John Simon III was described by his mother as a hungry baby, a “chunky” toddler, and a chubby little boy. However, by the age of 14, his weight had reached a dangerous 430 pounds. After undergoing weight-loss surgery that removed a portion of his stomach, John has successfully lost about 150 pounds, significantly improving his health and giving him newfound hope for the future. This fresh start will coincide with his enrollment in high school in California this coming fall.
Another remarkable case is that of Edward Kent, a high school sophomore from Minnesota who was diagnosed with fatty liver disease. Standing at 6 feet tall and weighing 300 pounds, Edward began using the obesity drug Wegovy in January, a month after its approval for children aged 12 and older. Since then, he has lost an impressive 40 pounds. His mother, Dr. Barbara Van Eeckhout, an obstetrician-gynecologist, believes that this achievement will have a lasting impact on his overall well-being.
John and Edward are part of a small but growing group of young teenagers who are pursuing drastic measures to combat their severe obesity. While critics caution against intervening at such an early stage, these young individuals and their parents believe that these aggressive and often expensive options are necessary after years of ineffective diet and exercise programs. Karen Tillman, John’s mother, emphasizes that her son had genuinely given his all in previous attempts to lose weight.
Obesity in adolescents has long-term consequences, with a staggering 80% carrying their excess weight into adulthood. To address this issue, the American Medical Association officially classified obesity as a complex and chronic disease a decade ago. However, the development of meaningful treatments has significantly lagged, according to Dr. Aaron Kelly, co-director of the Center for Pediatric Obesity Medicine at the University of Minnesota. Dr. Kelly emphasizes the need for early intervention rather than waiting until later in life when it may be too late.
In January, the American Academy of Pediatrics released guidelines recommending the consideration of obesity drugs for children as young as 12 and surgery for those as young as 13. However, these recommendations were met with controversy. Mental Health America, an advocacy group, criticized these guidelines as “dangerous” and “disheartening,” suggesting that they could lead to more eating disorders and perpetuate harmful weight-related stigmas. Despite the criticism, medical experts argue that diet and exercise alone are often insufficient for children with severe obesity. Dr. David Ludwig of Boston Children’s Hospital emphasizes the importance of non-drug options alongside new weight-loss medications.
Medical professionals who specialize in treating children with severe obesity agree that it is essential to intervene early due to a range of health issues associated with excess weight. In fact, more than 240 diseases are linked to obesity, including liver problems, diabetes, and inflammation. Signs of these conditions often manifest early, leaving doctors to deal with severe consequences. Dr. Janey Pratt, a surgeon at Stanford University who performed John Simon’s surgery, stated that many patients already showcase signs of major organ damage by the time they seek medical intervention.
At a young age, John experienced persistent joint pain, shortness of breath, and severe sleep apnea. His sleep disorder was so severe that, at just 12 years old, he needed coffee to stay awake. Additionally, he developed anxiety due to daily bullying at school, resulting in a two-month hospitalization for post-traumatic stress disorder in sixth grade. Despite his efforts to manage his weight through diets and exercise, intense food cravings always caused him to regain any weight he lost and more. By the time he sought help from Dr. Callum Rowe, a pediatrics resident at Children’s Hospital Los Angeles, John’s Body Mass Index (BMI) was a staggering 75, far above the charts used to screen for obesity. However, John expressed a profound desire for a journey towards wellness, a sentiment that Rowe found remarkable for a 13-year-old. With this motivation, John was referred to the weight-loss program at Stanford Medicine Children’s Health, requiring him and his family to travel 350 miles to Palo Alto.
Since the release of the American Academy of Pediatrics guidelines, enrollment in the Stanford surgery program has doubled, underscoring the demand for these interventions. However, less than 1% of eligible children actually undergo metabolic surgery due to hesitancy from doctors and barriers such as lack of awareness or financial constraints for families. Fees for weight-loss surgery can range from $20,000 to $100,000. Fortunately, John’s surgery was covered by Medi-Cal, California’s Medicaid program, which also funded 47 operations for children aged 11 to 17 last year. Medicaid coverage for weight-loss surgery in children varies significantly across the United States.
Studies show that, on average, children who undergo weight-loss surgery lose about a quarter to a third of their body weight. However, approximately 25% of these individuals regain the lost weight and require further treatment. In a clinical trial, adolescents taking Wegovy experienced a 16% reduction in body mass over nearly 16 months. However, research also shows that weight regain is common once individuals stop taking obesity drugs. Serious side effects such as gallstones and pancreatitis have been reported in some cases. Nevertheless, Edward Kent’s response to obesity medication has been positive, with his previously ravenous appetite diminishing significantly. His recent medical exam revealed improved liver function.
Similarly, John Simon has successfully lost about 35% of his body weight in less than a year. His liver function and insulin resistance have improved, along with a reduction in arthritis symptoms. He now sleeps better and moves more comfortably. Despite these successful transformations, John’s challenges extend beyond weight loss and health improvement. The severity of bullying he endured at his middle school even required teachers to accompany him between classes for his safety. Nevertheless, his mother hopes that John’s transition to a charter high school will provide a more compassionate environment for him.
At age 15, John looks forward to a brighter future. He has learned to cook healthy meals and has taken on a regular exercise routine at a local gym, accumulating an impressive 18,000 daily steps. His dream is to become an automotive engineer and hopes to achieve this through hard work and dedication. Ultimately, John’s goal is to live a happy and healthy life, free from both physical and emotional pain.
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