By Dr. David Katz

Today many parents are finding themselves in a difficult battle against their
child’s or teen’s obesity. Faced with few options, an increasing number of parents
are okaying bariatric surgery to help end their teen’s obesity. Dr. David Katz
warns of the dangers of this approach and offers an effective alternative.

Hilton Head, SC (November 2011)—Recent studies have shown that one in three children and adolescents in the U.S. are obese. If your teen falls into this category, you know the impact obesity can have on a young person’s life. Watching your teen suffer through failed diet after failed diet in addition to bullying and self-hate can understandably make you desperate for a quick fix. Otherwise, you’d never before have considered the drastic option of bariatric surgery.

The harsh reality is that more teens than ever are going under the knife to battle their obesity. The even harsher reality, notes Dr. David Katz, is that your teen’s obesity problem didn’t happen overnight. It’s the product of years of unhealthy living and eating, and as such, it can’t be “cured” overnight with a quick fix like bariatric surgery. To truly win the battle of the bulge, he says, you and your teen will need a more holistic approach.

“Bariatric surgery will only put a band-aid on a much more complex problem,” says Dr. Katz, senior medical advisor at MindStream Academy (, a health and wellness boarding school in South Carolina. “Yes, many obese teens need help to change their lives, but in order to do that they have to change their lifestyles. Obesity isn’t just physical. It involves emotional, environmental, and social factors—none of which is addressed on the operating table. To provide your teen with a long-term solution, you need to help them approach their obesity from all sides—mind, body, and soul.”

MindStream Academy provides exactly this kind of holistic solution. It offers a positive, safe, and caring natural environment and teaches teens proven, healthy life skills to handle the stress and triggers that lead to unhealthy habits. It provides a fully accredited middle school and high school curriculum, as well as hands-on intensive and comprehensive health coaching, including nutrition, fitness, and behavioral interventions for teens and tweens struggling with obesity and related issues.

“Keep in mind that the jury is still out on the true long-term effects weight loss surgery can have on teens,” says Dr. Katz, who is one of the leading international authorities on nutrition, weight management, and the prevention of chronic disease. “But there’s no denying the long-term benefits of learning life skills that foster sustainable good health and wellness. Fighting your teen’s obesity with these skills sets him up for success in a way that surgery simply can’t.”

Read on to learn more about why taking a holistic approach to treating your teen’s obesity is much better than going under the knife.

Think about the true cost of surgery. The cost of bariatric surgery is usually upwards of $30,000. However, in addition to the monetary cost of surgery, parents should carefully consider the risks that come with the operating table.

“When warranted, bariatric surgery is a very important option,” says Dr. Katz. “But there are kids out there who might manage to avoid the operating room through a feet-and-fork approach instead. For example, one teen at MindStream lost 90 pounds in a semester, felt totally confident in the ability to continue practicing everything learned there, and went from suicidal to optimistic.”

“I understand why parents consider an option as drastic as bariatric surgery for their teen,” he adds. “They desperately want to help their child and so they become more open to options they might not normally consider. But parents should keep in mind that there are alternatives to bariatric surgery. By tackling their teen’s weight loss through fitness, nutrition, and forming healthy, sustainable habits, they can avoid the risks associated with surgery.”

Help your teen replace willpower with skillpower. Many of the nation’s obese teens lack the skills necessary for achieving and maintaining healthy living. “Many mistakenly view obesity as the result of not having the willpower to resist overeating,” explains Dr. Katz. “But it’s really an issue of skillpower. When young people learn to better manage stress, to garden, to cook fresh, delicious foods, and to actually enjoy exercise and team sports, they develop skills that will help them maintain a healthy lifestyle for the rest of their lives. It’s important for teens to have a place to learn those skills in a safe and nurturing environment. With surgery, unfortunately, rarely do these skills become part of the recovery process.”

Give your teen the ability to cope. While teens who undergo bariatric surgery can’t eat as much, eating will very likely continue to be their stress-coping mechanism of choice. Without replacing that mechanism with more productive stress reducers, your teen could have ongoing weight problems. It isn’t uncommon for those who’ve undergone weight loss surgery to reach their optimal weight and then experience an existential crisis. They realize that they are the same person, just smaller. The point is this: Yes, what your teen is eating is a part of the problem, but unless your teen can address what’s eating him and learn how to love himself at any size, along with the skills to maintain a healthy lifestyle, surgery cannot truly change his life.

