The Telegraph
London, UK
16 May, 2008


Obesity crisis 'will lead to children having their stomachs stapled'

Primary school children could soon be undergoing stomach-stapling surgery as Britain's obesity epidemic worsens, a senior medical director has warned.

Steve Ryan, of Alder Hey Children's Hospital in Liverpool, said "significant numbers" of children aged two and three were being classed as obese. Conditions normally seen in middle age, such as Type 2 diabetes and sleep apnoea, were increasingly common among teenagers, he warned.

Mr Ryan said it is was "almost certain" that surgeons will have to staple children's stomachs within a few years.

At present, weight-loss surgery is only performed on adults when all other methods have failed. Although the procedure can lead to complications, Dr Ryan believes that for some children it will prove the best option.

"In the not too distant future I think we will be starting to consider surgery on children who are grossly overweight," he said. "In adults it is one of the things that can be very effective indeed, but it is a drastic step.

"Clearly you are not going to dive in and do that for children without a lot of careful consideration, but it would be an option. We have not performed any procedures yet, but a hospital like this one would probably be asked to. I would say it is almost certain."

Dr Ryan said the number of overweight children coming to Alder Hey from the surrounding area had risen dramatically in the past decade.

"There are more and more overweight children, and significant numbers of these are obese from a very young age – two to three years old," he said. "When I was a paediatrician starting out in 1991 there were very few children who were overweight, but that has changed and we are starting to see complications resulting from this."

Of the increasing number of cases of Type 2 diabetes in children, Mr Ryan said: "It is hugely common in people over 50 but we are starting to see it in teenagers. It is a huge worry because when I started it just didn't happen."

He added: "We are also starting to see breathing difficulties in overweight children. They are suffering from conditions that usually only affect adults, such as sleep apnoea, which requires sufferers to wear a mask over their nose or mouth at night.

"For the first time, we are having to give these masks to children. It is here and we are having to deal with it."


http://www.telegraph.co.uk/news/ukn...stapled%27.html

From the Mail
London, UK
16 May, 2008


Britain's couch potato children are now among the fattest in Europe

British children are among the worst in a Europe-wide obesity league table, with around a third weighing more than they should.

A couch potato lifestyle and a growing appetite for fast food is blamed for our boys and girls weighing in near the top of a 27-country fat league.

The findings come as a leading doctor warned that surgery such as stomach stapling will have to be used on children soon to tackle the obesity crisis.

Scottish girls take second place in the female rankings, with almost 33 per cent overweight. English girls are fourth, with 29.3 per cent too heavy for their height.

The heaviest girls are in Portugal (34.3 per cent), while the slimmest are in Latvia and Lithuania (3.5 per cent overweight).

Among the boys, Scotland was again second, with almost 35 per cent too heavy for their height. Only Spanish boys are heavier.

English boys are in sixth place at 29 per cent - compared to the lean lads of Lithuania, where only 8 per cent are overweight.

Obesity experts said the results could be partly explained by a couch potato lifestyle, in which TV dinners have replaced family meals and computer games are preferred to outdoor play.

Dr Tim Lobstein, of the International Association for the Study of Obesity, said: "There is a big industry selling us more TV to watch, more computer games to play, more DVDs to sit and watch.

"There is a big industry promoting screen watching which is a sedentary behaviour and you just get fatter while you do it."

The figures, which were compiled by the IASO from government and scientific studies, come as British doctors warn they are treating children as young as two for obesity.

Drastic stomach surgery, including gastric banding, is being carried out on children as a last resort.

Type 2 diabetes, which was once a problem for overweight middle aged adults, is being diagnosed in teenagers, and chubby children are being equipped with masks to ensure they do not suffocate in their sleep.

Dr Steve Ryan, medical director of Alder Hey children's hospital in Liverpool, said: "There are more and more of these children and significant numbers are obese from two or three years old.

"When I was a paediatrician starting out in 1991, there were very few children overweight but that has changed and we are starting to see complications resulting from this.

"It is here and we are having to deal with it."

But while British youngsters totter near the top of the heavyweight league, children in other countries are starting to lose weight.

New data shows rates of childhood obesity are stabilising in France and falling in Switzerland.

Restrictions on the advertising of junk food to children, the banning of vending machines in schools and national healthy eating drives may all have played a role in the change, the European Congress on Obesity heard yesterday.

Obesity experts welcomed the figures but warned the situation is still bleak - particularly in the UK, where rates of child obesity have quadrupled since 1984.

Dr Lobstein, director of the IASO's childhood obesity programme, said: "It is encouraging that there may be some signs this tidal wave of obesity is easing but it is not really subsiding, it is only stopping at a high level.

"The tide has come in but it is not going out. And in Britain, it is still coming in and is rising. The old picture of a jolly fat person couldn't be further from the truth.

"Although some fat people might indeed be jolly, the majority don't enjoy their condition and wish they were slim."

Dr Ian Campbell, medical director of the charity Weight Concern, said childhood obesity could only be tackled by parents, schools and government working together.

