When Lifestyle, Diet and Exercise Fail
In the United States, 15 percent of our teenagers are severely overweight with little hope that their obesity can be controlled. These severely overweight adolescents are susceptible to or already experience depression, school phobia, low self-esteem, low quality of life, joint/bone problems, diabetes, hypertension, hypercholesterolemia, kidney, liver, lung and heart disease, sleep apnea, increased risks for cancer and decreased life span.
A Lifetime of Trying
These adolescents have tried everything many times over: diets, medications, exercise, psychological counseling and medical supervision. A National Institutes of Health review of more than 4,500 weight-loss publications revealed the ineffectiveness of the standard diet, exercise and behavioral modification projects for severely obese patients. Adolescents seen by our staff at the New Hope Weight Management Project weigh between 300 and 500 pounds and have little hope of reversing their obesity and regaining their health.
Offering Hope
In 1993, the National Institutes of Health recommended bariatric surgery for severely overweight patients. Bariatric surgical procedures are designed to force a decrease in caloric intake by reducing the stomach size and/or inducing intestinal malabsorption. The clinical results confirm that a comprehensive weight management project, including nutritional education, an exercise regimen, psychological support, pharmacological therapy and bariatric surgical procedures will help a morbidly obese individual lose 50 to 60 percent of their excess weight and keep it off. More importantly, it will prevent the development of obesity-related diseases, help reduce or resolve already co-existing obesity-related medical complications. Successful, durable weight loss greatly improves an individual's overall health.
New Hope
The most commonly performed bariatric procedure (weight loss surgery) for both adults and adolescents in the United States since 1993 is the gastric bypass surgery. Weight loss has been achieved and the overall health of patients has greatly improved.
In 2001, the FDA approved the use of adjustable gastric band surgery as an alternative bariatric procedure for adults. The adjustable gastric band does not cause malabsorption, but instead acts by restricting the stomach size to help patients reduce food portion size and caloric intake. The gastric band is adjustable to regulate food intake, and reversible in that the device can be removed as needed. It has the lowest complication rate of all bariatric procedures. If complications do occur, they are less severe than those experienced by patients undergoing gastric bypass surgery. The University of Illinois Medical Center's adult bariatric team is among the leading gastric banding institutions in the U.S., having performed more than 700 adjustable gastric band surgeries. Our results show that this procedure offers effective weight loss and improves the co-existing morbidities at very low complication rates.
Who Needs Hope?
“I am a 15-year-old girl who has been overweight my whole life. I do not ever remember a time when I was thin like the other girls. At first I could keep up with them all but as I got older, it was harder to run as fast or walk as far.
“I have always been told that I am pretty and that it was too bad that I couldn't just lose some weight … that I just needed to try harder. I know that people want to help, but I am trying as hard as I can. I have tried eating less, but never seem to feel full. Then I feel bad about myself when I can't stop eating.
“I hear people worry about kids eating the wrong things, watching too much TV and not exercising enough. I am as active as I can be but it never seems to help. I don't watch TV often. We have good food in the house.
My mom is my biggest supporter. She does all she can to find the right foods and not have bad foods around. She walks with me and finds things for us to do together. I know she worries that she did something wrong and that makes me feel bad, too.
“Inside, I am just a teenage girl. I want to be like the other girls in my class. I am a good student and am going to go to college. The girl inside me would like to be friends with a boy, but I don't see how this will ever happen. Someday, I would like to have children, but worry that I will never be able to be a mom
“I find myself watching more and more, like a spectator … I just want to be active with the people around me.” |
New Hope for These Teens
Physicians at the University of Illinois Medical Center's New Hope Project for Pediatric and Adolescent Weight Management believe that the adjustable gastric band should be the primary bariatric surgical procedure for adolescents. It works. It is reversible. And it is adjustable. The complication rate is low and the mortality risk is even lower (less than 0.01 percent). Patients with the gastric band feel full after eating smaller portions of a regular balanced diet. Therefore, the resulting weight loss is not from starvation and unlike the gastric bypass procedure, it is not associated with any vitamin, mineral or nutritional deficiencies.
Making the Band Available to Teens
Physicians at the University of Illinois College of Medicine feel strongly that the adjustable gastric band is the safest bariatric surgical procedure for adults as well as adolescents. Currently, the FDA has only approved the gastric band for use in obese adults. We have obtained special permission from the FDA to study the safety and efficacy of the adjustable gastric band in teenagers (14-to 17-years-olds). The university's Institutional Review Board has approved the study and the FDA has further requested that our physicians organize a multi-institutional trial of the adjustable gastric band in adolescents. The data from these studies will be presented on a scheduled basis to the FDA for review. If the adjustable gastric band is as safe and effective for adolescents as it is for adults, the FDA is expected to approve its use for adolescents throughout the country.
Our Clinical Team
The New Hope Project clinical team has representatives from pediatric surgery, adolescent pediatrics, adult bariatric surgery, pediatric nursing, nutrition, psychology, exercise/movement science, physical therapy, anesthesia, pulmonology, endocrinology, hepatology and behavioral science. Other on-staff pediatric subspecialties are available for consultation as needed.
Core Physician Group
Mark J. Holterman, MD, PhD, chief, Division of Pediatric Surgery
Ai-Xuan L. Holterman, MD, pediatric surgeon
Christiane Stahl, MD, adolescent medicine specialist
Our Research Team
The New Hope Project is committed to ongoing research in the field of adolescent and pediatric weight management. Our multidisciplinary research team is involved in research relating to the many facets of this difficult problem. Our research team has representatives from pediatric surgery, adolescent pediatrics, adult bariatric surgery, pediatric nursing, nutrition, psychology, exercise/movement science, physical therapy, pulmonology, hepatology, behavioral sciences and endocrinology.
Our Education Mission
Clinical and Research members of the New Hope Project provide ongoing presentations to increase public and professional understanding of the problem of adolescent obesity management. Presentations are given at institutional, local, state, and national levels.
For Information on the New Hope Project, please contact 312-413-5655. |
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