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Hesham Atwa, MD, FACS, FASMBS, and Long Island Laparoscopic Doctors: Genetic Obesity Resolved through Adolescent Bariatric Surgery BY DANIEL K. BRANTLEY FOR APPROPRIATE ADOLESCENT PATIENTS, BARIATRIC SURGERY OVERCOMES GENE TIC PROPENSIT Y TO OBESIT Y, THOUGH THE E X ACT MECHANISM IS YE T UNKNOWN. CH A RT S A ND PERCENTILE S deter- mine weight goals within the adolescent population. Those young patients whose weight goes beyond the ideal traditionally have a single prescription: a hea lthy lifestyle, including diet and exercise. Unfortunately, this is not a lways suc- cessful. The result? Feelings of guilt and inadequacy in both parent and child, which does not aid in weight loss. According to Hesham Atwa, MD, FACS, FASMBS, a new approach is required. His perspective is based on recent research that indicates providers should not rely solely on lifestyle modi- fication when genetics may be the root cause of obesity. Rather, they should tell young patients something they've never heard: It's not your fault. "When they come to me, I ask why they think they're overweight, and 90% say because they eat too much or don't exer- cise," Dr. Atwa says. When he explains that obesity is not the adolescent or teen's fault, many get emotional. It is the first time they've heard such a statement, and the impact is profound. "[The medical community] never points a f inger for having … cancer," says Dr. Atwa. "Obesity is a medical problem." The AMA confirmed the designation of obesity as a disease in June 2013. Despite this, much of the medica l community continues to consider childhood obesity a personal choice that can be overcome with a commitment to lifestyle changes. Dr. Atwa, Founder and Clinical Director of Long Island Laparoscopic Doctors, says this approach fails children and sets them up for a lifetime of obesity that cannot be overcome without medical treatment. THE PREFERRED OPTION Today, nea rly 20% — more t ha n 14 million — of American children and ado- lescents are obese. One study showed that quality of life scores for obese children and adolescents are equivalent to those of children diagnosed with childhood cancer. However, the complications of childhood and adolescent obesity do not end with childhood. Left untreated, obese children and teens have a nearly five-fold risk of adult obesity, and 70% of them will continue in obesity after age 30. Once in adulthood, they have access to multiple treatment approaches. Diet and exercise, medication and bariatric surgery all offer positive results when applied appropriately. Beneficial as these therapies are, waiting to treat the disease comes with a myriad of risks. Minimizing or avoiding these risks requires that obesity be treated as early as possible. Among adolescents and teens, Dr. Atwa has found that the most effective treat- ment option for long-term weight loss is bariatric surgery. This finding is likely due to the nature of obesity during the early years. Adolescent obesity seems to have a genetic proponent that functions alongside environmental, Hesham Atwa, MD, FACS, FASMBS, Founder and Clinical Director of Long Island Laparoscopic Doctors 1 2❱❱❱❱❱ S U R G I C A L S O L U T I O N S