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Getting help for better habits for kids to fight obesity

Often, those who are overweight or obese have health challenges we don’t see.

Commonly, poor eating habits boost those challenges.

Ethan Milich is a case in point.

Milich, who turned 18 in June, doesn’t produce any of the five hormones the body needs, so he has to get synthetic versions. This and other health troubles help explain why he weighed more than 250 pounds as he approached high school and 366 pounds last summer.

Eating choices added to the load.

“It was a lot of pasta, tacos, a lot of carbs,” he said.

“What everybody else eats,” said his mother, Jennifer.

A year ago, Ethan and his mom turned to Children’s Healthy Weigh of Buffalo, a program at Women & Children’s Hospital. Any parent in the region concerned about what their child is eating, about their weight or whether they’re on the path to obesity can find out more about the program at or by calling 878-7723.

Ethan, who is 6 feet tall, arrived at Healthy Weigh a year ago with a Body Mass Index (BMI) of 51.4.

A BMI of 18.5 to 24.9 is considered a healthy weight; 25 to 29.9 overweight; anything 30 and above is obese.

The Healthy Weigh staff helped Ethan and his mother change their eating habits and encouraged more exercise. Ethan dropped 20 pounds – but at his weight, and with his health woes, Dr. Carroll M. Harmon, pediatrics surgeon-in-chief at Children’s and surgical director of Healthy Weigh, recommended a sleeve gastrectomy.

Only teens with a BMI over 45 and complications that might include hypertension, diabetes or sleep apnea are eligible for the laparoscopic surgery, said Harmon, who on July 11 removed 85 percent of Ethan’s stomach.

“There is no storage capacity in the stomach so the food just goes straight down into the small intestine,” Harmon said. “It appears to have fewer complications than gastric bypass with similar weight loss.” Gastric bypass surgery involves creating a gastric pouch in the digestive tract and connecting it to the small intestine. Both surgeries are irreversible but if the gastrectomy is ineffective, gastric bypass can be performed.

Harmon has performed three sleeve gastrectomies since coming to Children’s about 2½ years ago and another is scheduled in about a week. The first involved the youngest patient, a 13-year-old who weighed 550 pounds when starting Healthy Weigh.

“So far, the results are very encouraging,” Harmon said. “We don’t know really beyond three or four years about sleeve gastrectomy in teenagers because it’s still a new operation for them. Many children will lose about 100 pounds the first year and will seem to hold it out about three years. Some can lose all the way down to normal weight.”

Why does it work?

“The only hormone in our body that goes to our brain and helps us to eat is called ghrelin,” Harmon said. “It’s made by the stomach and since we’ve taken out 85 percent of the stomach, one theory is that it decreases appetite as well as makes the stomach so small you can’t eat as much.”

Such surgery is no quick fix. Surgery prospects must work at least six months to change their diet, exercise more and lose weight. They are closely followed afterward.

The Milich family cut out red meat, pasta, potatoes and corn. Ethan and his mother eat lean turkey and chicken, a limited amount of complex carbs and lots of fruits and vegetables.

“Oftentimes before surgery,” Harmon said, “many of our teenagers are frustrated by exercise and they can’t exercise very well because they have joint pain, get short of breath and it’s frustrating. One of the things that’s great about weight loss surgery is that suddenly, once they start losing their weight, they can really exercise. And it’s that combination of being on the diet and doing exercise that makes somebody like Ethan successful.”

Ethan spent a week in the Pocono Mountains camping after the surgery. He again can ride a bike. In two months, he finds out if he can go off the CPAP machine that helps him deal with sleep apnea.

He and his mom have become believers in the Healthy Weigh principles. Since he started, and with help from his sleeve gastrectomy surgery, Ethan has lost 66 pounds. His BMI is about 41. He is buying smaller clothes and has more energy.

The entire process has rubbed off on his mother, too.

“I’ve lost 45 pounds and lowered my BMI 4 or 5 points,” Jennifer Milich said. “I had to learn how to shop all over again, how to cook things differently. It was worth it.”


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