green, indicating low risk
Narration: All surgical procedures carry risks. Fortunately, adolescents usually have fewer medical problems compared to adults and, therefore, have lower risks of complications. Your surgeon will discuss these risks with you at your surgical consult.
Visual: Green chalkboard
On-screen text: Risks of Gastric Sleeve in Adolescence is Lower Than Adults
Overall risk of a teen having a serious complication is only about 1%.
Visual: Table showing stats for Sleeve Gastrectomy
On-screen text:
Staple line leak - 0.11%
Bleeding - 0.43%
Infection - 0.13%
Blood clot - 0.1%
Readmission - 2.68%
Reoperation - 0.5%
Reference: American College of Surgeons Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP). 30-Day Occurrences Report, Chicago: American College of Surgeons.
Narration: Only one of one hundred patients will have anything on this list: leak from staple line, bleeding, infection, blood clot, readmission, or a required return to the operating room. That means that ninety-nine of one hundred adolescents that have a gastric sleeve operation will not have a significant complication. Mortality following a gastric sleeve operation has not been reported in adolescent studies.
On-screen text: What are the Risks of Doing Nothing?
- High blood pressure
- Abnormal cholesterol
- Liver disease
Visual: Meter with colors going from green to red, indicator moves from green all the way to red, indicating high risk
Narration: The risk of doing nothing is high, and includes the possible development of medical problems, such as diabetes, high blood pressure, abnormal cholesterol, and liver disease.
Visual: Toolbox with scalpel icon with plus sign underneath
Visual: Bowl of produce, plus sing, barbells, plus sign, and head icon with plus sign icon
On-screen text: Nutrition + Exercise + Mental Health
Narration: We want to remind our patients that anti-obesity medicines and surgery are only a tool to control hunger and portion size. Our program helps you to obtain the very best result by combining nutrition, exercise, and mental health.
On-screen text: Healthy kids, Healthy Teens
215-427-4886
Narration: If your child or adolescent is struggling with their weight and you would like help for your child, contact us at Healthy Kids, Healthy Teens by calling 215-427-4886.
On-screen text: TowerHealth.org/PhillyKidsHealthyWeight
Narration: Thank you for watching this video and good luck with your child’s weight loss journey!
The St. Christopher's Healthy Kids and Teens Weight Program offers a comprehensive, multidisciplinary, and community-based approach to helping children and adolescents struggling with weight issues and medical problems related to excess weight. Families will find encouraging and uplifting opportunities to engage with our amazing team in ways that can change the direction of their child's life and health. Our program has two treatment options: medical weight program (non-surgical) and weight loss surgery program.
Medical Weight Program (Non-Surgical)
At St. Christopher's Hospital for Children, our medical team will identify medical issues contributing to weight gain and correct them, when possible. They will help the patients and their families make healthier nutrition selections, offer additional activity options, and help to modify excess screen time. Medications may be prescribed to help with weight loss.
Weight Loss Surgery
Weight loss surgery may be the best approach to long-term weight loss for children or teens who suffer from more severe obesity and have related medical problems (such as type 2 diabetes, sleep apnea, high blood pressure, fatty liver disease, or high cholesterol). The journey to surgery takes about six months and includes an evaluation with medical specialists and a weight loss surgeon. The child or teen will meet with a registered dietitian monthly for six months and be evaluated by a behavioral health specialist. A laparoscopic gastric sleeve operation is today's most frequent weight loss procedure performed for children and teens.
Why choose weight loss surgery for children and teens?
- Research has shown that bariatric surgery is more effective when done early rather than delayed until adulthood.
- Weight-related illnesses such as sleep apnea, type 2 diabetes, high blood pressure, fatty liver disease, and high cholesterol are often resolved by weight loss surgery.
- Self-esteem, quality of life, and psychological status are likely to improve in patients.
What to Expect for Pediatric and Adolescent Weight Loss Surgery
- We will first complete a thorough evaluation of your child or teen, including a past medical history, nutrition intake, physical activity level, blood levels, and vitamin/mineral levels. Other specialty evaluations will be scheduled if necessary.
- Our Registered dietitians will meet monthly with your child or teen for six consecutive months to review intake and provide comprehensive nutrition counseling and education.
- We may recommend weight loss surgery for patients with severe obesity, with a BMI greater than 40 with or without obesity-related medical problems, or with a lower weight if they have severe medical problems such as sleep apnea, type 2 diabetes, high blood pressure, fatty liver disease, or high cholesterol.
- Typically, patients stay at St. Chris one to two nights after surgery so we can control pain and monitor other medical conditions.
- Once discharged, patients may return to school and all other activities for two to three weeks.
- After surgery, our team follows up with monthly in-clinic visits, and then tailors future visits to the patient’s needs.
- We recommend weight loss surgery patients have lifetime follow-up visits for nutrition monitoring.