Teens with severe obesity are turning to surgery

Eighty percent of adolescents with excess weight carry it into adulthood, with potentially dire consequences for their health and longevity. Obesity was first classified as a complex, chronic disease a decade ago by the American Medical Association, but meaningful treatments have lagged far behind, said Aaron Kelly, co-director of the Center for Pediatric Obesity Medicine at the University of Minnesota. “It’s a biologically driven disease. It’s not a behavioral disease,” Kelly said. “We need to get on it early. Don’t wait until later in life because it’s too late.”

In January, the American Academy of Pediatrics issued guidelines that call for considering obesity drugs for kids as young as 12 and surgery for those as young as 13. The recommendations were immediately controversial. Mental Health America, an advocacy group, called them “dangerous” and “disheartening,” saying they would increase eating disorders and perpetuate harmful stigma regarding weight. Some on social media accused doctors and parents of taking the easy way out, blaming things like junk food or video games — or accusing parents of “child abuse.”

Dr. David Ludwig, an endocrinologist and researcher at Boston Children’s Hospital, warned 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.

But medical experts who treat kids with severe obesity say research is clear: Diet and exercise alone aren’t enough. More than 240 diseases are associated with excess weight — including liver problems, diabetes and inflammation — and the signs show up early, said Dr. Janey Pratt, a Stanford University surgeon who performed surgery on John Simon. “It’s already affecting major organs by the time they get to me,” Pratt said. “You’re dealing with a train that’s headed over a cliff.”