To what do you attribute the growth of obesity in our population?

Dr. Wittgrove: Obesity is such a complex disease. It is certainly rooted in genetics, but there are so many environmental issues that influence the overall expression of the genetic potential. The fact that we are less active and have more carbohydrates in our diet does not help. I believe that if you are so genetically encoded and you get about 40 percent over your ideal body weight, you no longer have the physiologic feedback of satiety and that makes it impossible (or nearly impossible) to stay on a diet unless you receive the tool of surgical intervention.

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Alison G. Hoppin, MD, is Associate Director for Pediatric Programs, Massachusetts General Hospital Weight Center; Attending Physician in Pediatric
Gastroenterology and Nutrition, Massachusetts General Hospital; Instructor in Pediatrics, Harvard Medical School, Boston, Massachusetts.Bariatric Times • March 2007

How are children and adolescents physically and emotionally unique in the field of obesity?

Dr. Hoppin: No general observations will apply to everyone, but there are some ways in which children and adolescents are unique. First, their bodies may be more responsive to healthy lifestyle changes than the bodies of adults. There is an excellent study¹ showing that an eight-month intervention to improve lifestyle using family-based behavioral techniques led to improved weight control 10 years later. With the exception of surgery, no interventions in adults have that type of long-term effect.

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Bariatric sensitivity is a very important part of patient care. What do you emphasize with your staff as the most important aspects of being sensitive to these patients?

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