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3 Reasons to be Cautious of Weight-Loss Medication and Surgery

I was rather alarmed to read a recent article that presented updated guidelines for treating obesity in kids, including weight-loss medication for kids as young as 13 and surgery for those as young as 12.

This line, in particular, astounded me: “This is no different than if you have asthma and now we have an inhaler for you.” That was from Dr. Sandra Hassink, medical director for the AAP Institute for Healthy Childhood weight.

Saying weight-loss surgery is the same as an inhaler? Since when does an inhaler involve surgery or life-long side effects? And an inhaler doesn’t involve sticking yourself with a needle once a week, every week, forever.

Also, while I know that some trials of the weight-loss drug Wegovy were with teens, I have to wonder about the long-term impact of the drug. Will it have some unknown effect once they reach adulthood, even more than the potential side effects listed?

Nor was I comforted to see the weight requirements for the drug. “The drug is indicated for chronic weight management in patients with a body mass index (BMI) of 27 kg/m2 or greater who have at least one weight-related ailment or in patients with a BMI of 30 kg/m2 or greater.“

By those standards, I fit into that category, with a BMI of 30. And I have to say I’d be horrified if someone suggested that I take a weight-loss drug.

Also, something that always confuses me about these things is that many websites discussing weight will say that people who are overweight or obese will improve their health by losing 5-10% of their body weight. But how does that jibe with the fact that you may still be considered obese or overweight even if you lose that much of your body weight?

And whether you’re an adult or a child, these interventions have some significant side effects and possible complications, all of which should be considered carefully before using them. I’m not suggesting that these treatments don’t have a place, but they should not be used as the default option of treatment.

If you’re considering either of these options, here are some things to think about.

Physical side effects

We all know that medications carry a worrying list of side effects, and Wegovy is no different. The many possible physical side effects include:

  • the potential risk of thyroid C-cell tumors

  • seizures

  • difficulty swallowing

  • increased hunger (particularly ironic for a weight-loss drug)

  • trouble breathing

  • a variety of digestive issues (constipation, diarrhea, and indigestion)

And those are listed among the more common side effects! That’s not reassuring.

Plus there’s the fact of giving yourself an injection once a week for the medication. That can’t be fun.

Bariatric surgery also comes with a lot of potential side effects and risks, including:

  • Inability to eat certain foods

  • Malnutrition

  • Gallstones

  • Dumping syndrome

  • Hernias

Plus, you need to go under anesthesia for the surgery, and that carries its own risks.

And in all cases, if you lose weight quickly, you could well have sagging and/or excess skin.

Mental side effects

And then there’s the mental aspect of it. For Wegovy, this could be anxiety, depression, confusion, nervousness, nightmares, depression, or suicidal thoughts.

On the surgery side, depression is also a possibility, as are alcohol and substance abuse disorders.

And in both cases, you’ll likely experience a change in your relationships. That can be very hard, and I can only imagine how much more difficult it would be for teenagers who already struggle a lot on that front.

Long term changes

How long these side effects may last likely vary by individual, but certainly for weight-loss surgery, it impacts how you eat permanently and requires careful monitoring of your food intake to ensure that you get the proper nutrition.

Also, while many people experience initial weight loss with bariatric surgery, most people don’t lose all the weight they want to. Often, the surgery is considered a success if you lose 50% of the excess weight.

Additionally, it’s very common for people to gain some weight back a couple of years after the surgery. In some cases, it’s a small amount, like 5%, but some people can end up regaining almost all the weight lost.

Consider all the impacts and options

I know that the recent change in guidelines for addressing obesity in kids was done in part because people have decided that waiting to see if the kids will lose weight on their own doesn’t work.

But that’s not the only reason to wait. Kids’ bodies are changing rapidly, and I worry that teens who have bariatric surgery won’t get the nutrition they need, or that those who use weight-loss drugs may suffer from it. From that perspective, waiting until they’re old enough to consider all the implications makes a lot of sense to me.

Adults, too, should take the time to really think about the possible side effects and what their desired outcome is. You may still decide that one of these options is right for you, and if so, I hope it works out well for you. I just encourage everyone to pause and reflect a bit before jumping on board with these options.


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