Some kids pack on extra weight when their tonsils are removed, U.S. researchers conclude in a review of earlier studies.
The possibility that the surgery, performed on more than half a million American children every year, might be contributing to the current obesity epidemic is "alarming," they write in the journal Otolaryngology - Head and Neck Surgery.
"For some patients this surgery might be considered more of a risk than a benefit," said Dr. Anita Jeyakumar, an ear, nose and throat specialist at Saint Louis University in Missouri, who worked on the review.
"Every patient needs to be evaluated as an individual to find out whether the risks outweigh the benefit," she told Reuters Health.
Tonsillectomy, as the procedure is called, is the most common type of major surgery done in kids. Still, with the increasing use of antibiotics to treat the condition, surgeons are doing fewer tonsillectomies than they did 40 years ago.
The procedure is covered by Medicare up to a few hundred dollars. It helps children with breathing trouble that disturbs their sleep, and is a last resort for those who suffer from repeated inflammation of the tonsils, the oval-shaped clumps of tissue at the back of the throat.
Jeyakumar and her colleagues found nine studies that used different methods to look at weight gain after tonsillectomy, with a total of nearly 800 children included.
More than half of the children gained weight, she told Reuters Health. Three of the studies looked at body mass index (BMI), a measure of weight in relation to height, which climbed five to eight percent after the surgery. The others, despite using different weight-scoring methods, showed similar findings, with several kids crossing the line from normal weight to overweight, and from overweight to obese.
According to the Centers for Disease Control and Prevention, 17 percent of American youths are obese, putting them at higher risk for heart disease, stroke and other disease later in life.
Exactly why this is happening isn't clear, although it may be that kids whose tonsils are often inflamed simply eat less than others, and tonsillectomy makes them eat like other kids again.
There are alternatives to tonsillectomy, including antibiotics for tonsillitis and ventilation devices for breathing trouble. But Jeyakumar said the latter usually don't work very well for kids.
Families of kids who already have weight problems may want to think twice about tonsillectomy, she said. And obese kids should consider starting a weight-loss program before surgery to head-off further weight gain afterward.
"It should be part of the discussion with the child and the parents," she said.