Doubts have always been raised about the effectiveness of (and need for) tonsillectomy in children. Researchers have now noticed a totally unexpected tonsillectomy side effect: they have found that the children undergoing surgery are at an increased risk of obesity. Why might that be, and what does it mean for the future of tonsil surgeries?
Children Undergoing Tonsillectomy are at an Increased Risk of Obesity
More than half a million children in the United States undergo a tonsillectomy every year. It is still one of the most common pediatric surgeries, although the number has dropped considerably over the past few years. The tonsils become swollen after repeated bouts of infection. The removal of infected tonsils causing sore throat used to be one of the main reasons for undergoing tonsillectomy.
Nowadays the primary reason behind the removal of tonsils and adenoids is to treat sleep disordered breathing syndrome so that the children can breathe better while sleeping. Doubts have always been raised about the effectiveness of tonsillectomy in children, despite the fact that the surgery used to be very common. However, researchers have now noticed a totally unexpected side effect of the surgery. They have found that the children undergoing tonsillectomy are at an increased risk of obesity.

One hypothesis to explain the association between tonsillectomy and obesity suggests that children with inflamed tonsils are not able to eat properly as swallowing food becomes painful. Their appetite returns to normal once the enlarged tonsils are removed. This can result in weight gain. However, there have been no studies to prove this belief.
The Study Establishes only a Link between Tonsillectomy and Obesity
Another study published in the February 2006 issue of the journal Pediatrics found some weight gain in children who underwent tonsillectomy or adenoidectomy for obstructed sleep disordered breathing syndrome. The possible explanation to this association could be that there was a significant reduction in sleep, waking and total motor activity in these children after undergoing the operation. Reduction in motor activity left excess calories which resulted in weight gain.However, scientists say that the study establishes only a link between tonsillectomy and obesity. It does not state that tonsillectomy is the cause of obesity in children. There is a considerable difference between association and cause. The study also did not determine the exact mechanism that results in weight gain after a surgery for removing tonsils.
Read More: New Guidelines for Children's Tonsillectomies
Julie Wei, a pediatric otolaryngologist from the University of Kansas, School of Medicine in Kansas City opines that the parents of children who may need a tonsillectomy should not be too worried about the results of this study. She points out that almost an entire generation of children who were born before World War II had underwent tonsillectomy to prevent rheumatic fever, a deadly disease in the pre- antibiotic era. There are certainly no indications that all of these children became obese.
Now that the studies have pointed out an association between removal of tonsils and subsequent obesity, parents may include potential weight gain as a side effect of the surgery. However, they should take these results with a pinch of salt and do not defer the operation in case it is essential for their ward’s health. However, the study may serve as a warning to keep an extra close eye on a child's diet after tonsil surgery.
- Anita Jeyakumar,Nicholas Fettman, Eric S. Armbrecht, Ron Mitchell. A Systematic Review of Adenotonsillectomy as a Risk Factor for Childhood Obesity. Published online before print January 4, 2011, doi: 10.1177/0194599810392328 Otolaryngol Head Neck Surg February 2011 vol. 144 no. 2 154-158.
- Photo courtesy of Kevan on Flickr: www.flickr.com/photos/kevan/3981073277