Stanford Children’s center is super proud that “Lucile Packard Children’s Hospital Stanford’s Adolescent Bariatric Surgery program is the first and only adolescent bariatric surgery program on the West Coast to receive accreditation by the American College of Surgeons Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program.”
While I don’t believe that Weight Loss Surgery meets basic medical ethical guidelines for a number of reasons, I’m not going to go into that today because the surgery is legal, and I believe that adults should have bodily autonomy. So whether they want to partially amputate their stomach or their arm (whatever their reasons) it’s their own business.
But that’s not what we’re talking about here. We’re talking about children whose incomplete brain development can make them incapable of fully understanding the consequences of this irreversible choice (indeed the press release highlights patients talking about being willing to risk their lives so that they can “ride a bike” and “shop for clothes at regular stores.”)
It may be difficult if not impossible for children to understand that they are signing on for a lifetime of restrictive eating and supplementation to balance the needs of a mostly amputated stomach while avoiding malnutrition. They may not be able to fully process the potentially very serious consequences of failing to follow the post-surgical diet and supplementation program – either because they would rather live off pizza and ramen like the rest of their college friends in a few years, or because they can’t afford (or decide they have better uses for) $125 a month on supplements for the rest of their lives, or for many other reasons.
It’s also highly unlikely that these kids have been fully educated on the dangers of this surgery. They’ve typically only been presented with stories of people who are happy that they had surgery, not given a balanced presentation that also includes people who deeply regret it and desperately wish they could change their choice, as well as hearing from the families of people who died.
Nor is it likely that they are presented with the concept of Size Acceptance (such that they are clear that there are options other than trying to accommodate bigotry and bullies through dangerous surgical interventions) or evidence-based approaches to health like Health at Every Size (since there are thin kids with the same health issues as fat kids, but they are given interventions that do not include amputating most of their stomachs.)
These kids will be left facing the very real possibility of a life full of horrific side effects and malnutrition, and it’s worth noting that if that’s the case doctors are very likely to simply blame the patients and their body size. Those patients can also safely assume that they will not be interviewed, or have their before and after pictures trotted out, for the next press release. Nor will other children likely be told their stories when trying to decide if they should enter adulthood without most of their stomach.
Tragically, there is also the inescapable fact that some of these children will die from this surgery. So instead of riding a bike (which lots of fat people do) or shopping in “regular stores” (and the fact that a healthcare facility would use the term “regular” in this way shows how deeply ensconced in fatphobia they are,) these children will be dead.
Their parents will have to bury them. Their family and friends will have to mourn them, they won’t ever ride a bike or shop again. They will be tragic casualties of the war on “obesity,” a war that wants us thin or dead and doesn’t much care which. Dead children will be the legacy of the war against body diversity and actual health-based (rather than size-based) health interventions.
So before anyone celebrates the fact that people who perform a barbaric (and highly profitable!) surgery on adults are accrediting people who perform barbaric surgery on kids, let’s maybe have a moment of silence for the children who will be killed by a combination of fatphobia and surgeons.
If you wish to contact them about it you may do so here:
The Lucile Packard Foundation for Children’s Health
400 Hamilton Avenue | Suite 340
Palo Alto, California, 94301
(650) 497-8365 | info@lpfch.org
Samantha Dorman
sdorman@stanfordchildrens.org
(650) 498-0756
Kate DeTrempe
kdetrempe@stanfordchildrens.org
650-721-8527
If you enjoy this blog, consider becoming a member or making a contribution.
Like this blog? Here’s more cool stuff:
Become a Member! For ten bucks a month you can support fat activism and get deals from size positive businesses as a thank you. Click here for details
Book and Dance Class Sale! I’m on a journey to complete an IRONMAN triathlon, and I’m having a sale on all my books, DVDs, and digital downloads to help pay for it. You get books and dance classes, I get spandex clothes and bike parts. Everybody wins! If you want, you can check it out here!
Book Me! I’d love to speak to your organization. You can get more information here or just e-mail me at ragen at danceswithfat dot org!
If you are uncomfortable with my selling things on this site, you are invited to check out this post.
Dances With Fat 
Ugh, this sickens me. Children’s bodies (and minds, as you point out) are very much still developing. Doing something like this to them is just so fucked up.
It’s really sick that these doctors profit off of bigotry. And now at the expense of children. How depressing.
There’s going to be documentaries about this in the future describing it as a form of child abuse.
Yep. Right up there with that guy who used to drive around in his Lobotomobile giving on-the-spot lobotomies to people who had something on a whole list of problems lobotomies were supposed to solve. (Spoiler: They didn’t.)
as young a four too
This makes me so sad and angry, not really just at the doctors and hospital performing the surgery, although they certainly bear responsibility. It highlights to me how much our entire culture is entrenched in the “everybody knows” thin = healthy, fat = unhealthy belief system. It seems that many/most people, even doctors who are trained in medical science and research, are not aware of the studies showing that long-term weight loss is nearly impossible and people can be healthy at a variety of different sizes. It is so, so, so deeply ingrained in us every day of our lives that thinner is better and fatter is worse most people take it as truth without ever slowing down to question what they think they know. That doctors, kids, and parents would willingly accept the possibility of death or lifelong malnourishment (among many other side effects) in the quest to be thin breaks my heart. I am willing to bet that many of them have never been introduced to or considered the idea that it’s okay to be fat and it’s not a problem to be fixed.
