Skip to main content
Part of complete coverage on
 

2-year-old gets weight-loss surgery: How young is too young?

By Kelly Wallace, CNN
September 21, 2013 -- Updated 1326 GMT (2126 HKT)
The two-year-old Saudi patient is seen here before bariatric surgery to reduce his weight.
The two-year-old Saudi patient is seen here before bariatric surgery to reduce his weight.
STORY HIGHLIGHTS
  • 2-year-old obese boy believed to be youngest ever to have weight-loss surgery
  • The boy suffered from sleep apnea which restricted his breathing when he slept
  • Doctors say typically girls under 13 and boys under 15 don't have weight-loss surgery
  • Women around the country reacted with sadness and concerns about the message it might send

Editor's note: Kelly Wallace is CNN's digital correspondent and editor-at-large covering family, career and life. She's a mom of two girls and lives in Manhattan. Read her other columns and follow her reports at CNN Parents and on Twitter.

(CNN) -- When you hear the story of a 2-year-old boy believed to be the youngest person in the world ever to have bariatric surgery, it's very easy to "point a judgmental finger," as one mom said to me.

"Wasn't there anything else the parents could do besides such a serious surgery at such a young age?" parents will ask.

But then you hear the story of now 18-year-old Maria Caprigno, who weighed 443 pounds when she was just 14.

"I was gaining 40 pounds a year," said Caprigno, in between classes at Bridgewater State University in Massachusetts. "They told me unless something drastic happened, I would not see my 18th birthday."

The child after surgery
The child after surgery

Listening to Caprigno, it becomes clear that the decision by the boy's parents -- and what they did or did not do before the surgery -- is not so black and white. And as parents grapple with the option of early surgical intervention for childhood obesity, they also must examine whether it's only their child's health on the line or if appearance and social standards are influencing these decisions too.

The boy, from Saudi Arabia, weighed 79 pounds by the age of 2, and suffered from severe sleep apnea which caused him to stop breathing while asleep.

Weight-loss 'sleeve' a good option?

Overweight kids, oblivious parents
Obesity in teens leads to heart disease
Mom defends putting 7-year-old on diet

After two different attempts to control the boy's weight through dieting reportedly failed, doctors decided to perform what's called a laparoscopic sleeve gastrectomy, which involves permanently removing 60 to 85% of the stomach and restricting food intake.

Dr. Jennifer Shu, a pediatrician in Atlanta, said such a procedure should be a last resort, and only after close monitoring and dieting have been attempted and proven to be unsuccessful.

Without knowing the details of this particular case, she said that if doctors had not performed the surgery, the boy could have faced physical problems such as pain, injuries and bowed legs, heart disease and diabetes down the road and even death, from the lack of oxygen caused by the sleep apnea.

"I think what (the doctors) are trying to say is this kid may not live without the surgery or without reversing that weight gain," said Shu, CNNHealth's Living Well expert doctor who is also a mother of two.

Shu says the current recommendation is to wait until the child is done growing or close to it, which is around 13 for girls and 15 for boys before considering bariatric surgery.

Caprigno had such surgery three years ago, when she was just 14. To her knowledge, at the time, she was one of the youngest people ever to have it.

It was an immensely difficult decision for her parents, who were both "morbidly obese," she said. Her dad, who also had bariatric surgery, still weighs over 400 pounds.

"My mom always said she was so nervous about putting me under this knife," said Caprigno, who said her mom had the lap-band procedure, which involves placing a device around the top of the stomach to control food intake, before she had hers.

"She told me she wasn't putting me under a knife that she hadn't been under herself," she said. "And I can't even imagine how difficult that decision was for her to allow me to do this and it must be so much harder for the parents of a 2-year-old to do that."

Signs of progress in childhood obesity fight

In my conversations with women across the country, a universal feeling about this case was sorrow for this little boy.

