As more teenagers have weight-loss surgery, a horrifying insight into the terrible price they pay as they grow up: Agony of the children given gastric bands as young as 13

• Last year 20 children as young as 15 had weight-loss surgery on the NHS
• Many had not even reached puberty when they had the invasive procedure
• Weight-loss surgery for children and adults has risen tenfold since 2000
  
• Malissa Jones, now 22, had a gastric bypass operation in 2008 at just 16
• Fears malnourishment has affected fertility
  
• Has been five stone of excess skin which she cannot afford to have removed
  

By Zoe Brennan

PUBLISHED: 17:54 EST, 8 May 2013 | UPDATED: 06:48 EST, 9 May 2013

At first glance, you wouldn’t notice anything amiss with the raucous group of teenage boys eating in the restaurant. Slim and athletic, yet demolishing piles of food with the industrial-furnace type of metabolism so coveted by older generations, they seem in the peak of health.

Study one of the party closely, however, and you notice something disturbingly different.

As his friends plough their way through mounds of pasta, pizza, chips and burgers, 18-year-old Emrah Mevsimler is chewing carefully on a salad, his face set in concentration. Any moment, he will stagger from the table in agony, gripped by pain.

Despite losing 4st in weight, Emrah is now calling for a worldwide ban on children having drastic antiobesity procedures

This is how Emrah, a careworker for disabled children, has lived for the past few years since he earned the dubious accolade of being the youngest person in the UK to be fitted with a gastric band.

The controversial operation, which made national headlines, was performed in 2007 when he was only 13 and weighed 16st 8lb.  Now in almost constant agony, he is desperate to have the band removed.

 

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Despite losing 4st in weight, the teenager, from Chelmsford, Essex, is now calling for a worldwide ban on children having drastic anti‑obesity procedures.

‘I just wish it was out of me,’ he says. ‘I’ve been through hell because of it. I think every doctor should refuse to do them on anyone under 18. A gastric band is not the answer to curing an overweight child.’

These are wise words, spoken by one who should know. Yet it would seem an increasing number of parents and doctors disagree.

Big changes: Emrah Mevsimler, left, and aged 12, right- a year before he had his gastric band fitted

A shocking number of children are undergoing potentially life-threatening surgery every year in a drastic antidote to the UK’s obesity crisis, which has seen a third of British school children classed as overweight before they start secondary school.

Last year it was revealed that up to 20 children as young as 15 had invasive weight-loss surgery on the NHS in Britain. Added to this is the undocumented number of British children whose parents pay for the procedure privately, at a cost of between £5,000 and £8,000. Many more children travel abroad with their parents to seek out cheap deals.

Like Emrah, many of these children haven’t even completed puberty when they go under the knife.

But are gastric bands really the answer to Britain’s alarming obesity crisis? Do they rescue children from a lifetime of bullying and misery, or do they simply swap one collection of serious health problems for another?

Certainly, the World Health Organisation has expressed concern over the use of bands in young people.

Last year, a WHO report warned there had been little research into the use of these techniques on children, with their unique metabolic needs, concluding: ‘Surgical complications in this age group remain a concern.’

Gastric band surgery involves fitting a band near the top of the stomach, restricting the amount of food that can enter, thus making the patient feel full. Follow-up operations can adjust how much food is allowed to pass through.

Other options are a gastric bypass, stomach stapling or a gastric balloon.

Malissa Jones from Selby, North Yorkshire, today (right), and as a 34st teen (left) has become anorexic after having a gastric bypass operation

Malissa, who lives with her husband Chris, near Wakefield, in West Yorkshire, says their biggest worry is that the bypass has affected her fertility

In a gastric bypass, a surgeon makes the stomach smaller in an irreversible procedure. Stomach stapling is similar to a gastric band but cannot be adjusted.

A gastric balloon is a temporary measure where a device is inflated in the stomach, giving a feeling of being full; it is removed once the patient slims down.

A gastric band is considered one of the most easily reversible options, but the surgery to remove it carries its own risks of infection, septicaemia and long-term damage to the stomach.

Positive publicity surrounding celebrities such as Fern Britton, who lost more than 5st after a gastric band operation, has fuelled interest in the procedure, with the NHS at the vanguard of a sharp rise in the number of operations.

