Hi.

I don't know whether or not this is the right place for this, nor is this the correct forum for it.

From what I can gather, this Forum is for those that have already had Surgery or want to have Surgery, I'd like to introduce myself first.

My name is Brian Johnson, I am currently 15 years old, and I weigh 320 pounds, and I've been thinking about Surgery for a good minute now, which I know surgery is not recommended to teens, but all of my life I've never seen the scale go down, even when I've walked every day from home, ate 2,000 calories, went on diets, tried everything.

Now, my first question is, is that I have a Fatty Liver and I'm not sure how much a Fatty Liver weighs, I've been told by multiple people that I do not look my weight, even Military official figures/recruiters have told me they would have never guessed that and that I look around 240-260. Now, aside from that, I've tried calculating my BMR and I'm wondering if my fatty liver is affecting my calculations because it says I'm burning 3,500 calories a day doing nothing, so whenever I eat 2,000 calories, I should be losing 1,500 calories/half a pound a day.

But that's not the case, so I'm wondering if my calculations could be wrong because I don't look like I'm 320, and that my calorie burned might be different or changed because of that, and that I'm not an average 320 pounds person. I don't know, I'm not 100% informed with Weight Loss/Fatty Liver affects on calories, I can run, go up stairs easily, and I don't share the struggles that a lot of people have at my weight and sometimes even at a lower weight.

My second question is, with all of this said, with a Fatty Liver, and my BMI being around 40-48 I think, should I consider weight loss surgery, and if it would be even possible for a 15 year old almost turning 16.

Apologies once again, if this is not the correct forum for this.

Thanks, though.
-Brian.

According to the internet: Nonalcoholic fatty liver disease (NAFLD) is one of the most common causes of chronic liver disease worldwide. Treatment recommendations for NAFLD are aimed towards weight reduction, thereby reducing insulin resistance. Unfortunately, lifestyle modifications have not yielded long-term success, while durable weight loss is routinely achieved with bariatric surgery.

https://www.medscape.com/viewarticle/763056

So what this summary says it that lifestyle modifications such as dieting and exercise have not yielded long-term success but bariatric surgery has.

Another article says: Nonalcoholic fatty liver disease is a progressive disease with potential evolution to liver cirrhosis and hepatocellular carcinoma.

Another article says: Nonalcoholic fatty liver disease (NAFLD) is one of the most common causes of chronic liver disease. It encompasses a spectrum of conditions associated with lipid deposition in hepatocytes. It ranges from steatosis (simple fatty liver), to nonalcoholic steatohepatitis (NASH–fatty changes with inflammation and hepatocellular injury or fibrosis), to advanced fibrosis and cirrhosis. Studies suggest that although simple fatty liver is a benign condition, NASH can progress to fibrosis and lead to end-stage liver disease. The disease is mostly silent and is often discovered through incidentally elevated liver enzyme levels. It is strongly associated with obesity and insulin resistance and is currently considered by many as the hepatic component of the metabolic syndrome. NASH cirrhosis is now one of the leading indications for liver transplantation in the United States.

I underwent RNY gastric bypass surgery because my health was deteriorating rapidly. I dieted and exercised and still could not shed the pounds but instead continued to gain the weight. I had the surgery to correct my health conditions. The surgery corrected a number of my health conditions including diabetes, high blood pressure, sleep apnea, acid reflux (GERD). It even corrected my asthma condition. If your focus is to become healthy and live a long productive life, then I would suggest the surgery. I dropped 120 pounds after surgery and my BMI went to normal. Weight loss was just a little gravy on top of health improvements.

One of the factors that enter into the equation is cost. The operation is expensive and therefore it is important to have insurance that covers the operation. Therefore the guideline requirements from your insurance policy will dictate how easy it is to obtain this surgery.

Many insurance policies are written very similar, so this will give you an idea:

Surgical treatment of obesity (bariatric surgery) is covered only if:

- eligible enrollee is 18 of age or over

- clinical records support a body mass index of 40 or greater (or 35-40 when there is at least one co-morbidity related to obesity). Applicable co-morbid conditions include the following:

* Type II diabetes mellitus (by American Diabetes Association diagnostic criteria).

* Refractory hypertension (defined as blood pressure of 140 mmHg systolic and or 90 mmHg diastolic) despite medical treatment with maximal dose of three antihypertensive medications.

* Refractory hyperlipidemia (acceptable levels of lipids unachievable with diet and maximum doses of lipid lowering medications).

* Obesity–induced cardiomyopathy.

* Clinically significant obstructive sleep apnea.

* Severe arthropathy of the spine and or weight bearing joints (when obesity prohibits appropriate surgical management of joint dysfunction treatable but for obesity).

- Documentation of failure to lower the body mass index within the last 12 months through a medically supervised program of diet and exercise of at least 6 months duration.

