Obese children turn to surgery

An operation to reduce the stomach's size is the last resort in the fight against weight gain.

Eric Decker knew at age five that he had a weight problem. "I was so much bigger than anyone else," he recalls. "I could never wear children's clothes as a kid." By age ten, Decker had seen dozens of doctors and nutritionists about his condition and was attending meetings of Weight Watchers.

He did lose weight, but usually put it back on. By age 17, Decker stood 5ft 9in and weighed more than 27 stone. He had a hormonal disorder, back and knee strain, and was at high risk of developing heart disease and diabetes, according to his doctors.

That's when the American teenager turned to bariatric surgery, an operation to reduce the size of his stomach and severely limit the amount of food he could ingest.

The surgery took place 20 months ago. Today, Decker weighs just 13 stone.

"At first my [mum] was really apprehensive about my having this surgery," says Decker, 19, who became interested in the procedure after he saw Carnie Wilson - a singer with the 1990s band Wilson Phillips - talk about her experience with bariatric surgery on television. "But this was a last resort. I had tried everything. Doctors told me I had to lose weight because it would eventually kill me."

Bariatric surgery, once considered a drastic alternative for obese adults, is gaining acceptance among doctors who treat severely obese children, though it remains controversial in some medical circles. Although no-one tracks the precise number of children and teenagers who have undergone the surgery, the number is thought to be small. Many surgeons who perform the procedure on adults now have patients who are children, and several children's hospitals across the US are launching bariatric programs.

An estimated 140,000 American adults will undergo weight-loss surgery this year - up from 75,000 last year. Ten years ago, the procedure was fairly uncommon in adults, and its growing popularity reflects a sobering reality: more people than ever before are severely - or morbidly - overweight. (Morbid obesity is usually defined as having a body mass index greater than 40; a score greater than 30 is considered obese.)

Morbid obesity has risen rapidly in children and teenagers too. An estimated 127,000 to 255,000 US teenagers have a body mass index of 40 or greater.

Bariatric surgery reduces the stomach from about the size of a football to the size of an egg. If patients don't adhere to permanent changes in eating habits they will suffer from pain, diarrhoea and vomiting.

For example, sugar, high-fat foods and carbonated beverages should be avoided. Total calories are typically limited to 1,000 to 1,200 per day - about a cup and a half of high-protein food.

Vitamin and mineral supplements have to be taken every day to replace nutrients that can no longer be absorbed in the intestine.