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Sunday, May 22, 2005

In The News:

Obese children turning to surgery
Andrea Mayes

CHILDREN as young as 12 are undergoing radical surgery to cure what doctors are calling Australia's obesity plague.

An estimated 50 to 60 children have already had lap-band surgery in Australia, and surgeons are struggling to cope with increasing demand for the operation.

George Fielding, a former Brisbane surgeon who now teaches obesity surgery at the New York University Medical School, told a conference in Perth that at least 3 per cent of Australian schoolchildren were so obese they needed surgery.

While acknowledging the solution was extreme, he said the problem had gone beyond an epidemic and was more accurately described as a plague. "I think epidemic's almost too polite a word - plague has connotations of something truly terrible," Professor Fielding told the Royal Australasian College of Surgeons conference.

"There are terrible consequences for children with this obesity ... They're all getting the diseases their grandparents have, and they're getting them when they're 12, 13, 14.

"They're getting diabetes, high blood pressure, sleep apnoea, heart disease at rates that would be unbelievable 10 years ago."

Paediatrician Louise Baur, a childhood obesity expert from Sydney's Children's Hospital at Westmead, cautioned that there was no strong evidence to support the benefits of lap-band surgery in adolescents, although it had been proved to be beneficial for adults. She said teenagers should be severely obese before surgery was considered, and should have failed to lose weight using conventional methods. "I would argue that most severely obese adolescents don't receive anything like adequate conventional therapy as yet," Professor Baur said. Intensive long-term support would be required for teenagers undergoing such surgery, she said.

Professor Fielding said for those teenagers already grossly overweight, diet and exercise did not work and surgery was often the only effective answer.

"Unfortunately these kids aren't just chubby little kids - they're humungously fat, sick kids," he said. "Diet and exercise do not work when you're morbidly obese."

The surgery involves inserting a band around the top of the stomach and tightening it to limit the amount of food that can be eaten.

Professor Fielding said the risks associated with the procedure were very small and the same as those for any operation involving general anaesthetic. He said it was too simplistic to blame parents when teenagers faced severe social pressures. Food was plentiful and easily available, especially junk food, and children led much more sedentary lives than previous generations, Professor Fielding said.

The solution was to tackle the root causes of the problem by banning junk food at school and encouraging children to be more physically active, he said.

Obesity Surgery Society president Harry Frydenberg said lap-band surgery had increased ten-fold in the past 10 years, and Australia would need another 100 specialist surgeons to cope with demand over the next 20 years.

"In the public hospitals there is two to three year waiting lists, and in a morbidly obese person, this can be life-threatening in lots of ways," Mr Frydenberg said.

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