Canadian teens who are severely obese because of medical conditions will be offered weight-loss surgery as part of a new program.

Some children aged 12 to 17 who are obese because of brain tumours or other conditions such as complications from Type 2 diabetes will be offered a minimally invasive type of weight-loss surgery at the Hospital for Sick Children in Toronto.

Katie Lougheed is seen before her weight-loss surgery and six months after. Katie Lougheed is seen before her weight-loss surgery and six months after. (Courtesy of Katie Lougheed)

The hospital announced Friday it will be the first centre in Canada to offer the surgical approach to pediatric patients who meet certain criteria for complex severe obesity. It is estimated about three per cent of Canadian children have the condition, which involves having a body mass index or BMI of greater than the 95th percentile for their age and gender.

One patient's cautions

Lauren Marela, 21, of Hamilton, Ont., went to Michigan for gastric bypass surgery when she was 19 and weighed 506 pounds. Doctors didn't know how long she'd live.

Marela's weight went down to 317 pounds last summer. She had no complications from the surgery, but arthritis now limits her movement.

Despite those physical challenges, the former binge eater attends meetings to advocate for herself and for others who are unable to work and are on disability.

She is unable to take anti-inflammatories for the pain because the drugs would burn through the new pouch in her stomach.

Marela is pleased about the new program but wishes the province also offered more surgical and treatment options for people who are severely obese with BMIs over 50.

She would like to have the procedure reversed and get a duodenal switch, or a partial removal of her stomach, which carries higher risk of complications, including malabsorption of nutrients. She thinks it would help her shed more pounds. Ontario no longer offers the procedure.

"Surgery is no easy way out," Marela said. After the procedures, patients have to be careful about how much fat and sugar they consume, the texture of the food, and how they chew it or else their heart may race and they'll feel sweaty and sick to their stomach.

She advised teens to do their research, combat any eating disorders and seek out support groups.

"The population is becoming obese at an alarming rate," she said, pointing to the increasingly sedentary nature of society, as well as the amount of fat, trans fats and preservatives in food. Marela urged governments to regulate trans fat.

Obesity rates are climbing, with 26 per cent of the Canadian population, including children, classified as overweight or obese

The surgery involves shrinking the stomach to reduce food intake, after people have unsuccessfully tried to lose weight through diet, physical activity and anti-obesity drugs.

The surgery is one part of the program, known as the SickKids Team Obesity Management Program, or STOMP. It involves an intensive behaviour management program to determine if the procedure, laparoscopic gastric banding surgery, is appropriate, alongside diet changes and medication in some cases.

Surgery a tool

The program includes doctors, a nurse practitioner, a dietitian, a psychologist and an exercise therapist who will help patients develop healthy eating habits, create exercise routines and learn new coping techniques. Teens and their parents will have support groups to teach them how to succeed, and researchers will monitor progress.

Sick Kids expects to admit 50 patients this year in the program, and up to 15 of them may undergo the adjustable and reversible surgery, said program director Dr. Jill Hamilton, an endocrinologist and associate scientist at the hospital.

"We're really offering treatment not just about the weight but around the complications, the health consequences and complications related to the overweight," Hamilton said. "It can be life saving."

Katie Lougheed went to Michigan for the surgery when she was 20, which she called the right time of maturity in her case. She wishes she had known about the option as a teenager.

"I decided to get the surgery because when I was only 20 years old and feeling the pain when I walked," Lougheed said. She was suffering tension headaches and didn't want to face worse problems as she aged.

Lougheed and Hamilton call the surgery a tool for becoming healthier.

"The surgery has definitely given me almost a sense of freedom," Lougheed said. "I'm not afraid to go out and go for that hike."

Socially, Lougheed said, she now feels more open with people.

Dr. Yoni Freedhoff, medical director of the Bariatric Medical Institute in Ottawa, welcomed the announcement that Ontario now has such a program. He called it an "absolute necessity" for a small subset of teens whose quality of life would suffer tremendously otherwise.

"The biggest thing for us and for a lot of people who do this work is not necessarily the pounds," said Geoff Ball, a professor of pediatrics at the University of Alberta in Edmonton. "But it's the reduction of the risks that really have a strong impact on the morbidity and potentially mortality in these boys and girls who can't breathe, can't sleep, they can't move."

The program is funded by the Ontario Ministry of Health and Long-Term Care and Sick Kids Foundation.