Weight Loss Surgery for Teens and Young Adults

A referral from your child’s pediatrician or your primary care provider is required before scheduling the first appointment with The Duke Children's Healthy Lifestyles Program. 

You should also check with your insurance plan to verify that weight loss surgery is covered for adolescents. Some plans exclude weight loss surgery as a benefit for people under the age of 18.

Weight loss surgery may be recommended for teens and young adults with:

• Class 2 Obesity, defined as having a body mass index (BMI) at or above 35 or 120% of the 95^th percentile for their age and sex, as well as related conditions such as prediabetes, hypertension and obstructive sleep apnea.
• Class 3 Obesity, defined as a BMI at or above 40 or 140% of the 95^th percentile for age and sex.

A team of pediatric obesity doctors, dietitians, mental health counselors, and physical therapists from the Duke Children's Healthy Lifestyles program will evaluate your teen. 

Physical Exam and Medical Tests
If your teen meets the necessary qualifications to be referred for weight loss surgery, they will meet with the bariatric team and undergo an extensive physical exam. This often requires special studies, (EGD/endoscopy) and occasionally consultations with other specialists (pulmonary, cardiology) if related medical conditions are present. We use this information to recommend the safest, most effective surgical approach for your child.

Nutritional, Psychological, and Lifestyle Evaluation
Your teen will also meet with a psychologist and dietitian who will help them understand the commitment they are about to undertake and how they can prepare for life after weight loss surgery.

Preparing for Bariatric Surgery Takes About Six Months
During the time, your teen will learn intensive health behaviors and lifestyle treatments. The Duke Children's Healthy Lifestyle providers can also evaluate your teen for anti-obesity medications and the nutritionists will discuss specialized diets to support healthy weight management.

Experienced Surgeons
While weight loss surgeries are generally safe for teens, each procedure carries its own set of risks and possible side effects. Having an experienced surgeon minimizes the likelihood that complications will occur. Our board-certified, fellowship-trained surgeons perform about 800 bariatric surgeries on adults each year. Studies show that surgical experience is an important indicator of a successful outcome.

Laparoscopic Approach Means Smaller Incisions, Faster Recovery
In most cases, the surgeon will make small incisions in the abdomen through which instruments and a video camera are passed to visualize the area and perform the procedure. Sometimes, surgeons may use devices such as magnets or robot-assisted surgery to enhance their surgical flexibility and precision. This minimally invasive surgery approach:

• Shortens hospital stays (typically one to three nights)
• Leaves small scars
• Promotes faster, less painful recovery

Sometimes a larger abdominal incision is necessary based on your teen’s weight, body shape, and surgery history.

Accredited for Weight Loss Surgery
We are North Carolina’s only weight loss surgery program for adolescents accredited by the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program -- and one of the few in the country. You can be confident that your teen is in expert hands.

Once your teen has recuperated from surgery, they will meet regularly with the specialists in the Duke Children's Healthy Lifestyles program and the weight loss surgery specialists. Our pediatricians and dietitians will help your teen overcome the challenges associated with major lifestyle changes. Our physical therapist will help them adhere to an exercise regimen designed to make them stronger and more mobile.

We also work closely with your primary care doctor to ensure your teens receive long-term support to maintain your health and build a healthy future. 

Why It's Important to Keep all Appointments
All follow-up post-bariatric surgery appointments with our team are attended, and that our team monitors labs regularly to ensure your teen's weight loss success after bariatric surgery.

Fertility Concerns Following Weight Loss Surgery
Among the benefits and risks of weight loss surgery is the increase in fertility following the procedure. This is a concern among teenagers who may experience the positive outcomes of improved self-esteem, body awareness, and socialization. We have honest discussions with your teenager about these and other concerns that may impact their life after surgery. We strongly recommend your teen practice pregnancy prevention for at least two years following bariatric surgery.

Post-Surgery Body Contouring
If unwanted, loose skin and tissue hide the results of weight loss surgery, our skilled plastic surgeons can work with your teen to smooth and shape their body and ensure they feel and look their best. (This is typically not covered by insurance.)