Kimberley Steele on Childhood Obesity and Weight Loss Surgery

Kimberley SteeleAccording to the Centers for Disease Control and Prevention, obesity has more than doubled in children and quadrupled in adolescents over the past 30 years. Addressing obesity at a younger age can help prevent obesity-related diseases and illnesses later in life. One way to do this is through adolescent weight loss (bariatric) surgery.

In today’s Ask the Expert column, bariatric surgeon Kimberley Steele answers several common questions about childhood obesity and bariatric surgery as a treatment option. Submit any questions you may have in the comments section below.

At what point is a child or teen considered to be overweight?
To be considered for bariatric surgery, a teen must meet the following criteria. However, meeting these criteria does NOT necessarily mean that weight loss surgery is right for someone.

  • Body mass index (BMI) greater than or equal to 40 (generally more than 120 pounds over ideal weight)
  • Obesity-related health problems (obstructive sleep apnea, diabetes, high blood pressure, significant quality of life or mobility problems)
  • Inadequate weight loss with organized weight loss attempts

Can children be genetically predisposed to becoming overweight?
The cause of obesity is felt to be multifactorial and may include:

  • Socioeconomic factors
  • Psychological factors
  • Behavioral factors
  • Genetic factors

What are traditional weight-loss methods suggested for children and adolescents? What other treatments are effective?
Traditional weight loss methods include a balanced and healthy diet and regular exercise.

However, because dieting and “medical” or “traditional” weight loss has been unsuccessful for the majority of teens who are extremely overweight, it has become increasingly important to consider how best to help adolescents in the fight against obesity. We know from adults that weight loss surgery can cure morbid obesity. Research has shown that weight loss surgery can provide an early and effective tool for the patient to help prevent serious health problems.

When is weight-loss surgery appropriate?
Weight-loss surgery is appropriate when traditional weight-loss methods have not been successful or if a child’s weight is a greater health threat than the potential risks of surgery. Studies show that the risk of adolescent bariatric surgery is no greater than that of adults undergoing the same procedure. In fact, adolescents tend to have fewer complications and a faster recovery.

There have been more than 5,000 adolescent bariatric cases performed since 2004. We believe that this increase demonstrates a realization that surgery does work for weight loss and that surgery can reverse significant health problems.

How does bariatric surgery help adolescent patients?
Research has demonstrated that bariatric surgery can be a successful measure for improving hunger and fullness signals in adolescent patients. It has also helped alleviate or at least improve adolescent patients who have multiple medical problems associated with their obesity, including type 2 diabetes, high blood pressure and sleep apnea.

What can parents do to prevent pediatric obesity?
The first thing is to identify factors in a child’s lifestyle that are promoting weight gain and to do something about those behaviors.

We use the term “behavioral modification” to explain how we can modify our behavior to decrease risks that lead to obesity, such as aiming to decrease the intake of calories.

Here are a few simple ways that every family can better understand nutrition and to make better food choices:

  • Cut back on sugared beverages, including soda and fruit juice
  • Reading food labels and cut out foods that list sugar in the first three ingredients
  • Eat a healthy breakfast!
  • Think about ways to increase activity throughout the day

If a child or teen is preparing for weight loss surgery, encourage them to adopt healthy eating patterns and develop an exercise routine. This will help surgical candidates prepare to be in the best physical condition for surgery. It is especially important that parents are committed to helping their child have success and be supportive of the entire process.


If you or your child is interested in a consultation with the Johns Hopkins Center for Bariatric Surgery, visit to view an online information session or see a list of in-person seminars.

Other recommended sources include The American Society of Bariatric Surgery and the American Obesity Association.

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