The article opened with a “before/after” photo and then spent 90% of its text talking about how much better their patients will look, how they won’t be bullied or socially excluded anymore once they’ve lost weight, and how best to coerce potential clients into committing to the surgery (by going through their parents). There were like two lines about diabetes tacked on where they could fit them.
For some reason I’m just getting this sneaking suspicion health isn’t really the priority here.
First they’ll come for your children. Pretty much. Get em young tell em there is only one way to be. To be healthy, fit, have fun, be attractive, have a life, have love, get a job, be treated like a”normal human being’ from people who’s standards for treatment of other human beings well continues to shrink into narrower and narrower sizes.
I was that kid. I can see that crying child, bewildered and aching wondering where friendship and kindness are and why everyone else seems to get to do things they are not welcome or allowed or expected to do. (If you also live in poverty, you can’t afford these things anyhow)
It’s your body, there is too much of it, you offend us, you are sick, you need help, there is something wrong with YOU, you need to change. It is not us it is YOU. And guess what. We are here to help you. We have the magic pill. It is a dangerous surgery that slices open and rearranges your guts so your body can’t absorb the healthy food and nutrients you put into it anymore.
You will be in pain, you may be sick, you may even be sick for all the rest of your life, but some of you will at least be less fat than you are now, and in the end, that is the REAL problem isn’t it.
You are too fat, this will make you less fat. You want to have friends at school and grow up and have a job and go to college and meet your soulmate and have children some day don’t you? Well this gut surgery will enable you to do just that.
If you don’t have this surgery you are looking at a lifetime of people not liking you,people who are nice to you on the phone but when they meet you they give you that up and down look and never see you again.
As a fat you may spend you high school years being ignored and humiliated by your peers. Excluded form the dating scene, unable to find cool clothes in your size, unable to do all the fun things other kids get to do. Go swimming, go hiking, go camping, play sports. None of these will be open to you. And if you try them, they will probably laugh at you.
And as you get older, on top of all this, you will get very very sick. You will probably get diabetes and heart disease and have your knees go out and then you will be sick and fat and disabled and dying.
Wouldn’t you rather give the magic surgery a go and have the life you see everyone else around you having?
You know your parents love you and want you to be healthy and happy. You know doctors are smart and know about peoples health and are here to help you to be well and happy and be the best you you can be. You can’t be that as a fat.
Turns to parents.
Sign here Mr. and Mrs. Blank and your child is on the way to being the happy, fun, attractive, healthy, well liked child you prayed you would have before he/she was born…
Really, the potential side effects and possible lifetime corrections for their altered body are nothing compared to what they will face as fat adults.
You know what the whole sicko argument could be broken down to?
If you are not fat or even less fat, people will be nice to you.
Yes, that’s it, Jen. It’s not about health at all. In the long run, WLS seems to make people sicker, but that doesn’t matter, as long as others think they “look good.”
I remember being a fat kid, elementary school age, throwing a crying fit because my parents took me to a doctor to get put on a diet. I felt like I was ugly, “wrong,” and not good enough for them. Everyone was rejecting who I was, and they were telling me to become a different, better person.
I can only imagine how a young child would react to weight loss surgery. If a kid could consider a diet punishment, WLS would be PTSD inducing torture.
This is me, this is exactly how I felt when I was 16 and my family first start talking about weight loss surgery to me.
I’m so sorry this happened to you.
I can’t wrap my mind around this.
You can’t get tattoos or piercings at this age, generally (yeah some shops will do them after age 16 with parental permission) – these are GROWING bodies that aren’t fully developed yet. I won’t stand in your way once you are an adult – your body, you choose – but this just seems…wrong.
Oh, yeah. Still growing, and still may have a growth spurt that turns all that fat into bone, muscle, organs, and basically, naturally becomes a tall, thin person.
Fat kids do that, sometimes, you know, without any intervention, at all.
A problematic comic strip I used to love, before I came to my senses, had a bit where the very-thin heroine’s sister, a fifteen-year-old girl, had a raging panic attack, because she gained A POUND. One. One, single pound on a fifteen year old girl, and she was panicking that she was going to grow up fat and ugly.
I suppose it never even occurred to her that she might also be getting taller, or developing breasts, or be about to start her period, or anything like that. Nope. PANIC! I GAINED A WHOLE POUND!!!!
And let’s not forget the fact that the parents have to sign off on this, and in a great many cases of surgery (ANY surgery), it is the parent who makes the decision, and not the child.
Yes, there WILL be children put under the knife to lop off their stomachs AGAINST THEIR WILLS because their parents made that choice for them!
