Teens with severe obesity are turning to surgery

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John Simon III was a hungry baby and a “chunky” toddler who grew into a chubby little boy, his mother said.

But by the time the California middle-schooler turned 14, his weight had soared to 430 pounds (195.04 kg) and become a life-threatening medical condition. Now, after weight loss surgery that removed a portion of his stomach, John has lost more than 150 pounds, boosting his health and his hopes for the future.

The children—and their parents—say the aggressive measures are a necessary option after years of failed diets and exercise programs.

The aggressive interventions are backed by some experts who treat obesity in children. Dr. Janey Pratt, a Stanford University surgeon who performed surgery on John Simon, says surgery was effective in his case.

Supporters of weight loss surgery or drugs in children say that they are safe and effective tools that are crucial when 80% of adolescents with excess weight carry it into adulthood—with dire consequences for their health and longevity.

But medical critics urge caution at intervening so early.

Dr. David Ludwig, an endocrinologist and researcher at Boston Children’s Hospital warns that the “justified excitement” over new weight loss medications shouldn’t eclipse non-drug options.

“Especially for children, diet and exercise must remain at the forefront of obesity prevention and treatment,” he wrote in JAMA, an open-access medical journal.

The Stanford program is among the busiest sites in the U.S., performing more than 50 of the 2,000 pediatric weight loss surgeries logged each year.

Those who take obesity drugs regain weight once they stop, research shows. Others see side effects that can be serious, including gallstones and inflammation of the pancreas. At the same time, neither surgery nor drugs will necessarily help children get down to what’s commonly called a “healthy” weight, a BMI of 25 or lower.

A key goal of the push to treat kids sooner is to have a better chance of helping them lose enough weight to reduce or halt obesity-related diseases.

This article was provided by The Associated Press.

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[John Simon and his mother, Karen Tillman in their home]

John Simon (interview): “My passion with food was exhausting. You know, I loved food at that time, you know? That’s the only thing that was kind of a comfort zone for me.”

[John Simon walks into a classroom at his middle school]

John Simon (interview): “After the surgery, I don’t do that no more. I don’t have the passion for food. Food is only for you to live on, not to enjoy and love it, have compassion (sic) for.”

[John Simon walks up stairs]

John Simon (interview): “So that’s why I feel like this surgery is so perfect for kids cause they don’t have to suffer that compassionship (sic) over food.”

[John Simon gets up from a school desk]

Dr. Janey Pratt (interview): “So John Simon had tried lots of different treatments. He had tried medications. He had tried lifestyle changes. You know, we’ve shown again and again that in kids with severe obesity and in adults with severe obesity, lifestyle change is not a good treatment. It does not work. Diet and exercise is ineffective at treating obesity. Surgery is effective, and it has long term results.”

[Photo of John Simon posing outside the hospital before his surgery]

[John Simon preparing his dinner]

[John Simon cuts a pepper for his dinner]

John Simon (interview): “The surgery is so important for kids so they can lose the weight, you know. I went through so many diets and I only lost thirty pounds and then I lost it. And I gained it right back. And it’s not that easy.”

[John Simon holds a small empty bowl that holds his meals]

John Simon (interview): “I eat this for every meal. Not for lunch but you know dinner and breakfast.”

Dr. Janey Pratt (interview): “The magical thing about surgery is that it takes that hunger away. And the children change. They become new people. They grow and they interact differently with others. It’s like a- it’s just such a change for them.”

[John Simon working out at a gym near his home]

[John Simon with his trainer]

John Simon (interview): “I work out it would be twice a week. Tuesdays through Thursdays, I go to the gym and see my trainer, Chris and we work out and after that I eat dinner and go to bed.”

[John Simon walks past his middle school]

This script was provided by The Associated Press.

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