Teen Turns to Surgery to Lose Weight Before Liver Transplant

Doctors offer new guidance about how to treat childhood obesity

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A Northern Virginia teenager turned to weight-loss surgery to lose enough weight to get a liver transplant after guidelines for treating childhood obesity were updated.

Emma Hardy, 17, struggled with her weight since she was a little girl.

“Even when I was eating healthy, I was still gaining weight,” she said.

A medical condition also contributed to the problem.

She did physical therapy and worked with a nutritionist, but nothing helped.

“I was very mad at myself that diets weren’t working and working out wasn’t working,” Emma said. “And I was so upset with myself, I kind of just shut down.”

As she shut down emotionally, her physical health continued to suffer. She learned her liver was failing and she needed a transplant. But to have one, she needed to lose weight.

Doctors at Children’s National Hospital recommended a different approach that included medication and weight-loss surgery.

“Being able to offer patients something other than diet, exercise when their genetics and their biology are just fighting that tooth and nail is huge and really has given so many of our patients hope that they didn't have before,” said Dr. Alicia Tucker, who treated Emma.

For the first time in 15 years, the American Academy of Pediatrics updated its guidelines for treating childhood obesity, including surgery and weight-loss medications for some children as young as 12.

Tucker says families and physicians now have more options as they move away from the longstanding approach of watchful waiting when it comes to weight loss.

“We're really happy to have the AAP put out these guidelines and to have it be something that's more recognized as a condition that does need chronic ongoing longitudinal care and treatment just like other chronic diseases like asthma and depression,” Tucker said.

Last year, Emma was cleared for gastric sleeve surgery, followed by a liver transplant and the medication Ozempic. She says that combination helped her shed more than 85 pounds.

“I feel more energetic; I’m not tired all the time,” she said. “It’s changed, pretty much, my whole life.”

She hopes her story shatters the stigma that prevents some people from getting help.

“It made me who I am today and made me want to advocate for kids like me and for adults like me,” she said.

Tucker says 60-70% of obesity is related to biology. She hopes the AAP guidelines help shift the conversation about obesity – that it’s not a choice but a chronic disease that needs to be treated with proper support.

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