It’s one thing for adults to choose it for themselves, but to allow children whose brains aren’t even fully formed, yet, to make such a choice is really, really bad, which is why we have the requirement that the parents must give approval. Unfortunately, that also means that many stupid parents will force their children to do it, because “they know better.”
Yes, young children will go into the hospital feeling just fine, and undergo these surgeries against their will, waking up sick, frightened and in pain. Why? So that others ( especially their own parents) will approve of how they look. This is the stuff of nightmares.
I have an awful suspicion that many of those same parents will be angry and disappointed at the aftercare that is required for these surgeries, which are functionally identical, after all, to losing part of one’s stomach to a massive injury or to cancer. Their kids will have to be extremely careful about what they eat for the rest of their lives or risk becoming miserably ill. It isn’t “just” a matter of eating less and becoming thin.
So Mom will serve a nice balanced fiber-rich meal with a drink, and the kid will point out that the doctor said that she can’t do that anymore, and the kind of parents who let their kids get cut up in the name of making them more acceptable are not likely to be reasonable about it not after all being a magical solution to whatever bugs them about their kids.
Sorry, forgot the last sentence AGAIN: All of the above is obvious to us, but the kind of person who would even contemplate doing that to their kid without a serious medical reason is likely to go right on regarding their kid as defective when they can’t just go “Yayzors all thin now let’s celebrate with pizza and Coke! :)”
Or the, “What do you meeeeeaaaaannnnnn, you don’t want to come to Grandma’s birthday celebration! There will be cake and ice cream!”
Which the child cannot eat, without serious and immediate repercussions.
People who undergo this surgery frequently become “anti-social” (Not, that’s not actually what the word means, but it’s common usage), because they can’t bear to face all the food they’d love but can’t eat at almost all social gatherings. Not all, but most, people who go the surgical weight-loss route have a really hard time, psychologically, especially when dealing with food and social situations. Sort of like alcoholics, trying to stay on the wagon, going to a party where alcohol is present, and then, having to watch others drink, and explain to all the people who think “I’m drinking, so there is no excuse for YOU not to drink, too!” and get all rude and pushy about it. The same thing happens with food and dieters, no matter why they are dieting. Even, “If I eat that, I will break out in hives and vomit on your shoes.” People (not many, fortunately, but certainly enough to mean you have to keep on your toes) will even sneak allergens into your food to “prove” that you’re lying about the whole allergen thing. And they’ll do it again, to prove that the first time was just a fluke, and you won’t really need to go to the emergency room, this time. And after that, well, they just don’t like you, and hope you die.
I am opposed to fat shaming and really any shaming. I was impressed you made sure everyone knew you weren’t shaming him for the heart attack especially since we knew what he was doing was shaming. Thank you for saying what u believe and what I believe in such a respectful matter. It is the only way to remove all shaming
I had gastric sleeve surgery at the age of 24. I can say undoubtedly that children and teens cannot fathom what that surgery does to you both physically and mentally. Even as someone who has “benefited” (I say that with a purposeful side eye toward supposed benefits of ridiculous body standards) from the surgery, I would never ever recommend it to children. This is horrid.
http://jamanetwork.com/journals/jamasurgery/fullarticle/400707
It took some looking, but I finally found these fairly recent statistics from a fairly reputable source (heads up for the pro-weight-loss language). The thing that raised my eyebrows was that the mortality rate increases as the years ago by, from 1% the first year to 5-6% after five (that and the complication rate, which I knew was high, but I wasn’t expecting *that*). I’m also surprised the statistics don’t seem to have changed all that much over the years; I’d have thought the risks would get lower as technology gets better, but that just doesn’t appear to be happening.
So likely these kids will then get bullied for not being able to eat the same foods as their peers. Not to mention how fucked up their bodies will get when the can’t absorb the nutrients they need to grow properly.
Many will likely have strange neurological problems in the future from nutritional deficiencies that are either blamed on them for not properly following the post-op regime (which some people cannot follow) or not attributed to the surgery at all. Relatives will say, “Well, thank heavens you had that surgery, or you’d be so much unhealthier now!”
Mailed this to them: Upon hearing about your decision to go ahead with barriatric surgery on children I found myself thinking this has got to be wrong. I see it isn’t. I would just like to comment that performing major surgery on still growing bodies, a surgery that is sure to result in the bodies permanently damaged ability to take in nutrients from food resulting in life long dependence on supplements and endless monitoring, a surgery with a very high rate of complications and death resulting from it and the fact that the main concern seems to be for the childrens appearance not over all health I have to say is please don’t do this. Could you not instead encourage healthy eating activities and exercise programs without the emphasis on weight loss and self esteem increasing interactions for these kids to help them grow up happy and healthy but not necessarily thin?
Stupid point you are offering barriatric services and fat equals death to such people. Just wanted to let my feeling be known. Also you may have seen of the recent heart attack of one of the abusive hosts of The Biggest Loser television show. Clearly thinness does not equal inviolate health and longevity. Thank you for your time.