Prescription Weight-Loss Medications
Pharmaceutical interventions are rarely considered for adolescents and then only for morbidly obese boys and girls who have not been able to lose weight after several months of dieting and exercise.
Nonprescription Appetite Suppressants and Dietary Supplements
Teenagers should not be taking over-the-counter oral appetite suppressants, although some do. In addition to lack of evidence for inducing weight loss, herbal supplements cannot be assumed to be safe.
Surgical Measures: Gastroplasty and Gastric Bypass
Abdominal surgery is reserved for morbidly obese youths suffering from serious complications such as sleep apnea and elevated blood pressure. In a gastroplasty, also referred to as “stomach stapling,” the surgeon uses a row of staples to reduce the size of the stomach so that it can hold no more than two to four ounces of food or liquid. Normally the stomach can accommodate as much as one and a half quarts. A gastric bypass decreases the intestine’s absorption of dietary fat. Here the surgeon staples across the upper stomach, closing off the remainder. Then he joins the open portion to the lower small intestine, thus bypassing 90 percent of the small bowel. Both procedures have high rates of future complications. Still, for a dangerously overweight young person with no other options, the potential results may be worth the risk. On average, patients slim down by about half.