Weight loss surgery on a child may be the only option in some cases but caution is needed, doctors and experts agree.
Brisbane-based surgeon Dr George Hopkins says desperate parents of obese children are screaming out for the surgical intervention yet the Australian hospital system is "unequipped" to meet their need.
Speaking at the Australian New Zealand College of Anaesthetist's Annual Scientific Meeting (ASM) in Brisbane, he implored his colleagues to start a conversation on the controversial issue.
"It's been discussed intermittently in small groups, but we need more than that for hospitals to start saying 'lets set this up'. Logistically our health system as it stands can't deal with this," he said.
Dr Matthew Remedios, a Brisbane-based gastroenterologist, performing the operation on a child depends on the situation but said the medical profession does need to be careful.
"Next will be lap-sleeving people in utero," he said during a Q&A session at the ASM on Sunday.
"As a community we should have some degrees of caution and thought before we rush into surgical procedures for overweight minors," he told AAP.
One in four Australian children aged 2-17 are now either overweight or obese.
Dr Hopkins has been performing effective sleeve gastrectomies on adolescents for years and says his patients have been getting younger.
One was an 11-year-old boy who weighed about 135kg but was unable to have the surgery unlike his 15-year-old brother.
The boy refused to go to school because the playground became too difficult for him psychologically.
"It was not worth it, he could learn nothing in the environment that had been created," Dr Hopkins told the meeting.
"It was literally gut-wrenching.
"The need out there is just screaming, it's just a question of getting everybody on board," he said.
"These parents are often desperate. If someone is dragging their kid along to see me because they care, they're prepared to go through all the steps to do it. It's not child abuse, it's anything but."
At the end of the day, however, there must be a consensus on how young is too young because there are risks involved with any surgical procedure, he acknowledged.
Dr Hopkins said "conservative management does not work" and to insist that it does is almost "perverse" because obesity can be the result of a genetic predisposition.
"Obviously prevention is always better than the cure, but we don't stand outside cancer clinics saying, 'if we just could have prevented it','' he said.
Dr Hopkins' comments echo the concerns of childhood obesity expert Professor Louise Baur, of The Children's Hospital at Westmead, who says the Australian health system is failing people who are struggling with obesity.
Research shows just one in 60 overweight or obese children are offered help in weight management from their doctor and "highly effective" bariatric surgery isn't easily accessible to those who need it most, she told the 2017 Royal Australasian College of Physicians Conference.