Amid Controversy, Adolescents Gravely Affected by Obesity Opt for Surgery and Novel Weight Loss Drugs

John Simon III, from his earliest days, had a hearty appetite. As he grew from an infant into a toddler and then a young boy, his weight increased correspondingly. However, by 14, his weight had escalated to a dangerous 430 pounds, a serious medical concern impacting his life quality and future aspirations.

He proclaimed his recent weight loss surgery as a “new beginning.” John, preparing to start his freshman year of high school in California this fall, is optimistic about his future.

Meanwhile, in Minnesota, Edward Kent, a 6-foot tall, 300-pound sophomore high schooler, was diagnosed with fatty liver disease. Shortly after its approval for children 12 and older, Edward began using the new obesity drug, Wegovy, in January, losing 40 pounds.

Edward’s mother, Dr. Barbara Van Eeckhout, an obstetrician-gynecologist, emphasized the significance of this health matter, stating, “This will impact him for the rest of his life.”

John and Edward represent a growing cohort of young teenagers seeking weight loss solutions through surgery and novel drugs that alter metabolism. Critics warn against such early interventions. Yet, these adolescents and their parents argue that these robust – and often expensive – measures become necessary after failed attempts with traditional diet and exercise regimens.

Adolescents carrying excess weight often continue to do so into adulthood, with grave implications for their health and lifespan. A decade ago, the American Medical Association recognized obesity as a multifaceted, chronic disease. However, meaningful treatments remain inadequate, according to Aaron Kelly, the co-director of the Center for Pediatric Obesity Medicine at the University of Minnesota. Kelly argued that obesity is a biologically driven disease requiring early intervention.

In January, the American Academy of Pediatrics suggested considering obesity drugs for children as young as 12 and surgical options for those as young as 13, sparking controversy.

Advocacy group Mental Health America labeled these recommendations “dangerous” and “disheartening,” citing increased risk of eating disorders and stigmatization. Critics accused doctors and parents of choosing an easier path, attributing blame to factors like junk food or video games, even leveling accusations of “child abuse.”

Boston Children’s Hospital endocrinologist and researcher, Dr. David Ludwig, urged for non-drug options to remain a priority. He insisted on the significance of diet and exercise in childhood obesity prevention and treatment.

However, professionals treating severely obese children argue that diet and exercise alone often fall short. Over 240 diseases are linked with excess weight, which can begin to manifest early in life, states Dr. Janey Pratt, the Stanford University surgeon who performed John Simon’s surgery.

John’s obesity led to significant health and social struggles, including joint pain, shortness of breath, sleep apnea, and bullying-induced anxiety. Despite attempts at dieting and exercise, his body mass index rose to 75, far off the typical scales. Dr. Callum Rowe, a pediatric resident, referred John to Stanford Medicine Children’s Health weight-loss program.

Participation in Stanford’s surgery program has doubled since the AAP’s guidelines were released. However, less than 1% of eligible children undergo metabolic surgery due to referral reluctance and prohibitive costs, which can exceed $100,000.

Medicaid’s coverage of weight-loss surgery for children varies by state. Children who undergo the surgery usually lose about a quarter to a third of their body weight. Still, about 25% regain the weight, necessitating further treatment. On the other hand, obesity medications, like Wegovy, have seen an increase in demand despite their side effects and the likelihood of weight regain once usage is stopped.

Both Edward and John have responded positively to their treatments. Edward’s voracious appetite has significantly diminished due to the medication, and his liver function has normalized. John, having lost about 35% of his body weight post-surgery, has experienced improved liver function and insulin resistance, receding arthritis, better sleep, and increased mobility.

John’s path to recovery goes beyond medical intervention, including managing bullying and improving mental health. He graduated from middle school and is looking forward to a more compassionate environment in a smaller charter high school. His ultimate goal is to lead a happy, healthy life, free from pain and excess weight.

Support for the Health and Science Department at Big Big News comes from the Science and Educational Media Group of the Howard Hughes Medical Institute. All content is solely the responsibility of AP.

Frequently Asked Questions (FAQs) about Adolescent Obesity Treatment

More about Adolescent Obesity Treatment

• American Medical Association on Obesity
• American Academy of Pediatrics Obesity Guidelines
• Stanford Medicine Children’s Health weight-loss program
• Mental Health America’s Statement on Obesity Treatment
• Boston Children’s Hospital Research on Obesity
• Wegovy, a new Obesity Drug
• Information about weight-loss surgery