Meet teenagers who had bariatric surgery – 11/21/2023 – Equilíbrio

After trying several treatments against obesity, including the drug Ozempic, Alice, 14, underwent bariatric surgery in June last year.

She comes from a family with a history of obesity. Her mother, Maria Carmen, also performed the procedure, as a form of encouragement.

Alice says it was the best decision of her life and that she had no complications during her recovery. The teenager has lost 31 kg since the surgery. Today, she says she dreams of being an endocrinologist.

According to Maria Carmen, there was a feeling of racing against time, as she saw her daughter gaining weight, which increased the risk of other diseases. “It wasn’t just the fear of depression, it was also concern about health.”

According to the ANS (National Supplementary Health Agency), between 2019 and 2021, 163 patients aged 16 or younger underwent surgery. In the SUS (Unified Health System), for the same period, the Ministry of Health registered 22 cases.

The option for the procedure in adolescents is seen as delicate by doctors. According to Tarissa Petry, endocrinologist at the center specialized in obesity and diabetes at Hospital Alemão Oswaldo Cruz, in São Paulo, clinical treatments for obesity are effective and have fewer side effects, with greater safety of use.

For surgery to be recommended for adolescents, the patient must have tried previous treatments, in addition to being committed to changing their habits.

According to Petry, one of the specific risks of bariatrics is the replacement of calcium, involved in young people’s bone formation.

In 2022, the SUS identified almost 1.4 million adolescents between 10 and 19 years of age as overweight, obese or severely obese. According to a study by the World Obesity Atlas, Brazil could have up to a third of children and adolescents living with obesity in 2035.

Petry states that the demand for treatment in this age group, whether clinical or surgical, is expected to increase in the country in the coming years. According to her, few cases receive proper treatment.

Ingrid Barreto, 33, had the surgery at age 12, when she weighed 114 kg. After the operation, she stabilized at 68 kg. Currently, she is an endocrinologist in Recife. Having undergone treatment, he says, influenced his choice of specialty.

She comes from a family with diabetes and hypertension. As a teenager, she underwent medication treatment, but was unsuccessful. The solution was bariatrics, which had positive impacts on sociability and health.

For the doctor, the procedure is a viable alternative, compared to the risks associated with obesity. “Without bariatrics, I don’t even know if I would be alive,” she says.

A study published in 2019 in The New England Journal of Medicine revealed that the incidence of weight loss in adolescents five years after the procedure was similar to that recorded in adults.

The comparison is with surgeries performed using the bypass technique (stomach reduction and intestine manipulation). Furthermore, there was a representative difference in the remission rate of type 2 diabetes (86% in adolescents versus 53% in adults) and hypertension (68% in adolescents versus 41% in adults).

On the other hand, Edmond Le Champion, associate professor in the department of surgery at the Faculty of Medicine of UFG (Federal University of Goiás), states that there is no quality evidence on the long-term effects on adolescents — 30 to 40 years after birth. operation.

According to Le Champion, there is concern about the resulting nutritional loss, which can impact aspects such as bone and psychological development. He criticizes the trivialization of the procedure in Brazil.

In SUS, surgery is offered to people over 16 years of age. It is indicated, for example, for patients who have a BMI (body mass index) greater than or equal to 50. The WHO (World Health Organization) considers a person with a BMI greater than or equal to 30 to be obese.

Beib Alves de Siqueira, 50, spent 94 days hospitalized due to Covid-19. During this period, her 15-year-old daughter gained weight.

With obesity 3 (defined by BMI 40 or greater) and hepatic steatosis (accumulation of fat in the liver), the teenager had a maximum weight of 128 kg. This year, her mother chose to take her out of school, where she was being bullied, and have surgery through the health plan, which took place at the end of September.

Self-esteem was also taken into consideration when making the decision. Beib says that the teenager created a world of suffering and that she feared suicide. “It was the best thing I’ve done for her to date. If I needed to, I would do it a thousand times over.”

After the surgery, the young woman started going to the gym and, by the beginning of November, she had lost 11 kg.

This report was produced during Folha’s 8th Training Program in Science and Health Journalism, which has the support of the Serrapilheira Institute, the Roche Laboratory and the Sociedade Beneficente Israelita Brasileira Albert Einstein