Mariana Castrillon, a 17-year-old from the Bronx, has struggled with her weight her entire life. When her body mass index (BMI) reached more than 56 in 2020, she was referred to the Adolescent Healthy Weight Program at Hassenfeld Children’s Hospital at NYU Langone.
In the past three decades, the prevalence of obesity has more than doubled in children and tripled in adolescents. In the wake of the pandemic, anxiety and stress have hindered the efforts to address obesity. According to a recent study from the Centers for Disease Control and Prevention (CDC), the rate of increase in kids’ BMI approximately doubled in 2020. Children who started 2020 at a normal weight or overweight, showed an increased rate of BMI across the board.
“That’s one of the biggest issues that some of my patients have brought up,” says Jun Tashiro, MD, MPH, a board-certified pediatric surgeon who specializes in bariatric surgery at the Adolescent Healthy Weight Program and an assistant professor in the Department of Surgery at NYU Grossman School of Medicine. “This pandemic has truly caused them to backslide on weight loss goals…or that they’ve become heavier than they’ve ever been before.”
At the Adolescent Healthy Weight Program, the care team gives teens the tools they need to achieve and maintain a healthy weight. But achieving this can be challenging, especially for young people who have experienced significant weight gain that is affecting their physical and mental health.
Addressing weight issues early in life can have a long-term positive impact on overall health. Teens with obesity are at a greater risk for asthma, diabetes, sleep apnea, high blood pressure, high cholesterol, liver disease, and bone and joint problems, both in adolescence and adulthood. Young people with obesity may also experience low self-esteem, anxiety, or depression, and withdraw from school, friends, and other activities.
At 342 pounds, Mariana felt limited in the activities that people her age would normally do. “Because of my weight gain, I couldn’t enjoy going to amusement parks without feeling embarrassed,” Mariana tells ABC7NY as part of their “Protect Our Children: Mental and Physical Stress” special.
At the beginning of 2020, Mariana’s pediatrician referred her to a team including Dr. Tashiro, Emily Breidbart, MD, a pediatric endocrinologist and assistant professor in the Department of Pediatrics, and Elizabeth A. Jehle, NP, the nurse practitioner for the program, who worked with Mariana over several months on diet, lifestyle counseling, and nutrition education, all virtually due to the pandemic. The team also collaborated with Becky Lois, PhD, clinical assistant professor in the Department of Child and Adolescent Psychiatry, who works with the program to address any psychological issues that may contribute to excess weight gain.
With its multidisciplinary approach, the team developed a personalized plan for Mariana that helped her get a healthy start on a new life.
When dietary and lifestyle interventions are not enough to achieve a healthy weight, the care team may recommend weight loss surgery for teens, also called adolescent bariatric surgery. The program provides gastric sleeve surgery, also known as sleeve gastrectomy, for people ages 13 to 17 who have a BMI of 40 or higher, or a BMI of 35 or higher and at least 1 accompanying risk factor, such as diabetes. This procedure reduces the size of the stomach, which helps people eat less and feel full faster. It can also reduce insulin resistance, a condition that can lead to increased hunger and weight gain.
“Research shows that bariatric surgery helps teenagers lower their BMI and reverse or significantly reduce their risk of type 2 diabetes and heart disease. By reducing the risk of obesity-related disorders earlier in life, surgical treatment can help prevent illness in teens and lead to better health as adults,” says Dr. Tashiro, who performs weight loss surgery for teens that qualify within the program.
With more than a year of medical weight management and a limited success of 10 pounds of weight loss, Mariana qualified to have the gastric sleeve surgery, which was performed by Dr. Tashiro and his team in October 2021.
As of April 2022, Mariana has lost more than 80 pounds, and is dedicated to keep going. A senior at a film-focused high school in the Bronx, she looks forward to attending prom in June, graduating, and going to college to study education.
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