As many as 90,000 children in England could be considered eligible for bariatric surgery, yet only 18 operations were performed last year, according to the new president of the Royal College of Paediatrics and Child Health, Prof Russell Viner. He said the NHS could be doing up to 100 times more obesity surgery on the most obese children and teenagers, and described the gap between those who undergo the procedure and those who are theoretically eligible as "exceptional".
Vicky Counsell, now 27, had gastric band surgery at 17 after being told by her doctor that without it her weight could kill her. She weighed 140kg (22st), her weight gain accelerated by steroids for a lung condition. Ten years on, she has lost more than 44kg (7st) and works as a support worker for older people. "Before the surgery, I couldn't even walk on the flat for 200m," she said. "Now I walk for miles."
Counsell said the operation was "an easy choice" but that living with a gastric band has been difficult. "I remember the doctors telling me I wouldn't be able to eat a lot of food, but I don't think I realised how tough it would be," she said. "At the very beginning I couldn't even keep water or juice down. Now I can't eat bread, pizza or anything high-carb." She described it as a lifelong commitment, which as a teenager she did not fully grasp.
Prof Viner stressed that surgery should be a last resort, following months or years of attempted weight management, but said: "We shouldn't shy away from last resorts. Bariatric surgery is incredibly effective. Once you are very, very obese, the chances of you losing a significant amount of weight without bariatric surgery are very low. We're talking about super-obese teenagers." He added that the first response must be prevention, but for those already severely obese, surgery is often "the only way".
NHS guidelines state that bariatric surgery for young people should only be considered in exceptional circumstances, and if they have achieved or nearly achieved physiological maturity. Prof Viner said barriers to surgery exist, but when done carefully within the NHS with an experienced team, it can be "life-changing". The number of operations on under-18s in England has remained stable: 18 last year, 11 the year before, and 16 five years ago.
