I had always been husky,” says Mario Pelayo-Guerrero of Atwater, Calif. “But I wasn’t obese. I did a lot of outdoor activity, like playing football with the guys for hours at a time.” Like many active, growing teenagers, Mario had a hearty appetite and packed in the calories, without much effect on his weight.
All that changed four years ago, when Mario, then 14, suffered a spinal cord injury that left him in a wheelchair. Nearly unable to move—but still eating with abandon—he began gaining weight at an alarming rate.
By age 17, he weighed 312 pounds.
Mario Pelayo-Guerrero, shown before undergoing bariatric surgery at Packard.
Mario tried diets, cleanses, and home remedies, all with minimal, temporary success. He suffered from breathing problems and was at risk for a blood clot. He and his family began seeking out weight loss surgery, but found that nearby hospitals in the Central Valley offered the procedure only to adults.
Their search eventually led them to Packard Children’s, the only children’s hospital in California to offer weight loss, or bariatric, surgery for minors. It’s one of the more recent additions to the Hospital’s arsenal against obesity. Since 2004, more than 40 adolescents have undergone bariatric procedures at Packard.
“It’s not a quick-fix operation,” says Craig Albanese, MD, the John A. and Cynthia Fry Gunn Director of Pediatric Surgical Services. “One hundred percent of these kids have very serious medical problems.”
Teens who qualify for bariatric surgery suffer from dangerous complications of obesity, such as diabetes, high blood pressure, and organ failure. Some may also have lung and breathing issues, or increasing pressure in the brain that can lead to vision loss. These conditions not only threaten the child’s health, they can also make the surgery itself very challenging. Packard is one of the few children’s hospitals in the country with the expertise needed to take on such complex cases.
Intended as a last resort, the surgery is a powerful tool, but only one step toward a healthier weight. Patients and their families must commit to a lifelong discipline of medical care, health education, dietary restrictions, and exercise.
Starting a full year before his surgery, Mario began attending regular appointments at Packard’s Pediatric Weight Clinic.
“Patients must demonstrate that they are able and willing to set realistic goals to their weight loss journey,” explains Susan Farrales-Nguyen, RN, MSN, FNP, program coordinator for bariatric surgery. “Having an involved, supportive family is essential as well.”
Despite the severity of his weight and health problems, Mario’s surgery was initially denied by his health insurance, a common obstacle for bariatric surgery for minors. But he was persistent, and the Packard team appealed his case to his insurer.
“I’m not in this to fit into designer clothes,” Mario says. “I needed to get my life back. I’m 18 years old and my mom had to dress me in the morning. She shouldn’t have to do that. I needed to get back on track.”
In April, Mario underwent a sleeve gastrectomy, an irreversible surgery that permanently reduces the size of the stomach to resemble a sleeve or tube.
“It’s a life-changing procedure,” says Lawrence Hammer, MD, professor of pediatrics and director of clinical programs at the Center for Healthy Weight. “It will forever change the way he eats.”
Mario is now on his way to a healthier weight.
Bariatric surgery patients at Packard typically lose 80 to 100 pounds of weight. In the five months since his surgery, Mario has lost 57 pounds, and is determined to lose many more. As important as the surgery itself is his new understanding of food.
“I used to eat until I was so full I could hardly breathe,” Mario recalls. “They’ve taught me to listen to my body and know when to stop.”
He will soon begin classes at Merced College and will continue to devote much of his time to daily workouts and intensive physical and occupational therapy.
“I think there’s a stereotype that this surgery is for lazy people,” Mario says. “But we have to work just as hard to lose weight as anyone else, if not more so.”
So far, the weight loss and rehabilitation have enabled him to gain more movement in his arms and legs, and he finds it much easier to move himself from his bed to the wheelchair each morning.
Mario recently had his picture taken for his college ID, and could see that his hard work was paying off—his jawline was noticeably more defined than in older photos.
“Being able to fit into a few regular-sized, designer clothes,” he adds, “isn’t bad either.”