Islamabad: The reported practice of performing bariatric surgery on children as young as three to six years in Khyber Pakhtunkhwa and promoting such procedures on social media has triggered serious concern among senior paediatric specialists and bariatric surgeons, who warn that the intervention is unsupported by scientific evidence and risks causing long-term harm to children.
According to doctors familiar with the matter, a bariatric surgeon in KP has carried out weight-loss surgery on very young children and shared pre-operative videos online, presenting the procedures as a solution for early childhood obesity.
The development has drawn criticism from professional bodies and specialists in child health, who say the practice falls outside accepted medical standards and raises ethical questions about consent, safety and patient welfare.
“As a bariatric and metabolic surgeon, and as a representative of the Pakistan Obesity and Metabolic Surgery Society, I feel compelled to address recent concerns regarding bariatric surgery performed on a three-year-old child,” said Prof Dr Maaz ul Hassan. “There is currently no robust scientific evidence, peer-reviewed research or internationally accepted guideline that supports bariatric or metabolic surgery in toddlers.”
He said international consensus statements restrict metabolic surgery in the paediatric population to carefully selected adolescents with severe obesity, and only after comprehensive multidisciplinary assessment, documented failure of structured medical therapy, formal psychological evaluation and long-term nutritional planning and follow-up. “The safety, long-term metabolic impact, neurodevelopmental consequences and ethical considerations of such procedures in very young children remain unestablished,” he added.
Child health experts say obesity in very young children often has underlying medical causes that require proper diagnosis rather than surgical intervention.
Renowned paediatric endocrinologist and former president of the Pakistan Paediatric Association Prof Dr Jamal Raza said such early-onset severe obesity is frequently linked to genetic or monogenic disorders. “This is clearly a case of monogenic obesity or a genetic-based defect. Bariatric surgery is absolutely contraindicated as the child will gain weight very rapidly again,” he said, adding that these children require specialised endocrine and genetic work-up, along with long-term medical and family-based management.
Doctors also warn that altering the digestive system of a child whose body and brain are still developing can have lifelong consequences. International studies have shown that bariatric surgery carries risks of micronutrient deficiencies, impaired bone growth, anaemia and other metabolic complications even in adults and adolescents, risks that are likely to be more profound in toddlers and preschoolers. There is little to no long-term data on how such procedures affect physical growth, brain development and psychological wellbeing when performed so early in life.
Renowned gastroenterologist and former Sindh health minister Dr Saad Khalid Niaz said the practice should be stopped immediately. “This is not innovation. This is experimentation on vulnerable children. Such procedures, especially when publicised on social media, undermine public trust in the medical profession and expose children to unknown and potentially irreversible harm,” he said.
Senior bariatric surgeons say the discipline itself is being put at risk by such practices. Prof Maaz said innovation in surgery must always be guided by scientific evidence, ethical responsibility and the protection of vulnerable patients. “When dealing with children, the threshold for intervention must be even higher. The integrity of bariatric and metabolic surgery as a life-saving discipline depends on responsible, evidence-based practice,” he said, urging healthcare professionals to adhere strictly to internationally recognised standards of care and to prioritise patient welfare over all other considerations.
Medical ethicists point out that young children cannot provide informed consent and that parents may be influenced by desperation, social stigma or misleading claims of quick fixes. They stress the need for strict regulatory oversight, particularly when medical procedures are promoted on digital platforms without clear disclosure of risks, alternatives and long-term implications.
Experts are calling on provincial health authorities and professional regulators to look into the matter, clarify whether proper multidisciplinary evaluation and ethical approvals were obtained, and ensure that child patients are protected from unproven and potentially harmful interventions. For most specialists, the message is clear: early childhood obesity requires careful medical assessment, family-centred lifestyle support and long-term follow-up, not drastic surgical shortcuts whose consequences may unfold over a lifetime.
Ends