Obesity — especially when it’s your child — can bring on a flood of emotions, from frustration with not seeing progress to fear about your child’s health. As a parent, you may feel guilty, especially if you have had your own struggles with weight.
While these emotions can be overwhelming, they’re fairly common. Obesity is one of the top childhood health concerns in the country. And with nearly 30% of Nebraska children ages 10 to 17 suffering with overweight and obesity, it’s one of our top concerns too.
So that children with severe obesity can gain confidence, hope, and a healthier outlook on life, we are committed to helping them lose weight. Our multidisciplinary and family-centered team starts by focusing on diet, exercise, and behavioral changes. If those methods fail, we move the discussion to bariatric surgery, a weight loss tool that alters the digestive system to either restrict how much food a patient can eat or reduce how many nutrients their body can absorb.
Even though bariatric surgery is more commonly performed in adults, teens who’ve undergone the surgery have had impressive results. Many teens lose a significant amount of weight and have improvements in obesity-related conditions, such as diabetes, liver disease, and high blood pressure.
Bariatric surgery is not a cure by itself. If you’re a teen, you’ll need to be committed to leading a healthy lifestyle by eating a nutritious diet and staying physically active. Parents, your role is to model a healthy lifestyle and support the eating and exercise changes your child needs to make.
“Bariatric surgery is not a cosmetic surgery. This is a life-changing surgery.”
—Robert Cusick, MD, pediatric surgeon
Weight Management (HEROES)
If you’re a teen looking for help with weight loss, or if you’re a parent looking to help your child, we’d start with our HEROES (Healthy Eating with Resources, Options, and Everyday Strategies) Weight Management Clinic. This clinic is dedicated to treating weight gain and weight-related health risks in children. HEROES is the only medically managed program of its kind in the Omaha area.
The HEROES team focuses on developing a healthy diet, exercise, and behavioral plan. But if these methods don’t work, it may be time to consider bariatric surgery.
Who Is A Candidate For Bariatric Surgery?
Who Is A Candidate For Bariatric Surgery?
Although bariatric surgery can have great results, it’s not right for everyone.
The first factor we consider is your child’s body mass index (BMI), a measure that considers height and weight together, to help us in determining the severity of excess weight. We also consider your child’s age and sex when calculating BMI.
Next, we use a chart to determine his or her weight status (underweight, normal/healthy weight, overweight, or obese). At Children’s, we only perform bariatric surgery on patients with a BMI of at least 40, or a BMI higher than 35 with another significant weight-related condition, such as diabetes, sleep apnea, or liver disease. We also generally reserve this surgery for patients over age 14.
In addition to BMI, there are several qualifications that patients must meet in order to be a candidate for bariatric surgery:
- Involvement with the HEROES clinic for at least 6 months
- Inability to lose weight despite eating healthy, exercising, and increasing healthy behaviors
- Completion of bone growth: Adolescents or teens are not recommended to have bariatric surgery if they are still growing because surgery can prevent the body from getting all the nutrients it needs to grow
- Stable mental health status: Mental health disorders, such as anxiety and depression, can lead to overeating or forgoing exercise — and since post-op healthy eating and exercise habits are critical for keeping weight off, we need to ensure that mental health problems won’t interfere with success after surgery
- Good family support: We encourage the entire family to work together at eating healthy, both before and after surgery
- Compliance is another key factor in determining whether or not your child is a candidate for surgery. Being compliant shows readiness and motivation to have surgery, and the ability to handle lifestyle changes after the operation.
At Children’s, compliance means:
- Coming to all scheduled HEROES appointments and referral appointments
- Maintaining consistent and timely communication with the HEROES team
- Taking medications as prescribed
- Continuing to follow the HEROES team’s recommendations for healthy eating and exercise
- Avoiding any tobacco, drug, or alcohol use
What Sets Children’s Apart?
Our surgeons and weight-loss experts are specially trained in pediatrics:
- We understand that teens undergoing bariatric surgery often have different physical and psychosocial needs than adults. We provide high-quality care that is individually tailored and age-appropriate.
- We partner with the adult bariatric surgery program at University of Nebraska Medical Center (UNMC). During every operation, there is both an adult and pediatric bariatric surgeon. This provides patients with the expertise of multiple surgeons with different backgrounds. It also allows for an easy transition into an adult program when our patients age out of pediatric care.
- Bariatric surgery isn’t a long, drawn-out process. The operation itself only takes about 1 to 2 hours. Most patients are able to go home after two nights in the hospital, and some are even able to go home after just one night.
- The bariatric surgery program is part of our HEROES Weight Management Program — the only medically managed program in the Omaha area. Patients work on lifestyle changes through the HEROES program before they can opt for bariatric surgery and to prepare them for success after their operation.
- Our providers actively participate in research and clinical trials. This means that we are aware of the latest advances in childhood obesity and bariatric surgery, and can integrate these advances into our care.
Obesity can affect systems throughout the entire body, increasing the risk of certain weight-related medical conditions. That’s why bariatric surgery is part of a multidisciplinary clinic, which means that your child doesn’t just work with bariatric surgeons — they also work with providers from several different medical specialties. A treatment team may include:
- Cardiologists: Physicians who treat heart disease and defects, which obesity can raise your child’s risk of developing, such as high blood pressure or left ventricular hypertrophy (the heart’s left chamber thickens and cannot pump correctly)
- Gastroenterologists: Physicians who treat disorders of the digestive tract, such as gallstones, liver disease, or heartburn (also called gastroesophageal reflux disease, or GERD)
- Endocrinologists: Physicians who treat hormone disorders, such as diabetes or polycystic ovarian syndrome
- Pulmonologists: Physicians who treat lung and breathing problems, such as obstructive sleep apnea
- Dietitians: Experts in the nutritional needs of children, including special concerns and needs of patients with obesity
- Exercise specialists: Experts in the physical activity needs of children, including special concerns and needs of patients with obesity
- Behavioral health specialists: Experts in addressing the impact obesity can have on mental health and well-being
What To Do Next
HEROES Weight Management Program
Before your child can be considered a candidate for bariatric surgery, they will need to participate in the HEROES weight management program. In order to participate, your child must be referred by their pediatrician.
Ask your child’s pediatrician for a referral to the HEROES program. Once we receive the referral, we will contact you with more information. You may also call us with questions about the program or requirements for participation.
If you have concerns about the costs related to the surgery, we can discuss this during your visit and check your insurance coverage for bariatric surgery.
For Referring Providers
In order for patients to receive bariatric surgery, you will need to refer them to the HEROES weight management program.
Your patient must meet one of the following requirements:
- BMI > 85th percentile with co-morbidities
- BMI > 95th percentile alone
Download our physician referral form.
Please fax your completed form to 402-955-4078. Once our staff has made sufficient attempts to contact the family, we will report patient status to the referring provider.
For referral criteria or to discuss options for management of high-risk patients, you can reach the Omaha HEROES Clinic at 402-955-4080, or the Lincoln HEROES Clinic at 402-955-8770.