“For their weight loss to be sustainable, it is essential for overweight and obese teens to find new ways of dealing with stress and anxiety outside of eating,” says Dr. Katz. “Thanks to a process called neurobiofeedback, today we can do exactly that. As part of our comprehensive counseling (clinical, therapeutic) program, neurobiofeedback retrains abnormal brainwave patterns through a non-invasive, psychotherapeutic, and behavioral technique. We can assist the brain to function better by self-regulation exercises to keep the psychological, neurological, and biological mind-body connection in harmony. In our work with this process at MindStream, we’ve found that it helps teens learn to relax their brains, and compulsive, anxious, and depressive overeating behaviors can be curbed.”

Remember that thinner does not equal healthier. Following bariatric surgery, your teen will experience weight loss and will eventually reach a more appropriate weight. But remember, true health is much more than just being thin. If your teen continues to live a sedentary lifestyle, he’ll be in danger of gaining his weight back over time.

“Overweight and obese teens have to learn how to move again,” notes Dr. Katz. “Perhaps more importantly, they have to learn that they can move. They can do a variety of exercises. They can become physically fit, and it’s okay for them to do it at their own pace. Often, overweight teens have wracked up years of being embarrassed because of their limitations during P.E. at school. When they learn to define their own fitness path, they begin to see that it is doable, and they get to celebrate with each goal that they reach. We are constantly celebrating our students’ successes at MindStream, and I think our students are constantly surprised by just how much they can accomplish.”

Understand that getting healthy is a group effort. With bariatric surgery, your child will have a doctor, but for the most part the doctor’s focus will be on the medical side of your teen’s surgery and recovery. The medical team will probably not have much time or opportunity to give your teen the additional support he’ll need in order to make long-term health a reality.

“The saying goes, ‘It takes a village…’” says Dr. Katz. “And it absolutely takes a village to impart to teens the skills needed to create a healthy lifestyle. They, of course, need the support of their families, but they also need fitness and nutrition specialists who can help them lose weight safely—with or without undergoing surgery. They also need help healing from the emotional stress that being overweight can cause.

“With surgery, once you leave those hospital doors, your teen’s support system diminishes significantly,” he continues. “It can be overwhelming. But when you opt for a more holistic approach—such as a health and wellness school like MindStream—your teen will have a much different experience. For example, at MindStream teens have the support of their fellow students, but they also have personal trainers, dance instructors, yoga instructors, martial arts instructors, teachers, a registered dietician, an executive chef, who gets them in the kitchen to learn firsthand how to cook healthy, delicious foods, their families, and yes, via the program’s equine-assisted psychotherapy, even horses. It’s an extensive support system that provides the students with many people to lean on when they need a little extra moral support.”

Know that aftercare is critical. If you do indeed decide that bariatric surgery is the best option for your teen, keep in mind that to achieve optimal success aftercare will be key. “Bariatric surgery is just one step in a much larger process,” explains Dr. Katz. “Surgery certainly helps teens and adults lose weight. But it doesn’t help them erase the years of emotional stress their weight may have caused. To keep the weight off and to be truly healthy, aftercare in the form of counseling and fitness and nutrition education are essential. As we’ve touched on above, once your teen leaves the hospital, rarely is this kind of aftercare automatically part of the process. You will have to seek it out, and it will be essential in order for you to maximize your teen’s success and ensure his health throughout his weight loss.”

“MindStream offers an alternative to surgery for kids who can take a semester to turn their lives around,” says Dr. Katz. “But it also offers a far more intensive after-program than is otherwise available to kids who have bariatric surgery. Either way, it can meaningfully improve outcomes in this challenging group.”

“Obesity in teens and children is an issue that should absolutely be curbed as early as possible in a child’s life,” he concludes. “However, when possible, I would urge parents to consider alternatives to making bariatric surgery their solution. Taking a less invasive, more holistic approach for teens means providing them a more sustainable, and I think overall healthier, way of life.”

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About Dr. David Katz:
As one of the leading international authorities on nutrition, weight management, and the prevention of chronic disease, Dr. David Katz is in the trenches of the war against childhood obesity. In fact, he warned us many years ago that today’s younger generation will not live as long or as healthfully as their parents. Dr. Katz is also a prolific author, having published over 120 scientific papers, numerous textbook chapters, nearly a thousand newspaper columns, and a dozen books to date. In 2009 he was nominated for the position of U.S. Surgeon General to the Obama Administration by the American College of Physicians, the American College of Preventive Medicine, and the Center for Science in the Public Interest, among other national and international health organizations. He is also the founding director of Yale University Prevention Research Center, director and founder of Integrative Medicine Center at Griffin Hospital, president of Turn the Tide Foundation, Inc., and editor-in-chief of the Childhood Obesity journal.

About MindStream Academy:
MindStream Academy ( is a full-service boarding school on a pristine 43-acre horse farm in South Carolina for teens and tweens who want to get healthy, fit, lose weight, take control of their lives, build self-esteem, and pursue a personal passion.

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