Yet far from being a safe solution to weight problems, the side-effects  of gastric surgery can include long‑term health problems such as bone-thinning, fractures, anaemia and kidney stones due to malnutrition, quite apart from psychological problems, including suicide.

Emrah described to Femail this week how he is desperate to reverse the operation. But because he had the original procedure abroad, he will have to pay to have it done privately — something he simply cannot afford.

‘If I go for a meal out with friends, by the end of the evening I am doubled up in pain,’ he says. ‘At times it gets so bad it can last days and I have to take time off work. I am not the person I would like to be. I have to sit at home when I’m in pain, so you do get depressed. I just want it removed now.’

Emrah’s story first made headlines in 2010 following the death of his mother Sharon, who earned a desperately sad accolade of her own when she became Britain’s most obese woman. At 42st, she watched in horror as Emrah began mimicking her obsessive eating habits. He was bullied at school and even made two suicide attempts.

‘I ate uncontrollably,’ Emrah says, recalling how he’d often get up at 5am to sneak in a few extra breakfasts before joining his family at the breakfast table. On his way to school, he would snack on sweets and fizzy drinks, then eat burgers and chips  for lunch.

Fearing he would end up bed-bound like her, Sharon paid £4,000 for an operation at the Obesity Solutions clinic at St Elizabeth Hospital in Zottegem, Belgium.

Two years later, she underwent gastric bypass surgery herself and lost 20st in weight. 

Malissa aged 16 with her mum Dawn, now says she was happier being fat than she is now having the band fitted

But the damage to her health was already done, and she died in 2010 of obesity-related illnesses, aged 41. For Emrah, the reality of living with the gastric band turned out to be a world away from the dream life his mother had envisaged for him. ‘It was fine to start with. I had to watch what I ate, and could only have small, healthy meals. But in recent years it has been causing me a lot of pain, he says.

‘I hadn’t even finished growing when it was fitted. It could now be too small, or it might have slipped, or my stomach could be damaged.’

He has since paid more than £3,000 to the private clinic where he had his original operation on 15 follow-up procedures to have his band adjusted to ease the pain. Now weighing just under 12st, he says he would have the band removed — but cannot afford the £4,000 required. He says: ‘I would have it taken out tomorrow if I had the chance.’

Malissa lost more than 25st in weight after her bypass, but in a cruel stroke of irony, eating became such an issue that she is now classed as anorexic

Emrah’s story is far from unique, so why isn’t the medical profession listening? Such is the demand for gastric band surgery that centres which provide it are already operating, or being planned, in Sheffield, Leeds, Nottingham, Oxford, Cardiff and Newcastle. Ashish Desai, a consultant paediatric surgeon, carries out the procedure at the NHS’s first paediatric bariatric (child weight loss) surgery service, at King’s College Hospital, London, which caters for 13 to 18-year-olds.

The youngest patient Mr Desai has operated on was a 14-year-old boy suffering from such extreme bone problems related to his obesity that he had to use a wheelchair.

Another of his patients was 17, weighed 23st and had a body mass index (BMI) of 45. A normal BMI is between 18.5 to 25. A further two patients were aged 16.

He says: ‘The patient should understand that this surgery is drastic and will require lifelong commitment and changes in diet and lifestyle,’ he says. ‘The four children I have treated have done very well, with an average weight loss of just under 4st.

‘They needed it. These are children who are morbidly obese. It is not an easy solution.’

Dr David Ashton, from the Birmingham-based private clinic Healthier Weight, has fitted gastric bands on around 25 children in recent years, including several on 14-year-olds.

He says: ‘Obese children have a very poor quality of life. They suffer psycho-socially, they are depressed, isolated and do badly educationally.

‘There is currently no treatment other than surgery which has been shown to deliver durable, long-term weight loss in either adults or teenagers.

‘Some people ask if our society has become so debased that in order to stop children eating too much, we have to operate on them? I ask them the killer question: “If you had a 15-year-old daughter with a BMI of 42, who was depressed and crying a lot, had evidence of insulin resistance (often a dangerous precursor to diabetes) and early erosive arthritis, on what possible grounds would you withhold this treatment?” ’

‘Most of these kids have a strong genetic capacity to put on fat. They are waging war against their own metabolism. Of course, there are environmental factors, too.’

