GESTIÓN EN SALUD PÚBLICA: BioEdge: Bariatric surgery for teenagers?

sábado, 25 de febrero de 2017

BioEdge: Bariatric surgery for teenagers?

BioEdge: Bariatric surgery for teenagers?

Bioedge

Bariatric surgery for teenagers?

by Michael Cook | 25 Feb 2017 |

American doctors are debating whether to offer bariatric surgery for severely obese young people. The market is huge: about 3 to 4 million teenagers are eligible, but only about 1000 a year have the operation. The proportion of adolescents who are severely obese has doubled nearly doubled between 1999 and 2014 – from 5.2% to 10.2 % of all people aged 12 to 19. But most doctors are deeply sceptical of the health benefits of the operation.

On the other hand, it is sometime the only thing that seems to work. “We’re at a point in this field where surgery is the only thing that works for these kids but we don’t know the long term outcomes,” Aaron Kelly, an expert in pediatric obesity at the University of Minnesota told the New York Times.

For many teens severe obesity is medically, socially and psychologically challenging. It is associated with type 2 diabetes, high blood pressure, sleep apnea, acid reflux, fatty liver and high cholesterol levels and depression. “I’ve had many patients tell me they’d rather be dead,” than remain fat, one doctor told the Times. .

On the other hand, it is not spectacularly successful. According to the most recent studies, most participants shed about one-third of their weight and kept it off for at least five years. But two-thirds remained severely obese and some developed vitamin deficiencies.

So doctors are thinking of offering the operation at an even younger age, since diets, exercise and behavioural therapy just do not work. The longer doctors wait, the more likely it is that the obese teenager will become an obese adult. “It obviously is a controversial area,” says Dr Marc P. Michalsky, of the Ohio State University College of Medicine.

We’ve often blamed the pharmaceutical industry for medicalising the normal ups and downs of life. But journalists are not above disease-mongering. I’ve just noticed a promising new ailment to which members of the Fourth Estate themselves are particularly susceptible: post-election stress disorder.

According to columnist in Psychology Today, “Countless Americans are reporting feeling triggered, traumatized, on edge, anxious, sleepless, angry, hopeless, avoidant of connection, alone, and suddenly haunted by past traumas they believed they had buried” because of the Trump election.

As of now, no pharmaceutical company is marketing a drug to cure these anxieties. Instead, therapists are recommending a range of behavioural strategies for dealing with the stress. “I advise my clients and friends affected by the election and its aftermath to reach out, connect, affiliate and show compassion for those similarly affected,” wrote Steven Stosny in the Washington Post.

Some people are indignant that Post-Traumatic Stress Disorder after battle is being compared to discouragement after an election loss. Republican Congressman Brian Mast lost both legs in Iraq because of a roadside bomb. Let him have the last word:

There was a big missed opportunity in naming it ‘Post-Election Stress Disorder,'” he says. “I would have preferred they name it ‘Post-Inauguration Stress Disorder,’ that way they could have called it ‘PISD.’ There’s a big difference between being pissed off about things and what happens on the battlefield.”