A toddler from Saudi Arabia has become the youngest person in the world to undergo bariatric surgery, after reaching 33kg at age two.
The boy, whose name has been suppressed, first saw an endocrinologist at 14 months, when he weighed 21.3kg. Four months later, after being put on a controlled eating plan, he had put on another 8kg.
By the time he was admitted to an obesity clinic, at Prince Sultan Military Medical City, the boy weighed 29.4kg. His morbid obesity had led to sleep apnoea, causing him to stop breathing for moments in his sleep, and his legs had become bowed.
Doctors ruled out any hereditary or genetic causes of the obesity, and after another failed weight loss attempt, and with a body mass index (BMI) of 41, the toddler was referred for surgery in 2010.
In the case, outlined in the International Journal of Surgery Case Reports, the team of surgeons removed the outer section of the stomach to reduce food intake, leaving an area about the size of a banana, in a procedure known as laparoscopic sleeve gastrectomy (LSG).
Unlike lap band surgery, the procedure is permanent.
"To our knowledge LSG has never been tried in very young age children," the surgeons wrote.
"We present here probably the first case report of the successful management of a two year old morbidly obese boy."
The surgery has been considered a success – after two months, the child had lost 15 per cent of his body weight and his sleep apnoea had "decreased substantially", his doctors said.
Within two years his BMI was in the normal range at 24 and he weighed a much more healthy 24kg.
"The results suggest that LSG can be a safe and effective alternative for weight control in morbidly obese children even of less than 3 years of age," the doctors concluded.
"However more studies and long term follow up is essential for monitoring the growth and development of children subjected to LSG."