An increasing number of children are getting stomach surgery to assist with weight loss, the most extreme method doctors recommend to challenge persistently rising obesity rates. Many young people who endure bariatric surgery didn’t lose weight through exercise, diet, or weight loss drugs. Pediatricians and researchers said bariatric surgery could be a more lasting, faster fix for patients with severe obesity.

In 2022, bariatric surgery was performed on 506 children at over 40 U.S. children’s hospitals that use a billing data bank called the Pediatric Health Information System, an increase from 2012. Obesity rates in children continued to increase during that time. According to the Centers for Disease Control and Prevention, one-fifth of U.S. children were obese before the pandemic, with research showing that weight gain in children rose during the pandemic.

Fifteen-year-old Rephoel Grossman tried weight loss drugs, diets, and appointments with dietitians before his weight hit 435 pounds in October 2021. Rephoel, at 5 feet 10 inches tall, had hypertension, sleep apnea, and high cholesterol. He became tired too fast to play sports and was too heavy to ride roller coasters. He also didn’t like flying because it was challenging to fit into airplane seats.

Rephoel underwent bariatric surgery last June at Nemours Children’s Hospital, Delaware, in Wilmington. His surgeon, Dr. Kirk Reichard, performed a sleeve gastrectomy, taking out part of Rephoel’s stomach to reduce appetite and limit food intake. Rephoel said he didn’t understand the meaning of full before his surgery, but he knows what it is now.

According to research from Dr. Thomas Inge, surgeon-in chief-at a children’s hospital in Chicago, people with severe obesity who got bariatric surgery as teens were healthier in the long run than those who waited until adults to get the surgery. Dr. Inge’s research tracked the health of 250 people for 10 years who got bariatric surgery as teenagers and helped advise the American Academy of Pediatrics recommendation that obesity treatment should start early and aggressively.

According to the guidelines, weight loss drugs and bariatric surgery can help kids as young as 12 and 13 because weight loss is challenging. The risk of enduring health harm increases the longer children have severe obesity. Researchers say that weight loss isn’t a matter of willpower. Years of research have shown that people who lose significant amounts of weight through exercise and dieting typically gain it back.

According to doctors, there’s a scientific reason: the body has a weight range that it tries to stay in, fighting to keep weight on. In ways scientists are still exploring, bariatric surgery changes that range, shifting hormonal signals between the brain and gut that communicate fullness and hunger. According to weight loss doctors, that’s why bariatric surgery can help when exercise and diet routines fail.

As for Rephoel Grossman, his life has changed drastically since his weight loss surgery. He’s sleeping through the night, and his sleep apnea has disappeared. He started playing basketball but says competing with classmates who’ve been playing their whole lives is challenging. However, he says he’s adding more activities to his schedule for the summer.

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