By the time she turned 13, she had 80 per cent of her stomach removed through bariatric surgery. She initially lost 29kg . But nine months after the operation, she regained some weight, and her intense hunger returned.

She was recently prescribed Wegovy, a weight-loss medication approved by the US Food and Drug Administration (FDA) for treatment of obesity in people aged 12 and older.

Lexi after her bariatric surgery in which 80 per cent of her stomach was removed. Source: Supplied

Wegovy belongs to the new class of injectable medications, originally used for the treatment of Type 2 diabetes but now FDA-approved for long-term weight management.

In January 2023, the American Academy of Pediatrics (AAP), the largest professional association of paediatricians in the US, updated its guidelines for treating children with obesity — for the first time in 15 years. It now recommends early medical interventions such as surgery and weight-loss drugs, in addition to lifestyle and behaviour changes.

Lexi, now 15, has been able to lose some weight with an appetite suppressant. She is, however, on the insurance waitlist for the weight loss drug Wegovy. Source: Supplied

Dr Fatima Cody Stanford, an obesity medicine physician and an associate professor at Harvard Medical School, says there’s been “a noticeable shift in recent years in how obesity and obesity medications are discussed within the paediatric and broader medical fields”.

However, she says irreversible treatment such as bariatric surgery and indefinite use of medication at age 12 “must be approached with caution”. It’s important to balance the potential benefits of anti-obesity drugs against the unknown long-term effects, she says.

“However, the psychological and emotional aspects, such as body image, potential dependence on medication, and identity formation, should be openly discussed.”

High cost of weight-loss drugs

“Surgery is final … there’s no reversing it,” she says, adding that she believes bariatric surgery remains an essential option if other treatments fall short.

American mother and daughter Brandy and Lexi are looking for obesity treatment that would work for Lexi, who has a genetic disorder that prevents her from weight loss Source: SBS / Colin Cosier

Bariatric surgery usually leads to substantial weight loss, but Lexi’s MC4R deficiency made her procedure far less effective.

Despite more weight-loss drugs hitting the market, many people in the US still can’t afford them.

Medicare, the federal health insurance, is prohibited from covering weight-loss drugs by law. Most private health plans don’t cover them either, primarily, due to their high cost. Bariatric surgery, on the other hand, is covered by insurance companies.