So if your health insurance policy was similar to mine, you would not be able to qualify because of age; but the moment you turned 18, you would get a green light because your BMI is over 40. So the best advise I can give you is to dig out your health insurance policy and read the fine print.

11 minutes ago, James Marusek said:

According to the internet: Nonalcoholic fatty liver disease (NAFLD) is one of the most common causes of chronic liver disease worldwide. Treatment recommendations for NAFLD are aimed towards weight reduction, thereby reducing insulin resistance. Unfortunately, lifestyle modifications have not yielded long-term success, while durable weight loss is routinely achieved with bariatric surgery.

https://www.medscape.com/viewarticle/763056

So what this summary says it that lifestyle modifications such as dieting and exercise have not yielded long-term success but bariatric surgery has.

Another article says: Nonalcoholic fatty liver disease is a progressive disease with potential evolution to liver cirrhosis and hepatocellular carcinoma.

Another article says: Nonalcoholic fatty liver disease (NAFLD) is one of the most common causes of chronic liver disease. It encompasses a spectrum of conditions associated with lipid deposition in hepatocytes. It ranges from steatosis (simple fatty liver), to nonalcoholic steatohepatitis (NASH–fatty changes with inflammation and hepatocellular injury or fibrosis), to advanced fibrosis and cirrhosis. Studies suggest that although simple fatty liver is a benign condition, NASH can progress to fibrosis and lead to end-stage liver disease. The disease is mostly silent and is often discovered through incidentally elevated liver enzyme levels. It is strongly associated with obesity and insulin resistance and is currently considered by many as the hepatic component of the metabolic syndrome. NASH cirrhosis is now one of the leading indications for liver transplantation in the United States.

I underwent RNY gastric bypass surgery because my health was deteriorating rapidly. I dieted and exercised and still could not shed the pounds but instead continued to gain the weight. I had the surgery to correct my health conditions. The surgery corrected a number of my health conditions including diabetes, high blood pressure, sleep apnea, acid reflux (GERD). It even corrected my asthma condition. If your focus is to become healthy and live a long productive life, then I would suggest the surgery. I dropped 120 pounds after surgery and my BMI went to normal. Weight loss was just a little gravy on top of health improvements.

One of the factors that enter into the equation is cost. The operation is expensive and therefore it is important to have insurance that covers the operation. Therefore the guideline requirements from your insurance policy will dictate how easy it is to obtain this surgery.

Many insurance policies are written very similar, so this will give you an idea:

Surgical treatment of obesity (bariatric surgery) is covered only if:

- eligible enrollee is 18 of age or over

- clinical records support a body mass index of 40 or greater (or 35-40 when there is at least one co-morbidity related to obesity). Applicable co-morbid conditions include the following:

* Type II diabetes mellitus (by American Diabetes Association diagnostic criteria).

* Refractory hypertension (defined as blood pressure of 140 mmHg systolic and or 90 mmHg diastolic) despite medical treatment with maximal dose of three antihypertensive medications.

* Refractory hyperlipidemia (acceptable levels of lipids unachievable with diet and maximum doses of lipid lowering medications).

* Obesity–induced cardiomyopathy.

* Clinically significant obstructive sleep apnea.

* Severe arthropathy of the spine and or weight bearing joints (when obesity prohibits appropriate surgical management of joint dysfunction treatable but for obesity).

- Documentation of failure to lower the body mass index within the last 12 months through a medically supervised program of diet and exercise of at least 6 months duration.

So if your health insurance policy was similar to mine, you would not be able to qualify because of age; but the moment you turned 18, you would get a green light because your BMI is over 40. So the best advise I can give you is to dig out your health insurance policy and read the fine print.

I really appreciate this.

Thank you for your time.

One thing I fear is that with time going extremely slow (for me at least) I'm afraid I will gain too much weight by the time I turn 18.

At your age, you really need to talk to your doctor and see what they doctor will suggest for you.

We cannot give you any advise as you are still growing and going on diet as a teen is not suggested.

Surgery is normally reserved for those who tried to lose weight multiple time but regained what they lost.

But keeping a food journal doesn't hurt and you could show it to your doctor so they can help you go on the right track. It also help to realize and sometime stop yourself of eating something you shouldn't (If you watch secret eater you will see what I mean the participant says they do know know why they are gaining weight and the show watch all of their habit to reveal how much they actually eat )

Your doctor can connect you with a nutritionist Start ther. It ought to be covered by health insurance Best to you.

Congrats Brian, on starting to look at ways to change your life! I really encourage you to have an open conversation with your parents. I know they must also be very concerned about your fatty liver and are probably wondering how they can help you.

I really like @Stella S's suggestion to get your PCP to hook you up with a nutritionist and maybe even someone like a physical therapist or trainer to get you started on a weight loss/exercise program. At the very minimum, your insurance company is going to want to see a 3-5 year history of your weight loss attempts. Even if you don't qualify for surgery until you are 18, you need to have doctor verified weights and also verify that you've worked with them to try to lose weight on your own. So start building the behaviors and history that will benefit your future self.

