A 2-year-old girl in India, who weighed nearly 99 pounds and was bound to a wheelchair, had a rare weight loss surgery, becoming one of the youngest persons to undergo the procedure in the country.

"Since bariatric surgery for children is rare, this case can be termed to be the youngest bariatric surgery patient in India in over a decade. The procedure had to be conducted as a medical emergency," the New Delhi-based hospital, where the procedure was conducted, said in a statement, according to NDTV. A healthy child of her age usually weighs between 26 pounds and 33 pounds.

During bariatric surgery, a part of the stomach is removed, due to which the patient would feel full and not hungry. This causes weight loss and significant improvements in health. The new stomach pouch holds a smaller volume than normal and reduces the amount of food intake.

"The child was normal at the time of birth and weighed 2.5 kg (5.5 pounds). However, she started gaining weight rapidly soon after birth and weighed 14 kg (30.8 pounds) at six months. She has an elder brother who is eight years old and has normal growth milestones for his age. Her weight progressively increased over the next year and a half reaching 45 kg (99 pounds) at 2 years and three months," Dr. Manpreet Sethi, a pediatric endocrinologist, said.

The doctor said the child developed significant obstructive sleep apnea with multiple pauses in her breathing during her sleep. Her condition was so bad that she was unable to sleep lying down on her back. Doctors were unable to find any hormonal or genetic reason for her obesity. The diet of the baby was also not responsible for her extreme weight gain as she had been putting on excessive pounds even when she taking just mother's milk, the Hindustan Times reported.

"While it was a tough decision to take, we finally decided to go ahead with the bariatric surgery as it seemed the only way to save her life. She had become so obese that even her parents could not lift their two-year-old child anymore and she was wheelchair-bound since the age of one year and 10 months," Sethi said.

A "multidisciplinary" team at the hospital decided to conduct the life-saving procedure, said Dr. Vivek Bindal, who was part of the team that conducted the surgery.

"We had a detailed discussion with the pediatricians, endocrinologists and the family, along with a thorough review of literature before taking up the child. She has undergone laparoscopic gastric sleeve surgery or sleeve gastrectomy where a portion of the stomach is removed surgically," he added.

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Representational image. Pixabay

During the procedure, doctors faced several challenges, including unavailability of proper medical equipment and no fixed guidelines to decide the doses of medicines, anesthetics or even ventilator settings.

"If the ventilator settings were set for a 45 kg person, her lungs would not have been able to deal with the pressure. But if we gave it according to a two-year-old, it would not have helped as her chest is heavy. We had to plan for all eventualities," Dr. Rajiv Uttam, a pediatric intensive care specialist, told the Hindustan Times.

Five days after the procedure, the patient's sleep apnea started improving and she stopped snoring completely. However, doctors said the girl has a long way to go before making a complete recovery.

The girl has been put on a special diet and is expected to lose weight over the next year. The diet will not only help her reduce weight, but also help maintain her nutrition requirements.

In the United States, millions of children and adolescents are affected by severe obesity. It is also considered to be an "epidemic within an epidemic" that poses a major public health crisis.

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