Young, Obese, and in Surgery

Though Shani Gofman had been teased for being fat since the fourth grade, she had learned to deal with it.

She was a B student and in the drama club at school. She had good friends and a boyfriend she had met through Facebook. She even showed off her curves in spandex leggings and snug shirts.

When her pediatrician, Dr. Senya Vayner, first mentioned weight-loss surgery, Ms. Gofman was 17, still living with her parents in Bensonhurst, Brooklyn, her bedroom decorated with glow-in-the-dark stars because she was afraid of the dark.

There was no question, at 5-foot-1 and more than 250 pounds, she was overweight. But she resisted, saying she could diet.

“I’ll lose weight,” Ms. Gofman assured her doctor.

Dr. Vayner said, prophetically, “It’s not your fault, but you’re not going to be able to do it.”

Along with the obesity epidemic in America has come an explosion in weight-loss surgery, with about 220,000 operations a year — a sevenfold leap in a decade, according to industry figures — costing more than $6 billion a year. And the newest frontier is young patients like Ms. Gofman, who allowed The New York Times to follow her for a year as she had the operation and then embarked on a quest to lose weight, navigating challenges to her morale, her self-image and her relationships with family members and friends.

But the long-term effectiveness of weight-loss surgery, particularly stomach banding, the procedure Ms. Gofman had, is still in question. And the push toward surgery on the young has brought some resistance from doctors who say it is too drastic to operate on patients whose bodies might still be developing and who have not been given much time to lose pounds on their own. […]

Cathy Taylor, a spokeswoman for Allergan, noted that the studies involved small sample sizes: the adult ones had fewer than 300 patients combined, and the Australian study, two dozen. Ms. Taylor said that the adult studies did not reflect recent improvements in the band and in surgical techniques, and that the complications in the teenage study were not serious.

Stomach enlargement, she said, “speaks to the importance of additional education for the adolescent to understand the importance of adhering to the new eating program.”

But that, said Diana Zuckerman, a psychologist and president of the National Research Center for Women and Families, goes to the heart of why teenagers are bad candidates for bariatric surgery: they are often immature, rebellious and uninterested in long-term consequences.

“It’s not just you can’t eat Thanksgiving dinner,” Dr. Zuckerman said. “You’re going to have to have this tiny little meal for the rest of your life.”

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