Obesity has become one of the major health problems across all borders, all ages and all races. Most countries of the world are facing this everyday increasing problem and spending a lot of their health-allocated budget to manage obesity-related complications. The dangerous trend of increasing obesity in children and teenagers is posing serious threats to the health of this particular age group. Besides rising incidence of heart attack and stroke, fatty liver disease and liver failure in teenagers is also attributed to obesity in significant part. According to American Liver foundation’s recent report 2-5% children and adolescents are suffering from non-alcoholic steatohepatitis or fatty liver disease and most of them are obese. Experts at liver transplantation centers are registering more and more cases of liver failure. They are of the view that if children and teenagers with obesity and fatty liver disease are not treated in time may finally succumb to liver failure and will need liver transplantation by 30-40 years of age.
- Fatty liver of obesity: in this condition only excessive fat is accumulated in the liver with no apparent inflammation of liver cells. This is the completely reversible condition if excess weight is lost in time.
- Nonalcoholic steatohepatitis or NASH is the advanced form of fat accumulation in the liver in which inflammation, destruction and scarring of the liver tissue are also present. Earlier stages of this condition are also reversible but when the disease is relatively advanced, may lead to fibrosis of liver (liver cirrhosis)
The result of non-alcoholic steatohepatitis is cirrhosis of the liver. It has been found that 1-2% patients (having non-alcoholic steatohepatitis) develop cirrhosis of liver annually. Cirrhosis of the liver is the end of the road disease and anyone who succumbs to cirrhosis of liver develops liver failure and finally needs liver transplantation. Liver transplantation, although a life-saving option for the patient, is practically difficult as donors are quite a few. Some lucky persons get a donor for liver transplantation and survive but for a few years with the agony of taking immuno-suppressive drugs. Some of the patients with cirrhosis of liver develop hepatocellular carcinoma (liver cancer).
Losing Weight Stands as Number One Check Against Liver Failure in Fatty Liver Disease
Liver failure does not come out of blue in fatty liver disease; several years of remaining obese and getting progressive liver injury lead to this condition. Fatty liver disease is completely asymptomatic condition initially that’s why not suspected until it is relatively advanced. The helping tools to detect liver disease at initial stages are blood tests and ultrasonography of liver. All the obese children and teenagers should be screened for fatty liver disease by these tests to detect the disease earlier.
As already stated, insulin resistance is the main culprit in causing fatty liver disease; measures that reduce insulin resistance are helpful in reversing this condition. The most efficient check against fatty liver disease progression is excessive weight loss. In fact, losing weight earlier is the key. Bariatric surgery is the number one choice in such instances as it causes excessive weight loss over shorter period of time. Teenagers having body mass index 35 or more should undergo Bariatric surgery to stop dangerous happenings. Bariatric surgery not only prevents fatty liver disease but also reverses even severe liver disease. Cirrhosis is the only condition which can not be reversed so, earlier consideration for Bariatric surgery prevents lethal complications.
Some bariatric surgery procedures are available which have proven efficacy and safety to lose weight in teenagers. Laparoscopic gastric banding, gastric sleeve surgery, gastric bypass (Roux-en-Y procedure) and duodenal switch surgery-all are safe in adolescents. Bariatric surgery is safer at dedicated Bariatric surgery hospitals where experienced surgeons, anesthetist, clean and sterilized operation theatres, trained staff at every step and latest equipment makes things easier and safe. Now, Bariatric surgery is no more a feared choice in teenager to lose weight due to dedicated Bariatric surgery hospitals.