"I'm very saddened to learn of the extreme measures that were taken for the health of this toddler," said Lori Garcia, a mom of two boys, ages 5 and 10, and host of the blog, Mommyfriend. "Were there no other or better alternatives than two failed attempts at dieting?"

Renae Wortz, who is a mom and nurse practitioner, also wondered whether there might have been a less invasive treatment to help the boy lose the weight, but she also thought about what she would do if she were in the same situation.

"I think parents will do anything, even if it's extreme, to help a sick child," said Wortz, who is one of the co-founders of the blog, Mom Colored Glasses. "Maybe they weren't able to stick to the diet, but maybe they were. Maybe they did everything they could to help him lose weight, but weren't successful in the end."

Why is it so hard for kids to lose weight?

Another pressing concern is the unknown long-term impact such a surgery could have on the child's development, including intellectual problems down the road. "The brain just grows so rapidly between birth to 3 years old, he's still in that very phase of development," said Shu. "So we don't know what kind of effects the surgery may have."

"Medicine is not a perfect science and without prior data (exploring similar cases), such impacts would be uncertain and that uncertainty would have to be factored in to the risk/benefit decision for the child's health," said Alpita Shah, an international finance and community development lawyer in Chicago.

iReport: Before weight loss, 'Every beat of my heart hurt'

Beyond the medical uncertainties and possible complications (which could include leakage, infection and blood clots), weight-loss surgery on a 2-year-old raises the question: What does this story say about us? What impact might it have on other kids and families struggling with weight?

"Skinny is not an equation for health," said blogger and author Liz Henry, whose work will be featured in the upcoming book "The Good Mother Myth." "This is unchartered territory and a dangerous precedent for still growing and maturing bodies."

Henry, who is passionate about body image issues, worries about the message this case might send.

Stay in touch!
Don't miss out on the conversation we're having at CNN Living. Follow us on Twitter and Facebook for the latest stories and tell us what's influencing your life.

"While this may be an extreme case, it can lead to other parents looking at the rubber-band wrists and pudgy thighs of their toddler and immediately seeking medical intervention that leads to irreversible harm," she said.

"I truly hope that pediatric gastric bypass surgery doesn't become just another 'norm' in our culture of instant gratification and 'easy fixes,' " said Wortz.

Physicians group labels obesity a disease

For her part, Caprigno, who has lost over 130 pounds following her surgery, and has completely changed the way she thinks about food, the takeaway from this story is for all of us to talk more openly about obesity and to understand what it is in the first place. The American Medical Association just recognized it as a disease back in June.

"We definitely need to recognize that there's no one to blame for this and that there are genetic components that play a part, lifestyle plays a part, and we just need to change how we view obesity because there's such a stigma," said Caprigno, who currently works with the nonprofit the Obesity Action Coalition.

"We try to get everyone to understand that this is a disease. It's not something we choose," she said.

Follow Kelly Wallace on Twitter and like CNN Living on Facebook.

How young do you think is too young for bariatric surgery? Leave a comment below.

