The medical community and the general population at large were confronted by two stories this week which were thought-provoking. A 4 year old boy from India suffering with genetic Prader-Willi syndrome had weight loss surgery to control a disease which caused him to feel hunger continuously. Surgeons decided to perform a sleeve gastrectomy to keep his weight under control. This was then followed by news of a 2 year old Saudi boy (pictured) who had a sleeve gastrectomy after diet and medical treatment failed to keep his weight down.

I would have to say no one knows what the long term outcome will be for these two children, as this is unfamiliar and uncharted territory for weight loss operations. There is no doubt in my mind that the medics looking after these two boys had their best interests at heart and one might argue that left unchecked their weight may have been a cause of death in their early life.

Regardless of how one feels about the underlying causes of obesity at such a young age or indeed the degree of involvement of the parents in the second case, it is apparent that obesity is on the rise and commonly occurs at a much younger age than in previous decades. Weight loss surgery is the only effective treatment we currently have to face an epidemic of bad eating habits, less physical activity and a capitalistic food industry which has led to a rise in “passive” obesity.

The big question is whether these children will have developmental abnormalities due to nutritional deficiency. This is less likely to occur with sleeve gastrectomy than a gastric bypass. A band, although reversible would have been difficult to adjust and retain at such a young age with a growing body which may have led to complications such as erosion or migration. The right choice of operation has been made with the added benefit that a gradual stretch of the stomach will allow these boys to have a near-normal sized stomach when older. Suffice to say, these boys will be closely observed over the coming years by the medical community, as there is much to be learnt from their weight loss journeys. If anything, this should be a blessing, as continuous follow up is in itself a good way to ensure healthy diet and lifestyle patterns are being adhered to. I wish both these boys the best of luck and a healthy future.

by Ahmed Hamouda