Are you OK with a 2-and-a-half-year-old child undergoing bariatric surgery?

by Char Wilkins and Jan Chozen Bays

Mindful EatingA two-and-a-half-year-old boy weighed 79 pounds, three times normal weight for his age, and he suffered from sleep apnea. After his parents’ two attempts to control the boy’s weight through dieting failed, surgery was approved.1 A laparoscopic sleeve gastrectomy was performed on the boy which involved removing the outer margin of the stomach to restrict food intake, leaving a sleeve of stomach, roughly the size and shape of a banana. Unlike a lap band, the surgery is not reversible.

You might take a breath right now and become mindful of your thoughts, emotions and bodily sensations. Anger? Fear? Denial? Sadness? Any judgments?

Welcome to the world of excess that affects all of us . . . at any age.

Over a period of 14 years (199-2012), the National Health and Nutrition Examination Survey collected information about the prevalence of obesity and severe obesity in the US, examining differences in the trends by age, race/ethnicity, and sex. During that time, 17.3% of children in the United States aged 2 to 19 years were found to be obese. Additionally, 5.9% of children met criteria for class 2 obesity and 2.1% met criteria for class 3 obesity. Although these rates were not significantly different from 2009 to 2010, all classes of obesity have increased over the last 14 years.3

We in this mindfulness community need to not only contemplate our responsibility to the obesity crisis which is fed by greed in its many forms, but we need to act, not react.

Dr. Rohit Kohli, MBBS Associate Professor in the Department of Pediatrics at the University of Cincinnati College of Medicine, while acknowledging bariatric surgery can be a life-saving procedure, said:

There are case reports now in the literature and in the public domain in which 4- or 5-year-old children have undergone bariatric procedures. We should definitely think about this, as a community, with open eyes. There are consequences for bone development and metabolic concerns such as mineral and vitamin B12 deficiency or beriberi developing in these children. When we put all of this together as a consequence of a bariatric procedure and weigh it against the benefits that we have just outlined, it is a fine line that we need to walk.

As a pediatrician, first and foremost, I have learned to say, "Do no harm." We need to take a step back, acknowledge that these procedures work, but in the same breath try to understand the consequences, both moral and physiological.2

But we who practice and teach mindfulness can do more than “do no harm.”

We can help people learn to eat mindfully. We can help them understand how conditioned patterns around eating can impact the way they eat for their entire life. We can help people make connections between thoughts and emotions and disordered eating. We can help them rediscover how to listen to the body so as to know what hunger, fullness and satiety are. We can help people of all ages slow down and re-discover the pleasure of eating through engaging their senses.

And we can help them find alternatives to work with a truth they already suspect: You can never fill the hole in your heart by filling up the stomach.

Our kids are eating their anger, sadness, disappointment and fears.

We tend to point fingers and talk about the issues that swarm around food, eating and body image: the media, fast food chains, genetically engineered food and stressed life styles. Most of us feel pretty helpless in the face of corporate and global forces that shape our lives. We have to acknowledge that we cannot change all these external factors. However we can change our relationship to our bodies and our food. We can choose to focus our time, energy and love on helping one person, one child.

Jan Chozen Bays and I (Char Wilkins) have been teaching people for many years, individually or in small groups, how to rediscover a kinder and more joyful relationship with themselves, food and eating. A few years ago we formed a teaching partnership in order to spread the benefits of mindful eating by training other professionals in these skills.

Questions to explore:

  • What do you think about mindful eating for kids?
  • How do you feel about bariatric surgery for children? Laparoscopic adjustable gastric band, the Roux-en-Y gastric bypass, sleeve gastrectomy, or a nitrogen inflated balloon placed in the antrum of the stomach?
  • Do you have experience with mindful eating?

About the Author

Char Wilkins

Char Wilkins, MSW, LCSW, is a mindfulness-based psychotherapist who works with individuals, couples and groups incorporating the intention and skills of mindfulness as a foundation from which to explore one’s life. She specializes in working with stress-related physical and emotional issues, with women who have experienced childhood abuse and trauma, and those who suffer with depression, anxiety and disordered eating.

Char is certified as a Mindfulness-Based Stress Reduction (MBSR) teacher by the Center for Mindfulness, UMass Medical School, Worcester, MA. She teaches MBSR, Mindfulness-Based Cognitive Therapy (MBCT), and Mindful Eating/Conscious Living (MECL) for the general public.

She leads professional trainings in MECL, MBSR, an Adv. training for MBCT and MBSR teachers. Char maintains a longstanding personal meditation practice and is currently studying Qigong and Taijiquan. She provides one-on-one consultation for professionals who wish to incorporate mindfulness into their work. She is a member of the Advisory Board of The Center for Mindful Eating and is the owner/director of the Center for Mindful Living, LLC and A Mindful Path, LLC in Connecticut.