All other states in Australia allow obesity surgery for teenagers and recently published guidelines from the peak Bariatric Surgery body in Australia (ANZMOSS) clearly support this surgery in 14+ age group.
In this video, Dr Leon Cohen from TeenTime Bariatrics in Perth explains the current situation in Western Australia.
Published 2 Feb, 2023.
Why Does WA Not Allow Bariatric Surgery For Teens
Channel 9’s Monika Kos interviews Dr. Leon Cohen.
Video Transcription
Monika Kos: A Perth surgeon is calling for weight loss surgery to be available to teenagers in WA so they don’t have to travel interstate for the procedure. WA is the only state in the country where weight loss surgery for 16 to 18-year-olds is banned. Dr. Leon Cohen is the surgeon behind the push and we welcome him to the program. What is the surgery being banned in WA Dr. Cohen and why?
Dr. Leon Cohen: Thank you Monika. This surgery is bariatric surgery. It largely involves an operation called sleeve gastrectomy and it had actually been available to 16 to 18-year-olds in the private setting for almost over 20 years. It’s just that remarkably in November 2021, all of the private hospitals withdrew their support for surgery in that age group.
So in response to that, my work around has been that I’ve had to send patients suitable for the surgery at that age group to the eastern states and particularly to Adelaide where they freely offer that service in fact in the age range of 14 to 18.
Monika Kos: Surgeons removed their support for that procedure for what reason?
Dr. Leon Cohen: The principal reason that was given to me, and this occurred without any initiating adverse event or circumstance that would normally provoke such a response, was that they feared an issue of adverse risk and reputational damage if they were to pursue surgery in that age range and there was a complication.
Monika Kos: How needed is it among WA teenagers?
Dr. Leon Cohen: This surgery is absolutely needed. We are not advocating that bariatric surgery should be given or offered to all obese patients. It is part of the panorama of care that needs to be offered and available for patients who are morbidly obese.
It starts with good public health messaging and programs. It continues with individualised care from their general practitioners and primary health givers. It continues with some very new and exciting drugs that may help them in that pursuit.
But at the end of the day, if nothing else works and they are appropriate, bariatric surgery remains the most powerful modality to reverse the comorbidity and to improve their health and restore their life span.
Monika Kos: How many teenage patients have you sent interstate for this surgery?
Dr. Leon Cohen: So currently we have sent one patient to Adelaide. We have two other patients in preparation. But Monika, can I just say this? This is the calculus that drives me in this pursuit. If you have a 14-year-old individual who has a BMI of 40, at the age of 14, and they do nothing about it, they will have typically lost an average of 14 years of life. We can turn that around in an operation that typically takes 30 minutes to perform and for which the patient spends one night in a hospital.
Monika Kos: So that’s your argument for having it reinstated here. How are your calls for this surgery to be allowed in WA being received?
Dr. Leon Cohen: I think that the hospital managers will be receptive. There certainly has been a change in some of the hospital managers and that gives new opportunities to push that case.
But most importantly, there has been the delivery of updated guidelines in 2022 that firmly indicate that the surgery should be available to patients.
Not only in the private setting but in the public setting as well where it is sadly lacking for patients who are 14 years or over and I think that the greatest risk of reputational damage occurs in hospitals that don’t align themselves to those guidelines.
Monika Kos: We have a few viewer comments. Leah Bobbie writes, “Poor kids. Their body, their choice.”
Dr. Leon Cohen: Absolutely and that choice though is part of the consenting process. At the moment, they don’t have that choice to pursue the most powerful modality and it is totally unfair and unsound to accuse a patient of being responsible solely for their obesity.
The fact is that all of us are living in a toxic, obesogenic society and the question is not why are there so many people who are overweight and obese. The question really is why are there relatively few.
Monika Kos: Allan Gilbert says, “Why clog up theatres for overweight youth? Blame the parents for letting them get like that in the first place.”
Dr. Leon Cohen: Well, I think that’s a morally reprehensible argument. That’s like blaming the child for the sins of the father. The fact of the matter is that there is no more powerful modality to reverse their obesity than bariatric surgery. Traditional methods, diet and exercise, when compared to bariatric surgery, very typically fail in the long run.
Monika Kos: Trish Ryan says, “I know a number of friends who’ve had weight loss surgery and are now bigger than they were before. Sadly there’s never a quick fix. Take it from an overweight teen. It’s a lifelong battle.”
Dr. Leon Cohen: It is indeed a lifelong battle and that is why typically after diet and exercise programs, they regain their weight.
No one claims that bariatric surgery is a perfect solution. All of us must anticipate that there is likely to be some weight regain but a properly developed and applied bariatric operation has shown remarkable durability and there is good, strong data to show that even at 10 years, the benefits from the bariatric surgery persist.
Patients should not give up their aspiration to improve their health because of some bad outcomes in the occasional person.
Monika Kos: Dr. Leon Cohen, we really appreciate you joining us today. It’s a fascinating topic. We’re sure many parents will be considering. Thank you.
Dr. Leon Cohen: Thank you.
Mercy Bariatrics Perth
Why does WA not allow bariatric surgery for Teens. This situation was relevant when published on 2 Feb 2023. Please get in touch to find out if this has since changed and your teenager’s current options.
