Stephanie Atwood had bariatric surgery when she was 15 and weighed 348 pounds, weight she gained because of the removal of her pituitary gland due to a recurring brain tumour. Three years later, she’s 100 pounds lighter, and says the experience is ‘like a second chance at life.’
Three years ago, Stephanie Atwood was five feet tall and 348 pounds (158 kilograms). She was so obese, she found it difficult to walk, fit in a car or even leave the house.
She was 15.
Doctors had to remove her pituitary gland when she was nine years old because of a recurring, non-cancerous brain tumour. It threw her body's ability to regulate appetite out of whack. Ms. Atwood could eat a full meal and be starving minutes later.
After gaining a dangerous amount of weight and trying diets and medication, doctors at Toronto's Hospital for Sick Children performed bariatric surgery on the Oshawa, Ont., teen to alter her stomach so she could feel full. Three years later, Ms. Atwood, now 18, has lost 100 pounds and says she has gained her life back.
Now, SickKids has created a program to help other teens battling obesity, and has become the first centre in Canada to offer bariatric surgery routinely to pediatric patients. The program officially launches Friday.
The SickKids team obesity management program is geared toward 12- to 17-year-olds with "complex obesity" - those who are overweight as a result of a medical condition such as a brain tumour, have a serious condition such as congenital heart disease that's complicated by obesity, or have complications from obesity such as type 2 diabetes or life-threatening sleep apnea.
"We're really treating a proportion of children who suffer from much more serious problems related to their obesity," said Jill Hamilton, director of the program as well as an endocrinologist and associate scientist at SickKids. "They have a very tough life."
But the program will also prompt ethical questions about the use of weight-loss surgery in young people, and the public may blame or judge patients or their families, Dr. Hamilton said.
"People will say, 'Oh they're too young to be doing surgery, this seems so radical,' but … this is just [about]getting to a size where you can fit behind a desk in the classroom where the chair is attached."
Bariatric surgery is just one component of the system. Incoming patients will go through an assessment and an intensive behaviour modification program to determine the best course of treatment. Some teens may end up on medication and some on specialized diets, Dr. Hamilton said.
The intensive nature of the program means only about 50 patients will be treated every year.
Of those, about 10 to 12 are expected to need bariatric surgery, Dr. Hamilton said.
SickKids will use laparoscopic adjustable gastric banding, a reversible type of bariatric surgery that uses a circular tube filled with saline solution to restrict the top of the stomach, forming a small pouch that becomes full quickly.
The Children's Hospital of Eastern Ontario will offer a similar program that won't include surgery. Any CHEO patients who are bariatric surgery candidates will be referred to Toronto.
Dr. Hamilton said she hopes to expand the program, without the surgery component, to children age 5 and under.
The country's obesity epidemic can't be solved through passing blame, Dr. Hamilton said. Many factors, such as mental illness and high cost of healthy foods, complicate the issue and highlight the need for policy changes, prevention strategies and food-industry marketing, she said.
"It's not such a straightforward issue of just eating less and exercising more," Dr. Hamilton said.
While the new program is just one part of a possible solution, it fills an major gap in providing care to obese children who are struggling with potentially life-threatening medical complications, Dr. Hamilton said.
"These are kids that really can't function very well," she said. "We have these kids that have type 2 diabetes, that have hypertension, on medication. These kinds of things shouldn't be happening."
A few years ago, Ms. Atwood's mother was considering buying a wheelchair to help her daughter get around.
Now, Ms. Atwood is taking a culinary arts program in college, has a part-time job and is working on a diet and exercise plan she hopes will help toward her weight-loss goals.
"I don't think I ever really saw a future for myself, in general," Ms. Atwood said. "When I got the [surgery] it was like a second chance at life."