ADVERTISEMENT
Part of complete coverage on
November 21, 2014 -- Updated 2220 GMT (0620 HKT)
November is National Adoption Awareness Month. CNN's Michaela Pereira grew up in a family of five adopted girls in Canada and eventually reunited with her biological half-sister.
November 20, 2014 -- Updated 1939 GMT (0339 HKT)
It began for Nickolay Lamm as a question: What would Barbie look like if she had the dimensions of an average woman?
November 20, 2014 -- Updated 0216 GMT (1016 HKT)
Bill Cosby was thought of as a perceptive comedian and genial father figure. Now, that persona pairs with another, much darker image.
November 18, 2014 -- Updated 1735 GMT (0135 HKT)
If you think 'my teen would never sext,' you might be mistaken. Recent studies suggest it's more common than many parents might want to admit.
November 14, 2014 -- Updated 1144 GMT (1944 HKT)
I pictured myself graduating from college, getting a cool job and even having a cute place of my own. Instead, I wake to the early-morning sounds of my family dog barking and my parents making coffee downstairs.
November 18, 2014 -- Updated 1738 GMT (0138 HKT)
Samantha Futerman and Anais Bordier tease, poke and prod each other like they've grown up together, but they didn't. Neither woman knew she had an identical twin sister until less than two years ago.
November 13, 2014 -- Updated 1402 GMT (2202 HKT)
A school district in Maryland has decided to remove all references to religious holidays from its school calendar, leaving some in the community frustrated.
November 13, 2014 -- Updated 1706 GMT (0106 HKT)
Female veterans often have a harder time finding employment than their male counterparts. But why?
November 14, 2014 -- Updated 2019 GMT (0419 HKT)
I simply couldn't believe my eyes. At a children's party this year, I witnessed full-on "mean girl" behavior.
November 10, 2014 -- Updated 1724 GMT (0124 HKT)
Several children were sent to the hospital after being sickened by ingesting detergent pods.
November 12, 2014 -- Updated 1446 GMT (2246 HKT)
There are plenty of times when I literally wish I could take a hammer to the portrayal of girls and women in the media. In a new ad, a little girl gets to do just that.
November 8, 2014 -- Updated 1509 GMT (2309 HKT)
"Playing doctor" and "I'll show you mine if you show me yours" are common rites of passage in childhood sexual behavior, according to the experts.
November 6, 2014 -- Updated 2012 GMT (0412 HKT)
A tech startup claims credit for making Alex from Target go viral, but there's skepticism about how involved it was, if at all.
November 4, 2014 -- Updated 2247 GMT (0647 HKT)
A soft toy for cribs lets babies post pictures of themselves to social media.
November 4, 2014 -- Updated 1655 GMT (0055 HKT)
Schools are increasingly confronting a controversial question: Should they do more to monitor students' online interactions off-campus to keep them safe?
November 6, 2014 -- Updated 1656 GMT (0056 HKT)
The National Toy Hall of Fame recently inducted three new favorites into its hallowed halls. What's your favorite?
October 31, 2014 -- Updated 1409 GMT (2209 HKT)
We don't know, and may never know, what led to the Washington school shooting, but we have to ask ourselves, following this tragedy, if we are doing enough to help our boys deal with difficult emotions without resorting to violence.
October 29, 2014 -- Updated 2301 GMT (0701 HKT)
The viral video of a New York woman being catcalled on the street has men asking, "So, what should I do?" The answer starts with respect.
October 30, 2014 -- Updated 1840 GMT (0240 HKT)
Trick-or-treating and dressing in costume have been Halloween traditions for a good long time now, but it seems we're still struggling to get it right.
October 31, 2014 -- Updated 2038 GMT (0438 HKT)
Yes, there's actually corn in it. Corn syrup, if that counts.
October 28, 2014 -- Updated 1828 GMT (0228 HKT)
Walmart found itself sending apology tweet after apology tweet after the Twitterverse raked it over the coals for a major goof on its website.
October 27, 2014 -- Updated 2002 GMT (0402 HKT)
There aren't too many times when I'm speechless about what I consider an outrageous example of parenting. This is one of those times.
October 27, 2014 -- Updated 1157 GMT (1957 HKT)
Holy crap, LeVar Burton.
October 24, 2014 -- Updated 2138 GMT (0538 HKT)
