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UCSD Clinical Trial Underway to Help Obese Children Lose Weight

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Aired 4/19/09

(Photo: Hollie Johnson with UCSD dietician Jill Jarrett. Kenny Goldberg/KPBS)
American children are fatter than ever. The Centers for Disease Control says between 1980 and 2000, the percentage of children who were overweight doubled in the U.S.  The agency says today, more than nine million American kids are obese.  A clinical trial is underway to see whether a particular type of surgery is a safe way for severely obese children to lose weight.  KPBS Health Reporter Kenny Goldberg has the story.

Hollie Johnson is 17-years-old. She's battled the bulge for as long as she can remember.
Hollie Johnson: I've been overweight since forever. Being overweight has been something that's made me unhappy my whole life, you know, just not having a very good sense of self-worth.
Johnson says she's tried nearly every diet known to man.
Johnson: And just nothing seemed to stick. It was nothing that was consistent enough for me to just stay full. That's my biggest thing, that's why you eat, you know, you're hungry and I just never had that thing in my head that said, okay, stop now.
Last year, Johnson's weight ballooned to 246 pounds on her five-foot-five frame. She was at her wits end.  Then, she heard about a clinical trial for obese adolescents at UCSD. The trial is testing whether a type of surgery called gastric banding is safe and effective for teens. The surgery involves placing an adjustable band around the upper part of the stomach. It creates a smaller gastric pouch that limits the amount of food a person can eat.

The Food and Drug Administration approved the procedure for adults in 2001. But it's not yet approved for kids. Johnson enrolled in the clinical trial. She had her surgery six months ago. Last week, she checked in with UCSD dietician Jill Jarrett.
Jarrett and Johnson: So let me take your measurements really quick. Let's see where you are now… Alright, so we have 37 for the waist, and 43 for the hips. And you started at 48 in the waist and 54 in the hips….Wow.
Wow is right. In just six months, Johnson has lost 77 pounds. She's gone from a size 24 to a size 12. And she feels great. Johnson is one of 14 obese teens in the local arm of the trial. Nationwide, 150 kids are enrolled. UCSD surgeon Santiago Horgan is directing the San Diego trial. He says for morbidly obese teens, gastric banding works.

Dr. Santiago Horgan: I don't see downsides, because these kids have been pushed around for the last five or ten years, they have been isolated by society, they have isolated themselves, because of obesity. They are depressed, they have been demoralized by their schoolmates.
Dr. Horgan says after the surgery, it's like night and day. He when kids start losing weight, they regain their self-esteem, and do much better at school. In addition, the weight loss can help eliminate conditions like type 2 diabetes and high blood pressure. But not everyone is sold on the idea of surgery being the cure.
Dr. Christine Wood: From my perspective, we have to be looking stronger at the prevention piece of this.
Dr. Christine Wood is a pediatrician in Encinitas. She's written a book on healthy eating for kids. Wood says we need to look at some of the environmental factors that contribute to obesity in children…like the availability of fast food, and a lack of exercise.  And she wonders what's wrong with helping kids before their weight gets out of control?
Wood: We treat the disease when it becomes a crisis. What are we doing to treat the problem before we get to that crisis point? And that's the whole piece of preventive medicine that I think we've sort of missed in many ways.
Dr. Horgan doesn't disagree. But he says right now, we need solutions.
Horgan: Today the only answer to stop this epidemic disease is surgery. There's no other way.
Hollie Johnson is on a roll. Thanks to the surgery, a strict diet and exercise, she now weighs 176 pounds. But she's not satisfied.
Johnson: I figured by the time I got to where I'm at now, I would be happy, but I'm not, I'm not done yet. 125. Then that's where I'll stay. No less than that, though, I don't want to look sick.
Johnson and other teens in the study will be monitored for five years. The maker of the gastric banding device could ask for FDA approval when the results are in. Kenny Goldberg, KPBS News. 

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