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Bariatric Rapid Fire Sessions: Latest Evidence and Trends in Pediatric...
Part of
Obesity 25 items
Chapter 1 of 6 · Evidence & Research
Surgery timing
Optimal BMI for Bariatric Surgery Intervention
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Educational content from recorded physician discussions — not medical advice. Talk to your (or your child's) care team about your situation.
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What the experts said
BMIs in the 40s will predictably get patients to BMIs less than 30
The younger clinicians can intervene with bariatric surgery, the more it helps quality of life
Once patients cross the BMI 50 threshold, the probability of mitigating risk associated with BMI 35 and above becomes challenging
At BMI 49, the time for medication has passed and surgery must be discussed
At BMI 49, surgery may fail to get patients out of the severely obese category
Topiramate and phentermine can buy time for a 12-year-old to gain maturity before surgery
Even after bariatric surgery, some kids will still need pharmacotherapy
Obesity is a heterogeneous disease with a very wide range of response to surgery and other treatments
If a patient has been in a program for 3 to 6 months and healthy living is not sufficient to control the disease, clinicians need to move on to medications
Dexamphetamine has an evidence base for hypothalamic obesity patients
Hypothalamic obesity patients have a biological drive to gain weight and defeat surgery that is profoundly different from other patients without brain injury
Private insurers are limiting dietitian visits to 3 per year, which is insufficient for obesity as a chronic disease
Sugar taxes can be regressive depending on socioeconomic class
Obesity does not occur because of sugar per se in and of itself, so taxing sugar products will not have the desired impact
Most obese patients meet objective criteria for binge eating disorder when screened with questionnaires, even if they do not come in with a formal diagnosis
Bariatric surgery is a very good way to extinguish binge eating behaviors
A prior diagnosis of binge eating disorder may pose a higher risk for weight regain after surgery
The rate of patients meeting true diagnostic criteria for binge eating disorder is under 5% when screened routinely
Many obese patients have disordered eating consisting of restricting during the day and overeating in the evening
Disordered eating applies to every obese patient, with feelings or emotions around eating and food, even when DSM criteria are not met
Tom has presented data showing that operating at a lower degree of obesity allows moving people into a much healthier state
Patients above BMI 55 have only about a 14% probability of getting down to a BMI below 30 (data published by Tom in 2009)
Kelly Branno showed data that sugar taxes decrease consumption and generate revenue
Jim Mitchell's work in the LABS consortium demonstrates good resolution of binge eating symptoms after bariatric surgery