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.
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