Safe, accessible exercise facilities and nourishing and affordable meals should be a priority, he said.

• Cash is the most effective way to get children to lose weight, according to a study.

More than 100 families were given either a low carbohydrate diet, a low energy diet or support in the form of a weekly motivational letter.

The final option was giving children a cash bonus each time they improved their body mass index. The congress heard that cash was the best motivator for children.

For adults it was a combination of all four methods.


http://www.dailymail.co.uk/pages/li...in_page_id=1797

I find this very disturbing. I understand obesity in children is bad - (IMO - more so for self-image than health). But surgery for children? Especially surgery that is considered elective by many? A doctor would have to get a court order to perform such a surgery on any child of mine - and then they might just have to catch me as I flee the country.

A drastic step? That's an understatement. Given the miniscule amount of food a person is allowed to eat after such a surgery, how are the children supposed to get the nutrients and such they require as growing children. I suppose they could just take a vitamin - but that's not the best source of nutrients.

The article says it itself - in adults this type of surgery is considering a last resort. Why would a doctor consider this for a child in the manner obviously contemplated in this article (by this doctor) when a simple change in eating (cut out the junk food, sugary drinks, cakes and biscuits, etc.) would take care of the problem?

Not that lap-banding or stomach stapling is a quick resolution, but I think this is indicative of society's general attitude - of not wanting to take responsibility for itself and wanting an 'easy' solution.

Now that you get that I am opposed to such a procedure for children, I do wonder if the side effects from such a surgery seen in adults would be seen in children. Children tend to be more resilient ...

Children are actually more vulnerable to nutritional deficienies than adults, so surgically altering food energy and nutrient intake potential, with a known a well-documented side effect of nutrient deficiency is likely to be more harmful to a growing child/adolescent than an adult.

I wasn't referring to nutritional deficiencies but the effects of the actual surgery ...

Can you clarify then? I'm not sure how a nutritionally deficient state, which leads to profound negative potential consequences over the short and long term, isn't an effect?

I'm thinking along the lines of how children physically react to the surgery itself - not what they eat/can't eat after the surgery. For example, recovery time after the surgery: Do children recover faster? With fewer side effects? Can their bodies tolerate the procedure better?

I don't have specific examples of how adult bodies react to the surgery - just vague ideas of what I've heard. I just wonder if a child's body could tolerate such a surgery better than an adult body.

If you are talking about physically healing after surgery then perhaps kids are better off. But I think Regina is dead on about the long term impact of nutritional issues, and no, children will not regrow the nutrient receptors that are lost when the duodenum is bypassed, nor have normal gastric juices produced which also aid in the absorption of nutrients. As a result, they face the prospect of developing bodies that are not getting iron, absorbing B12, or getting normal uptake of a plethora of other nutrients. We're talking lifelong nutritional supplements and, for a lot of people, monthly shots of B12.

I checked out this surgery years ago. Have no problem with adults doing it if they are informed. Think even *considering* doing it on a child should be criminal.

From the perspective of physically tolerating the surgery, I would think a child could potentially tolerate the actual surgery better, healing though would be an open question since our ability to heal is highly dependent upon nutritional status, which following the surgery falls immediately....so whether they'd recover faster, or with less complications, remains an open question.

What I find truly disturbing about this is that it's uncharted territory - there is no short or long-term data on outcomes in children and it seems the surgeon's are totally willing to set aside the dearth of evidence and proceed into the unknown here - basically using children as guinea pigs while they "hope for the best" when they haven't even been able to resolve much of the nutritional issues in adults that follow the surgery!

Stuff that relates to children always disturbs me.

I am having a hard time understanding how a culture that rightfully abhors such thing as vaginal mutilation of young girls in other cultures, would be willing to perform digestional mutilation in their own culture. Yes, in both cultures, allegedly "the end justifies the means." It's not much different.

It would require actually killing me to do this on my child. WTF kind of people think sticking a knife in a child and screwing up their body for life and likely killing them through half a dozen inevitable malnutrition-related diseases/disorders, a good idea?

What I cant get my head round is that doctors and parents are prepared to put children through this kind of thing - surely its easier to stop em eating so much - afterall arent the parents in control of what goes into their kids tummies in the first place?? if not they should be. cos then they wouldnt need to go to such inhumane measures - all because they cant say no to their kids and feed em cr~p!!

Exactly.
At least childern as young as 2 or 3 ("significant numbers" of children aged two and three were being classed as obese).

What are the people feeding 2 and 3 year olds to make them so fat???

Well if the people around me are any clue, they're feeding them unlimited amounts of dr. pepper in their toddler cups and unlimited amount of cheap chips-crackers-etc. because they're bulk food to keep them busy and then dosing them with prozac because when they're actually awake, they're either hyper or cranky. Of course the government paying some people to stay home and raise their 4 individually fatherless kids is also paying for the doctor and the medication to medicate the 2 and 3 year olds so their activity level does not inconvenience their mother. Don't get me started . . .

Do we live in the same neighborhood?