Bariatric surgery provides San Jose siblings with a new lease on life

Thanks to dedication, hard work, and an experienced medical team, Michelle, 17, and Miguel, 15, the Rangel siblings from San Jose, are looking ahead toward a brighter future and much-improved medical outlook. In the past 21 months, with support from their family and the Adolescent Bariatric Surgery program at Lucile Packard Children’s Hospital Stanford and Stanford Medicine Children’s Health, the siblings have lost a combined total of over 200 lbs.

“It’s been a life-changing transformation,” said Sophia Yen, MD, adolescent medicine specialist. “I salute Michelle and Miguel for being so motivated, and for having such an extremely supportive family.”

The journey to their weight loss surgeries last November and December actually began a year prior, in November 2013, when the family first decided to attend a group meeting at the Stanford Medicine Children’s Health Pediatric Weight Clinic . Michelle weighed 365 lbs. and Miguel was at 385.

“They had been overweight since they were young,” said mom Teresa Rangel. “We had tried everything.”

Most frightening were the medical complications and comorbidities associated with obesity that had begun to afflict the kids’ teen years, such as hormonal imbalances, sleep apnea, knee pain, and pre-diabetes.

Like all patients considering bariatric surgery, they went through an evaluation period. This included a six-month lifestyle modification program, during which patients undergo a series of clinical assessments and trainings. From psychologists to nutritionists, the Pediatric Weight Clinic care team ensured the siblings would have the dedication necessary to be successful. There was no success with any other means of weight loss, so the option for bariatric surgery was on the table. Rangel left the final decision to her kids, as she knew it was their commitment that mattered.

“The kids were a little afraid, but they knew it was their only chance to have a better life,” Rangel said.

Part of the process to ensure the teens’ success was meeting regularly with dietitian Bryan Lian, RD, part of the bariatric care team that approved Michelle and Miguel for their procedures.

It’s a team with major experience. In 2004, Lucile Packard Children’s Hospital Stanford became the first children’s hospital in California to offer bariatric surgery to adolescents.

“We take everything into consideration; their attitude and understanding about nutrition, what their food environment looks like, and the social challenges of refusing food,” Lian said. “Preparing these young people with the honest realities of this process is essential to setting them up for success, and Miguel and Michelle truly owned their progress.”

Still, it’s no walk in the park. Pre-surgery, the Rangel siblings lost significant weight through the

MyPlate model diet and an exercise regimen. The initial pre-surgery weight loss took six months, during which Michelle lost 30 lbs. and Miguel lost 45. Forget any misconceptions of eating whatever they would like before or after the surgery. The diet around the time of surgery involves a restrictive 8-10 week course before they can return to eating “normal” foods, including a full liquid diet for a month following the surgery, followed by 2-3 weeks of pureed foods.

The physical downtime was easier than the diet restrictions. Each was in recovery at home for only about a week after their respective surgeries, which were led by Matias Bruzoni, MD. Then, they were “eager to get back into school,” according to mom.

At six months post-surgery, most patients average a weight loss of 20 to 50 lbs. Michelle and Miguel were leading that curve, each having lost close to 50 lbs. Today, that 50 has turned into over 100 lbs.

“Michelle and Miguel are very dedicated to their health,” said Yen, who noted that they never miss a clinic appointment. They even wake up at 5 a.m. to work out with a family friend who trains them, “part of a renewed spirit,” mom said.

Miguel now sees the opportunity to go to college and earn a scholarship by playing sports. Before surgery, this was never a consideration. Both enjoy being outside more now. Michelle talks about getting into cosmetology school, and credits the surgery with helping her feel more comfortable about what’s in her future. To a mother, that’s priceless.

The health concerns associated with obesity have dissipated along with the weight loss, and Yen expects that their health and quality of life should continue to improve. Now, having started the new school year, Miguel has joined the football program at James Lick High School in San Jose, although he’s most excited for the soccer season.

For Teresa, it’s a relief to know her children are in a much better place. “I can see in their faces that they’re more comfortable with who they are,” said Teresa, “and you can tell that they like feeling and being healthy.”

Discover more about our Pediatric Weight Clinic or call (650) 736-2114.