美國兒科學會呼籲爲肥胖兒童做胃繞道手術

Call for more obese kids to have gastric bypass surgery

美國兒科學會呼籲爲肥胖兒童做胃繞道手術

I find myself shaking my head in disbelief when I read that the American Academy of Pediatrics is recommending gastric bypasses in young children. I'm gobsmacked because weight loss surgery is normally the last resort for severely obese adults who have failed to control their weight over decades and had lots of failed attempts at weight loss.

當讀到美國兒科學會建議爲兒童做胃繞道手術的新聞時，我搖了搖頭，難以相信居然會發生這樣的事情。我感到非常詫異，因爲這種減肥手術通常是嚴重肥胖的成年人在長達數十年的時間內反覆減肥失敗、無法控制體重時纔會採取的最後手段。

Not surprisingly, most doctors have been reluctant to consider surgery for obese youngsters for fear it might stunt their development. But the American Academy of Pediatrics (AAP) says more youngsters – including obese pre-teens – should be getting bariatric surgery which, in whatever form, shrinks their stomachs to curtail their eating.

大多數醫生都不願爲肥胖兒童做胃繞道手術，這不足爲奇，因爲這種手術可能會導致發育遲緩。但美國兒科學會（AAP）表示，更多的年輕人——包括肥胖的青春期前兒童——應該接受減肥手術（不考慮其形式），從而縮小胃容量、減少進食。

They say the surgery in teenagers is safe. Furthermore it leads to rapid weight loss which lasts several years. It's reported that diabetes and high blood pressure (side-effects of obesity) disappear after surgery. Even in children younger than 12 who had weight loss surgery, it’s claimed there was no negative impact on growth.

該學會表示，這一手術對青少年而言是安全的。手術結束後，患者的體重會在數年內快速減輕。據稱，手術後患者的糖尿病和高血壓（肥胖的副作用）症狀都消失了。即使是對於12歲以下接受減肥手術的兒童而言，他們的成長也不會受到負面影響。

The AAP says youngsters should be eligible for surgery if their body mass index is 40 or higher. A BMI of 30 and above is considered obese. Recovery after the op isn't always plain sailing. Post-operatively, patients can be physically sick if they overeat, or consume foods high in fat or sugar.

美國兒科學會表示，如果年輕人的身體質量指數爲40或更高，則符合手術條件，因爲身體質量指數大於或等於30則被視爲肥胖。術後恢復並不總是一帆風順的。手術後，患者若繼續大吃大喝或攝入高脂肪或高糖飲食，他們可能會感到身體不適。

The op can also interfere with patients getting vital nutrients, as they can consume only a limited amount of food. Lead author of a research review, Dr Sarah Armstrong, also admitted being concerned that youngsters who haven't gone through puberty may not be mature enough to understand the life-changing implications of surgery.

手術還可能影響患者的營養吸收，因爲術後患者只能攝入少部分食物。一篇研究綜述的主作者莎拉·阿姆斯特朗（Sarah Armstrong）醫生也承認，她十分擔心尚未經歷青春期的年輕人，他們可能不夠成熟，無法理解手術對生活的改變。

But age alone shouldn't rule out bariatric surgery as a potential treatment, said Dr Armstrong, a professor of paediatrics at US Duke University. She added: "Children with severe obesity develop health problems earlier than those with lesser degrees of obesity, including diabetes, high blood pressure, fatty liver disease, and sleep apnoea."

年齡不是排除減肥手術作爲一種潛在治療方法的唯一因素，美國杜克大學兒科學教授阿姆斯特朗醫生說道。她補充說：“與肥胖程度一般的兒童相比，嚴重肥胖的兒童出現健康問題的時間更早，包括糖尿病、高血壓、脂肪肝疾病和睡眠呼吸暫停。”

To take the long view, obese children are prey to these devastating complications at a much earlier age than children of normal weight.

從長遠角度而言，肥胖兒童比體重正常的兒童更早遭受這些破壞性併發症的困擾。