Texas Children’s Bariatric Surgery Program has been changing the lives of adolescents and their
families for over 15 years. For teens who have medical conditions related to obesity, bariatric
surgery can improve their health and quality of life. These significant changes occur over a long
period of time, which is why Gia Annette Washington, PhD, assistant professor within the
Department of Pediatrics, Section of Psychology, is an important part of the clinical care team.
While physicians manage medical conditions and plans out surgery, Dr. Washington and her
associates ensure that the adolescent’s mental health is well supported throughout the process.
Before surgery
To ensure that adolescents who have weight loss surgery are ready for the lifestyle changes that
are required, they are seen by a team of physicians for at least 6 months prior to having surgery.
During that time, Dr. Washington performs a limited psychological evaluation focused on health
behaviors, including the family’s attitudes and traditions around food.
“In some families with intergenerational health habits that lead to obesity, some things,
like mindfulness around eating, are overlooked,” said Dr. Washington.
She also focuses on an adolescent’s social supports and mental health. Some obese
children have become withdrawn after years of being overlooked due to their weight. Others are
more confident in themselves and eager to improve their health.
“Sometimes I see adolescents who have psychological concerns, like severe anxiety or
depression and that might be from some experiences of teasing or harassment, or a child who has
always coped with anxiety through disordered eating,” said Dr. Washington. Teens who need
more mental health support are seen regularly by a mental health professional of their choosing.
Approaching a surgery date
As the time for surgery draws near, adolescents and their families are making decisions about the
type of surgery to have, if at all, and facing concerns about how these decisions are going to
impact their lives.
“I want the teen and the family to feel supported in this decision about weight
management intervention,” said Dr. Washington. No one is pressured into a specific intervention,
and families are offered every opportunity for education along the way. Some might be
concerned about appearing too thin, or how it will look to their friends when they are eating
different food at the lunch table. Each of these concerns can be addressed in detail so that the
teen feels prepared for the changes ahead.

After surgery
At Texas Children’s Bariatric Center, care continues after surgery to help the family transition to
a new way of approaching their health habits.
“Usually at the end of my initial evaluation I’ll inform the family that I can be a part of
their care team to whatever extent is needed but in particular I might pop back up again about 6-8
weeks after surgery when a lot of our patients seem to hit a little bit of burnout,” said Dr.
Washington. At this point, adolescents sometimes become more irritable as they tire of clinic
visits and unexpected attention, and they can’t use food in ways they may have previously to
manage their emotions.
“It isn’t uncommon for overweight or obese kids to be overlooked, and sometimes
challenges around social negotiation, body boundaries or setting limits, are new skills. So for
some of our kids after surgery, they might need some support in navigating those kinds of peer
challenges,” said Dr. Washington.
Despite these challenges, teens can go through the Bariatric Surgery Program with a high
degree of commitment and enthusiasm about the long-term benefits of a healthy weight and see
significant improvement in their lives.
“I want them to feel empowered,” said Dr. Washington.
Learn about Texas Children’s Bariatric Surgery Program by calling 936-267-7333.