Dr Ashton says he would not carry out irreversible gastric operations on children: ‘I would emphatically not do a bypass on a child, as they are still growing. A band is the least invasive of these interventions. But I say to patients: “This is not easy; it is a tool that you can use. You need to follow a special diet. If you live on cheesy Wotsits and muffins, you will still absorb the calories, and “outeat” the band.”

‘But if it works, this is a tremendously life-enhancing procedure for these children.’

Charlotte Hill, 18, from Hanley Swan, Worcestershire, had a band fitted at Healthier Weight a year ago, and now weighs just over 14st.

Both her elder sister Katie and mother Juliet have also had it done, Katie when she was just 14.

The weight loss caused by the band over the years (left aged 18, two years after having the band fitted, and right now, aged 22) has left Malissa with 5st of excess skin which she can not afford to have removed

Juliet, 42, says: ‘Diets have never worked for the women in my family. We’ve tried everything, including slimming clubs and exercise, but it’s a battle we can’t win. Food is an addiction.

‘Looking at my beautiful girls and knowing they’ll have a happy, healthy life is all I need to know we’ve done the right thing.’

Charlotte agrees and denies it is the easy option for lazy, greedy people, as perceived by some critics. 

‘People see it as a quick fix, but you have to work at it. I am eating healthily and exercising,’ she says.  ‘Before this, I was bullied at school. Now, I don’t feel self-conscious when I go out.’

Katie adds: ‘I was gaining weight at such a pace, I’d probably be more than 20st and housebound by now without the surgery.’

But psychologist Jane McCartney argues that gastric surgery overlooks the issues beneath obesity, and should never be considered for children at such a young age as Emrah and Katie.

‘Their underlying worries were not addressed,’ she says. ‘They still face crippling mental distress and anxieties about their body,’ she explains. ‘If children are eating because they are miserable, unless you look at why they are miserable, nothing is fixed.

‘A gastric band is not the panacea for everything that is wrong in your life.’

And while some children may see positive results, Emrah is far from alone in regretting his surgery.

Malissa Jones, now 22, had a gastric bypass operation in 2008 when she was just 16. Also from a family prone to weight problems, she weighed 4st by the age of five. By 16, she weighed an astonishing 34st, and was named Britain’s fattest teen.

Requiring a dress size 30 and with a BMI of 72.4, she had to wear an oxygen mask when lying down, as her weight crushed her internal organs.

Malissa lost more than 25st in weight after her bypass, but in a cruel stroke of irony, eating became such an issue that she is now classed as anorexic.

‘I could only manage softly-cooked veg, so a typical day’s eating for me will be about 300 calories — that’s three cooked carrots, two pieces of parsnip and a roast potato.’

There were other side-effects to her rapid weight loss: ‘No one had warned me how saggy and ugly my extra folds of skin would look,’ she says. ‘When I looked into having it removed, I was told it would cost £20,000 privately.

‘I weigh 9st, but because of all the excess skin I still have, my doctors say my true weight is nearer to 7st. 

Malissa, pictured aged 18, with her sister Charmaine, six months after her surgery says she wishes medics had explained other options to her

‘I find eating physically painful: I have to force food down. My body isn’t able to absorb all the nutrients properly because of the bypass.’

Malissa, who lives with her husband Chris, near Wakefield, in West Yorkshire, says their biggest worry is that the bypass has affected her fertility. She has suffered a number of miscarriages, including a little boy who was stillborn at 27 weeks. ‘The doctors don’t know if I will ever be able to carry a baby full-term,’ she says sadly.

‘I want people to know gastric surgery isn’t the answer to obesity. If I could only turn the clock back and lose weight with a combination of diet and healthy eating, I would.’

Emrah offers similar words of caution: ‘I would say to another child thinking of having the procedure, this is a last, last option — and not an easy one. Mum did the right thing for me at the time, but if I’d been educated properly about eating, I wouldn’t have had to do it.

‘When I had my band, I didn’t see any other way out. I wish the medics had explained other options to me.’

Malissa’s sentiments are even sadder. ‘I know this might sound ungrateful,’ she says. ‘But I can’t help but feel I was happier being fat.’