[IMAGE: Yes, children really do receive this "informative" T&A booklet, complete with suggestive imagery and terms, before having that T&A]
In one analysis of 127 children six months to one year after surgery, the average body mass index of the kids increased by about 7 percent. In another analysis of 249 children, 50 to 75 percent of kids had weight gain after surgery. While most weight gain happened in the first year after surgery, scientists don't know definitively whether it levels off after that.
Oh, dear. Alert the media...oh, never mind.
According to the report, the study authors speculate that the recent increase in childhood obesity might trace in part to the 500,000 children who undergo tonsillectomies every year in the United States. I'll get into the problem with that kind of speculation below. Let's just say that someone got to make a checkmark next to "Current buzzword used?" with that bit of imaginative thinking.
What the news report does not clear up is whether or not this "greater than expected" weight gain adds up to a gain into "overweight" or "obese" territory for children who were within normal weight parameters before the operation. As the piece notes, it's likely that children who have tonsillectomies for the usual indications--repeated strep infections, breathing difficulties--might start eating more or using the energy more efficiently post-op.
Furthermore, the report mentions that there are growth spurts and weight gain after tonsillectomy in the pediatric population. That is, in fact, the case: children who have tonsillectomy for sleep-disordered breathing show gains in height, weight, and growth after the surgery.
The piece closes with the standard de rigeur pap that parents should watch their offspring post-op for weight gain and talk to a pediatrician if they're concerned. The closure-satisfying implication is that the findings of this study are so, um, weighty, that they warrant a specific parental eye to those pediatric pounds after a tonsil surgery. Yes, just one more thing to add to the parental worry list, based on this report. Indeed, I'd be more inclined to caution parents to take their children to the pediatrician if the little wee one does not put on some weight post-op.
Here, I'll drag into this the fact that tonsillectomy rates have likely gone down since the 1950s, before the obesity epidemic struck. Indeed, until the 1960s, it was the most frequently performed surgical procedure in the United States. With the decreasing rates of this surgery over the decades, it's hard to come up with a way that it could be responsible for the increasing obesity rates during my lifetime, which began in the 1960s. (Weird coincidence note: The author of the paper I just linked happens also to have authored the introduction to a re-issue of Rats, Lice, and History, my current reading. These random event pairings are happening to me so much lately that I'm starting to get suspicious).
The head and dek of this MSNBC piece are as follows:
Getting tonsils out tied to kids' weight gain
Researchers wonder if common surgery plays role in child obesity epidemic
Oversimplifying headline aside, the dek in particular makes no sense in the harsh light of common sense and facts. What's to wonder about? A child--like mine--has repeated strep infections, which in children can mean fevers, low dietary intake, and vomiting for days, a cycle that repeats the minute every antibiotic treatment ends. Guess what? Post-surgery, that child's going to put on a few pounds once they can (a) swallow again without pain, (b) do so without vomiting, and (c) live for weeks at a time without contributing valuable energy to a fever rather than to growth.
I'd have been surprised if the researchers had not found weight gain following tonsillectomy. It's the obvious hypothesis, unlike the silly speculation that this operation might be contributing to the "obesity epidemic." That's just dropping in a buzz phrase in a desperate grab for clicks and eyeballs, and nothing more. In this case, it looks like the researcher carries some of the load for overreaching. Anyone want to hypothesize whether or not there are gains involved in that?
ETA: Now there is a growing list of links for this story, so I've annotated below. Many include more commentary on "childhood obesity" in the context of these findings (which don't seem to have much to do with obesity), while others gloss over the findings and launch straight into a lot of statistics about childhood obesity.
- Children often gain weight after getting tonsils removed (WTMA-"the Low Country's Big Talker", using a reasonable headline)
- Kids gain extra pounds after tonsil surgery (Reuters, with a headline that doesn't reflect anything I've read so far; are they "extra"?)
- Kids who have tonsils removed more likely to gain weight (AOL; in this one, the study author is quoted as suggesting that parents might "overfeed the child when recovering from chronic illness"--not possible in the two weeks following this surgery, as eating is very difficult for them, and they are far more likely to experience initial weight loss following the surgery)
- Removing tonsils linked to weight gain (from KETK, "news you won't see anywhere else"; hope that's true because this one sensationalizes the "7% increase in BMI," without a context for what the initial BMI was)
- Children may pack on pounds after tonsillectomy (Newsday; once again, why wouldn't children do that?)
- woo, and I mean WOO, here's one of my faves: from NaturalNews.com: Tonsillectomies cause kids to gain excess weight. This appears to be a fab opportunity for NN to suggest that people not let their children have tonsillectomies because, on top of its being a "huge money maker" and something that doctors are "often quick to urge" (my son had 12 strep infections before being referred for one), now we have to worry about fat! And...there's a picture of a fat kid, just to bring that point home.
- A reasonable story from WebMD, including a caveat from an expert not associated with the study. She points out that just about everyone born before WWII had their tonsils out, and obesity just wasn't a problem then.
THREE-WAY TIE FOR MOST MISLEADING HEADLINES
- Tonsil removal, childhood obesity link (Herald Sun)
- Children who have tonsils out 'more likely to become obese' (courtesy of The Telegraph. This piece literally concludes that children who have a tonsillectomy are "at increased risk of becoming overweight." This and the dek indicate a "quote" from someone, but that quote is not reflected in the article)
- Tonsil removal 'linked to childhood obesity' (from The Mirror. This one's so egregious that only its first two sentences discuss the study at all, while the remainder quotes a bunch of information about childhood obesity, with no context for the study being described. People, this is how the vaccine-autism misinformation flood got started.)
Leave it to a blogger to get a good headline out of this story and to make a decent point: Tonsil removal possibly linked to weight gain in children. Blogger notes "scratching her head over this one," as either the child needs a tonsillectomy or the child does not; what does this information do for us?
Otolaryngology — Head and Neck Surgery is the official scientific journal of the American Academy of Otolaryngology — Head and Neck Surgery Foundation (AAO-HNSF). The study’s authors are Anita Jeyakumar, MD; Nicholas Fettman, MD; Eric S Armbrecht, PhD; Ron Mitchell, MD.