Centro Hospitalar Lisboa Central will extend bariatric surgery to teenagers

The Centro Hospitalar Universitário Lisboa Central (CHULC) will extend the performance of bariatric surgeries to adolescents, advanced endocrinologist José Silva Nunes.

At this point, we are going to start moving forward with adolescent surgery ”, probably, from 16 years old, said the specialist of the Surgical Treatment Unit of Obesity of CHULC, who spoke to Lusa about the National Day of the Fight Against Obesity, marked this Saturday.

Currently, CHULC, which integrates the hospitals S. José, Curry Cabral, Estefânia, Santa Marta, Capuchos and Maternidade Alfredo da Costa, only performs this type of surgery after the age of 18.

More than 300 obese patients are operated, on average, annually at CHULC.

We have 18-year-olds, already officially adults, who have already undergone surgery, but in the future we will have even more young people ”, following a collaboration between Hospital Curry Cabral and the pediatric hospital D. Estefânia, said the endocrinologist.

José Silva Nunes explained that pediatric surgeons and pediatricians at Hospital D. Estefânia will also accompany these young candidates after bariatric surgery.

Right now, ages [em que se fazem este tipo de cirurgias] are between 18 and 65 years old, although the issue of the upper limit is a bit elastic, because if a person is 66 years old and has severe obesity and has multiple secondary pathologies, it is not because of one year that we are going deny a beneficial solution for your health ”, he stressed.

The specialist said that in the past they have had patients aged 15 years who have had interventions, but that the plan should cover young people aged 16.

He recalled that the Curry Cabral Hospital had a multidisciplinary childhood obesity consultation, but that it was not for surgical purposes.

There was a multidisciplinary consultation, with endocrinology, psychology and nutrition, and we had some young people very close to 200 kilos, but who did not progress to surgery at this stage ”, said.

According to José Silva Nunes, women who mostly resort to bariatric surgery to lose excess weight are between 80 and 85% of the total number of patients.

It is not that men are not obese, but many of them are reluctant to seek help and others consider that they are as they are and are not aware ” for the problem, commented.

However, stressed the endocrinologist, surgery “It’s not for the aesthetic issue”, but because of the health implications of obesity, such as an increased risk of cancer, diabetes, hypertension, coronary heart disease, obstructive sleep apnea.

The person thinks that a cancer patient is a skinny patient, obviously there are also skinny patients, who unfortunately end up having neoplastic processes, but obesity alone gives an increased risk of multiple cancers ”, warned the endocrinologist.

Therefore, he concluded, “There is a brutal panoply of pathologies that are secondary to the excess of adipose tissue, therefore, improving or decreasing the amount of fat that a person has inherently decreases those comorbidities that people have”.

João Silva Nunes also warned that “Physical inactivity is one of the main causes of weight gain” e “The portuguese population is very sedentary”.

The World Health Organization estimates that there are 650 million adults living with obesity worldwide. In Portugal, according to the National Health Survey 2019, the data points to 1.5 million people.

Frustration of a life of unsuccessful diets

The frustration of a life of diets without results, low self-esteem and discrimination for being obese leads many patients to resort to barric surgery, which they see as the “miracle solution” to their problems.

The history of obesity in most of these patients started as early as childhood and when they appear at the consultation, at 40, 50 years old, they report several failed attempts on diets, Sandra Velez, a clinical psychologist who is part of the team at the Surgical Treatment Unit of Obesity at the Centro Hospitalar Universitário Lisboa Central (CHULC).

They have low self-esteem, the frustration of not being able to lose weight and deal poorly with their body image or feel discriminated against at a professional level and even at the level of interpersonal relationships ”, said Sandra Velez, who monitors these patients before and after surgery.

As the waiting time is sometimes long until surgery, there are patients who end up giving up. Motivation is very important because “oftentimes [os doentes] think that bariatric surgery is a miracle solution and is not ”, said.

Therefore, it is necessary to understand and assess the person’s motivation levels for the surgery.

They come looking for a solution with a passive posture and have to realize that they have to have an active posture, change their lifestyle and adhere to other behaviors for a healthier life and the motivation can arise in a more sustained or no.”

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