'We had to do it for him'
Obese teens seeing results from UIC gastric band program
Thursday, June 21, 2007
Mack Downey cannot stop staring at himself in the mirror. At first glance you might think he was a little narcissistic-and Mack would probably agree he's being overindulgent.
But Mack wasn't always like this. In fact, less than a year ago, he weighed 104 pounds more than he does now and was gaining weight at an average of 50 pounds per year.
"I used to have low self-esteem. It used to be terrible," says Mack, 16, of Columbus, Ohio. "I would just get into trouble for no reason at all. They [classmates] just beat me down to the point where I just didn't care anymore. Now I'm overconfident I think. I feel like another person."
Weight has been a battle for Mack for as long as he can remember. By 9, he and his mother knew they had to do something. They tried fitness camps, programs at the National Institute of Health and a "fat camp" where Mack lost a lot of weight but started gaining it back the minute he got home.
Desperate, his mother turned to the Web to find other options. What she found was the New Hope Pediatric and Adolescent Weight Management Project at the University of Illinois Medical Center in Chicago. The program's success hinges on the surgical planting of a gastric band.
Mack fought the idea, but his mother pushed ahead.
"It was necessary. The program likes for your children to be on board because it's much easier if they're going to work with it. But we had decided whether he was on board or not this is what we were going to do," Jacqueline Downey says. "We had to do it for him. I don't think he'd make it to 30 if we hadn't."
The UIC program is for teens who are morbidly obese and normal diet and exercise will not control their weight gain. Children who enter the program first undergo nutritional training-they will be expected to continue exercising and eating well after the surgery is over.
According to Dr. Allen F. Browne, clinical director of the project, by combining diet, exercise and the gastric band there is an 80 percent chance that a child can take off 60 percent of their excess weight.
The adjustable gastric band works by creating an hourglass stomach, Browne says. The stomach becomes a small upper pouch connected through a small channel to a large lower pouch, which then goes on through the intestine normally. The trick, he says, is that when the upper pouch fills up, a signal goes to the brain that tells the patient they are full.
The surgery is approved for kids 14 and older and most patients have no side effects. The band can be adjusted as the child ages to control weight gain and loss.
"These kids ... have to be brave enough to come through the door after they've failed and been told they were failures and been told they were bad and lazy and dumb. The way they've been treated by not only society but by the healthcare system is truly shocking as you get to know them," Browne says.
"We tell the kids nobody fails and nobody flunks out."
It's amazing, he says, to watch the changes after surgery. The kids are so proud of themselves.
Mack certainly wouldn't argue with Browne. In fact, he plans on telling his tale to other kids like him to help them through the process. And he's prepared to do something no teenager wants to do-to admit his mom was right.
"Most of the stuff that happens to me on a daily basis wouldn't happen to me without my mom," he says. "It's awesome having a person like that in your corner, someone who will go to bat for you. I got a keeper."
Weighing your options
The LapBand is only approved for use in patients 18 years old and over. The FDA has offered no opinion on its use in younger patients. The University of Chicago, New York University and Morgan Stanley Children's Hospital are the only institutions providing information to the FDA on use of the adjustable gastric bands in younger patients (ages 14-17) at this time.
Soon, a study sponsored by the Allergan company, makers of the LapBand, will begin to provide more data to the FDA. This study will involve seven institutions from around the country, including UIC.
• With an adjustable gastric band, the patient has an 80 percent chance of losing 50-60 percent of their excess weight.
• The child's mental health issues improve.
• Associated physical health problems such as asthma, myocardiopathy, hypertension, Type 2 diabetes, dyslipidemia, polycyctic ovary disease, slipped capital femoral epiphysis, non-alcoholic steatohepatitis (NASH), sleep apnea and focal nodular sclerosis of the kidneys will improve or completely resolve.
• Women will have an easier chance of becoming pregnant, have safer pregnancies and have healthier babies when they decide to have children.
• The risk of dying from an adjustable gastric band is about 1 in 10,000.
• The risk of complications such as wound infections, tube breakage, erosion of the band into the stomach and gastric prolapse is about 1 in 10.
Christy Breithaupt is a freelance writer living in Chicago. She is expecting her first child.