Tuesday, 14 January 2020

The Academy of Pediatrics Wants To Amputate Kid’s Stomachs – There Are Much Better Options

THEREI~1I saw the article in the LA Times Science Section, and then I saw red. The title was “More kids who are severely obese should have weight-loss surgery, pediatricians say” and the premise is that more children, including pre-teens, should be given stomach amputation (aka weight loss, aka bariatric surgery) procedures according to a new policy guideline by the Academy of Pediatrics.

(If you want to skip the possibly triggering discussion and just get some resources to help kids without amputating their stomachs, just scroll down to where it says resources.)

Let’s remember that by “preteen” they mean children 12 and younger. Children who have likely not even started puberty yet, are not remotely done growing. The American Academy of Pediatrics wants to surgically alter their digestive system to fundamentally and permanently interfere with their ability to absorb nutrients.

It’s not just the fact that these children are supposed to spend the rest of their lives participating caloric restriction that would be seen as a major eating disorder red flag worthy of immediate intervention in anyone else, it’s also the fact that this is a child who is going to be sentenced to a lifetime of eating that is complicated, risks long-term malnutrition, and sets them outside of the social norm. Every birthday party, every holiday meal, possibly every school lunch etc. they will have to eat differently than those around them. And their lives and the quality of those lives literally depend on their ability to follow restrictions and requirements around eating that adults (with fully developed prefrontal cortexes) often struggle with.

Just a few of the side effects of these barbaric procedures include low iron, calcium, vitamins D and B12, as well as a thiamine deficiency. This is extremely serious – adolescence is a time of development (for example, 50% of total adult bone mass is supposed to develop during this period, which is severely hampered by a lack of calcium and Vitamin D.)

Let’s remember that children don’t, typically, buy their own groceries. And many,  especially 12 and younger, don’t prepare their own food.  So their parents/guardians have to be diligent every single day for the rest of the time that child is in their care, with serious consequences to their children (but no likely consequences to the parents) if they should fail. So we are asking children to undergo a surgery that can have a serious negative lifelong impact and they aren’t even able to control the things they need.

Let’s also take a moment to realize that, even though a weight-neutral health practice (essentially focusing on supporting actual health rather than body size manipulation through forced starvation) has strong evidence of efficacy among adults with far fewer possible negative side effects, they didn’t even try to see if that would also work for children, preferring to literally butcher them instead. For profit. This was never about health,

Evan Nadler, MD is a good example of the issues here. He told Endocrine Today “A patient of any age — if they meet standard criteria for weight-loss surgery — should be referred to a surgeon so that they may, at a minimum, learn about the surgical options.” This on the strength of a study he undertook that only had 105 subjects and reviewed data for only 30 days post-surgery.  Three of the patients required a second surgery due to complications, one had major complications that didn’t require surgery, four experienced “minor” complications (where minor included one requiring  parenteral nutrition, and three others requiring hospital readmission for IV fluids and steroids.) And that’s just in the first 30 days after which, remember, they took to the media to recommend that more and younger children should have their stomachs amputated.

In fact, the “long-term” research that exists on childhood stomach amputations is only about 8 years, and most of the research is far shorter. Of course, if the surgery or post-surgical complications don’t kill them, the children will be alive much longer, potentially with a lifetime of malnutrition and complications the doctors who were so eager to profit from butchering their digestive systems haven’t even bothered to predict.

Not to mention that they use fatphobia as a reason to give these kids surgery, which means that they are teaching these kids that the solution to bullying is to risk your life in an attempt to give your bullies precisely what they want.

This is unethical in the extreme. I think it is difficult for an adult to ethically consent to these surgeries, but there is absolutely no way that ethical consent can be obtained from a child for this procedure – no. possible. way.  A child cannot possibly understand what this means for them, what the complications could be, or what the lifelong ramifications might be. And no parent or doctor should be able to sentence a child to that life.


Here are some resources to help kids of all sizes that do not involve amputating a perfectly healthy organ. Feel free to leave more in the comments.

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