There was a very important study done in Sweden on obese teens. It's important to note that the surgery helped resolve many obesity related diseases in the teens (including fatty liver resolution). But it's also important to note that up to 25% of the teens had to complications that let to more surgery or hospitalizations and vitamin deficiencies.

Here are a couple of articles about this study:

https://www.sciencedaily.com/releases/2017/01/170105213120.htm

https://medicalxpress.com/news/2017-01-good-long-term-results-obesity-surgery.html

The thing is...that WLS only works long term if you actually change the behaviors that got us obese in the first place. In the early days, you will lose because of the surgery. It's like, even a blind squirrel will find the nut! But unless you really are focused on diet and lifestyle from then on out (tracking your food in a daily diary, weighing and measuring foods, making super healthy food choices at every meal, not sliding back into eating sugar and other carby crap, not drinking liquid calories or booze), the chances are good you will regain 50% of more of your previous weight. And even more, you will need to take vitamins on a set schedule and drink a set amount of liquids every day--for life. Those are pretty adult responsibilities that even a big majority of adults can't handle. You also really should avoid alcohol for life as well--and with a fatty liver, it's going to be really important for you to do the same regardless of having surgery.

It sounds pretty depressing right? I mean, you're a 15 year old kid (male)...how do you NOT go to the kegger in college? How do you not pound down burgers and fries with friends? I'm bringing this up, because these are issues you MUST consider prior to surgery. Are you emotionally capable of choosing the road less traveled in order to experience health and a long life? Can you really exercise that type of control and maturity in the face of peer pressure? "Oh, that won't happen to me" belief will not protect you. It will happen to you. You will face these dilemmas.

I hope you continue to process all the information and take initiative to start working with your family doc and a nutritionist/trainer and see if you can get a handle on things to start reducing your fatty liver. If you're drinking already...quit. I'm adding you to my prayers!!! ((hugs)) And I really believe you've taken the first step in working on a success plan for your future!!!

Hi.

I don't know whether or not this is the right place for this, nor is this the correct forum for it.

From what I can gather, this Forum is for those that have already had Surgery or want to have Surgery, I'd like to introduce myself first.

My name is Brian Johnson, I am currently 15 years old, and I weigh 320 pounds, and I've been thinking about Surgery for a good minute now, which I know surgery is not recommended to teens, but all of my life I've never seen the scale go down, even when I've walked every day from home, ate 2,000 calories, went on diets, tried everything.

Now, my first question is, is that I have a Fatty Liver and I'm not sure how much a Fatty Liver weighs, I've been told by multiple people that I do not look my weight, even Military official figures/recruiters have told me they would have never guessed that and that I look around 240-260. Now, aside from that, I've tried calculating my BMR and I'm wondering if my fatty liver is affecting my calculations because it says I'm burning 3,500 calories a day doing nothing, so whenever I eat 2,000 calories, I should be losing 1,500 calories/half a pound a day.

But that's not the case, so I'm wondering if my calculations could be wrong because I don't look like I'm 320, and that my calorie burned might be different or changed because of that, and that I'm not an average 320 pounds person. I don't know, I'm not 100% informed with Weight Loss/Fatty Liver affects on calories, I can run, go up stairs easily, and I don't share the struggles that a lot of people have at my weight and sometimes even at a lower weight.

My second question is, with all of this said, with a Fatty Liver, and my BMI being around 40-48 I think, should I consider weight loss surgery, and if it would be even possible for a 15 year old almost turning 16.

Apologies once again, if this is not the correct forum for this.

Thanks, though.
-Brian.

Hi and welcome!!!!


I'm so excited for you to be starting your journey, don't be nervous.

(Fyi: you can post wherever and whenever you want, it's a tool for you to get all the information you need)

I can really only answer your second question. I think for the first question consult a bariatric surgeon in your area or even your pcp. I do know that the liquid protein diet with help shrink the fatty liver. We all have to do that anyway in order to get the surgeon to do the surgery.

I would imagine that a bariatric surgeon will want you to wait until you turn 18 for the surgery. Some might consider doing it a little sooner with parental consent but i doubt it. Yes you would still qualify for surgery given your current height and weight.

In the meantime i would suggest use this group and other online bariatric support groups to learn more about the process as a whole. That way when it's time for your surgery you will be completely comfortable and you'll know exactly what you want to do for your body. For example: this gives you time to research the differences between the sleeve, bypass and lapband and decide which would be best for you. It will give you an idea of how you will be eating post op etc.

Best of luck to you!!! Feel free to ask any other questions and if you ever feel like you need more support privately most of us are fine with people sending us private messages with questions. We're all here to help.

-jodi