Traci Williams, MD - 2024 Pediatric Bariatric Surgery Update Course

Kids and teens experiencing obesity are at higher risk for mood disorders including depression and anxiety, body image difficulties, self-esteem issues, peer relationship problems, bullying, and lower resilience.

Psychosocial concerns in obesity have a reciprocal relationship where poor sleep impacts mood and attention, which then affects self-esteem and other factors.

Kids and teens who experience obesity tend to be at risk for ADHD.

Long-term mental health care is advised post-operatively, including assessment with 3-month screens for depression and anxiety.

As physical health improves after bariatric surgery, the quality of moods, emotions, and relationships are likely to improve as well.

Teenagers typically do not spend a lot of time thinking future tense, making preoperative discussions about post-surgical lifestyle changes important.

Stress has a connection with relationship with food, which is relevant for teenagers dealing with academic performance pressure.

People who experience obesity tend to have disconnection from their body and are not fully connected to their sense of physical self.

After bariatric surgery, the change in how patients view themselves does not happen as quickly as the physical changes, leading to body dysmorphia where teens do not recognize they are changing even when others comment on it.

Positive body image and bodily satisfaction continue to be a work in progress even post-operatively and will not just happen as a result of having surgery, whether bariatric or cosmetic.

Teens who have been bullied and isolated, then lose weight post-surgery, can suddenly receive male attention that puts them at risk.

If social concerns are mild, basic tools for managing conflicts with peers or difficult conversations should be provided; if more severe (difficulties forming or keeping friendships, dating issues), referral out is needed so issues are addressed in tandem with the bariatric journey.

Pediatric bariatric patients are often excluded from traditional eating disorder outpatient programs because their BMI doesn't meet criteria or their symptomatology doesn't meet criteria for inclusion, despite having disordered eating.

In the mental health world, there is not a good understanding of obesity or how obesity develops, with the general thinking being that obesity is caused by binging or binge eating, which is not typically the case.

Many pediatric bariatric patients have restrictive eating patterns, contrary to the assumption that they all have binge eating.

PSYPACT allows for telemedicine visiting across 40 states, enabling psychologists to provide care without being locally licensed.