Critics pounced on supermodel Gisele Bundchen for advocating a little mommy "me time" recently. When did it become a crime to admit that you -- as a parent -- put yourself first?
October 24, 2014 -- Updated 1621 GMT (0021 HKT)
Sally Kohn says a video of little girls dressed as princesses using the F-word very loudly to condemn sexism is provocative. But is it exploitative?
October 24, 2014 -- Updated 2027 GMT (0427 HKT)
Not again.
October 24, 2014 -- Updated 1641 GMT (0041 HKT)
"Breaking Bad's" drug-dealing chemistry teacher Walter White will have to stop making the sale at Toys R Us.
October 22, 2014 -- Updated 2006 GMT (0406 HKT)
I happen to agree with Renee Zellweger that all the chatter about her face is "silly." But I, and many other women I talked with via email Wednesday, would add some other choice words to the mix to describe the non-stop attention about her appearance: nasty, cruel, hurtful, invasive and sexist.
October 21, 2014 -- Updated 2206 GMT (0606 HKT)
I have long thought millennials, who expect flexibility in the workplace, would be the group that would bring an end to the stigma that is too often associated with flex time -- the belief that wanting a flexible work arrangement means you aren't willing to work as hard. But now I'm thinking it's going to be men who will get us there.
October 22, 2014 -- Updated 1140 GMT (1940 HKT)
Say it with us: Kids today have it sooooo easy.
October 21, 2014 -- Updated 1829 GMT (0229 HKT)
An Atlanta judge reportedly reprimanded an immigration attorney for bringing her 4-week-old to court for a hearing -- a hearing she asked the judge to reschedule because she was on her six-week maternity leave.
November 18, 2014 -- Updated 1604 GMT (0004 HKT)
Monica Lewinsky tweeted for the first time. She called herself "patient zero" of cyber-bullying.
October 17, 2014 -- Updated 1943 GMT (0343 HKT)
Meet Shyanne Roberts, a 10-year-old competitive shooter with something to prove: "Kids and guns don't always mean bad things happen."
October 20, 2014 -- Updated 1350 GMT (2150 HKT)
strawberry ghosts
We love Halloween season. Sweets. Sweaters. Sipping hot cider (maybe spiked). Halloween can certainly get you in the spirit, and nothing warms our hearts like these healthy Halloween treats that help you stay energized instead of stuck in a sugar coma.
October 17, 2014 -- Updated 1923 GMT (0323 HKT)
Does your baby cry during long flights, causing you to want to disappear from the glares of fellow passengers?
November 20, 2014 -- Updated 2114 GMT (0514 HKT)
Ask any teen if they suffer from social media anxiety and they would probably tell you no. But the truth is getting "likes" and the fear of missing out are adding stress to teens' lives.
October 16, 2014 -- Updated 1313 GMT (2113 HKT)
Many photographers have taken it upon themselves to document stillborn and terminal babies' precious moments after birth.
October 14, 2014 -- Updated 1946 GMT (0346 HKT)
As part of the insurance coverage offered to its female employees, Facebook is paying to freeze their eggs.
October 14, 2014 -- Updated 1815 GMT (0215 HKT)
Amal Alamuddin was well-known in many important circles long before she snagged the world's most eligible bachelor. But Amal Alamuddin is now Amal Clooney, according to her law firm's website.
October 14, 2014 -- Updated 1642 GMT (0042 HKT)
Trends in young adult fiction have shifted from wizards to glittering vampires to bloodthirsty "Hunger Games" and now, to teens coping with illnesses and realistic issues.
October 15, 2014 -- Updated 0056 GMT (0856 HKT)
Before he died this year, 14-year-old Martin Romero wanted to do something for his community.
October 13, 2014 -- Updated 2233 GMT (0633 HKT)
A 12-year-old girl called Dick's Sporting Goods out on its lack of female athletes in the Basketball 2014 catalog.
October 13, 2014 -- Updated 1636 GMT (0036 HKT)
Before he was even born, Shane Michael Haley had already met the Philadelphia Phillies, been to the top of the Empire State Building and shared a cheesesteak with his parents.
October 10, 2014 -- Updated 1939 GMT (0339 HKT)
I couldn't quite believe my eyes when I read the initial comments from Microsoft's CEO on how women who don't ask for raises will receive "good karma."
cnn, parents, parenting, logo
Get the latest kid-related buzz, confessions from imperfect parents and the download on the digital life of families here at CNN Parents.
ADVERTISEMENT