New Delhi, July 3: A 14-year-old teenager from Uttar Nagar in west Delhi weighing 237 kg underwent a weight reduction surgery in Max hospital Saket a few months ago. Mihir Jain, the teenage boy, is the world’s heaviest teen to have undergone gastric bypass surgery, said a veteran bariatric surgeon at Max hospital, Dr. Pradeep Chowbey, who performed the operation.

With a body mass index (BMI) of 92, Mihir could hardly stand. A BMI above 60 falls under the category of super-super obesity.  Dr. Chowbey told Times of India (TOI), “When I saw him first, I wasn’t confident on operating him successfully. He was too heavy for that.”

Dr. Chowbey prescribed Mihir a very low-calorie diet (VLCD) of about 800 calories. A normal diet has 2,500 to 3,000 calories. Mihir followed the restrictive diet much to the doctor’s dismay. Dr. Chowbey said,”To my surprise, Mihir came to us again after four weeks. He had lost a good 10kg. I was happy to see their dedication and suggested them to continue the same diet for another two months which helped reduce the weight further to 196kg. But then we realised that for further reduction, surgery will be required and posted his case for operation in April.”

Mihir was born in November 2013 with a normal weight of 2.5kg. However, his weight gradually increased to 60-70kg when he was five years old. His mother Puja Jain said,”Most members in our family are overweight so we didn’t take it seriously then. But then a time came when he couldn’t even walk properly due to heavy weight. He stopped going to school after Class II and I had to teach him at home.”

Mihir reportedly said, “I stayed mostly in the house lying down or sitting.” He happily declared,”Pasta is my favourite food. Pizza is second favourite.”

When the family first sought medical help in 2010, the doctors refused to perform surgery on Mihir as he was too young. There were various challenges that the doctors faced when they decided to perform the gastric bypass surgery. Administering anesthesia on an obese person is a challenging task as the fat present in tongue, throat, and neck restricts the space necessary to insert a tube into the lungs. Dr. Chowbey said, “Also, there no guideline on the anesthesia dosage for a person weighing 200kg. Our doctors relied on their experience to decide on the right amount of anesthesia.” In Mihir’s case, a special flexible equipment known as laryngoscope was used to deal with the difficult body condition. The doctors had to use long and easy to maneuver surgical instruments to operate beneath the 10-12 inches of fat in the patient’s body.

The operation lasted for nearly two-and-a-half hours because the doctors had to re-route the digestive system so that the patient’s hunger is satiated after less food intake. “The surgery was uneventful and we were able to discharge Mihir within a week. He comes to the hospital for a follow-up though. Also, he has been asked to continue the restrictive diet,” Dr. Chowbey said.

The crisis had taught Mihir’s mother about the importance of being physically active and take care of one’s health by avoiding junk food. She said, “Now I tell my daughter, Nandini, to eat wisely.”