Usually, a 20-month-old’s milestone weight hovers between 11 to 12 kilograms, but for little Ibrahim, it was almost 10 kilograms more. The excessive weight left him crippled both internally and externally. From the time when he touched 5 months of age, infantile obesity landed Ibrahim in the hospital bed several times, almost once each month, with the complaint of acute respiratory distress, and was managed medically. On May 22, his condition worsened with additional complaints of sleep apnoea, leaving it beyond medical management. His treating physician, Dr Prashant Patil, a paediatric endocrinologist, referred him for surgical intervention to Dr. Sanjoy Borude, the bariatric surgeon. Bariatric surgery is all about downsizing the stomach so that the stomach pouch volume decreases with a limited capacity for holding food.

Paediatric Bariatric Surgery | Empowering Change

The abdominal cavity of a 20-month-old is very small. Furthermore, there is no set guideline for bariatric surgery in toddlers like Ibrahim, thus making Ibrahim’s surgery more challenging as the instruments and the staples available are all for adults. Over and above, anaesthesia and the probability of blood loss due to surgery made both doctors reconsider the pros and cons and finally decide in favour of the surgery. The condition was challenging, but the surgery was accomplished. The fundus, the upper part of Ibrahim’s stomach where ghrelin (hunger hormone) is secreted, was removed.

Leptin Receptor Anomaly

Ibrahim is a patient of the rarest of the rare conditions, with only 90 total cases reported the world over and 3 cases in India, including that of Ibrahim and his elder sister Zoya, who was operated on back in 2011.

This rare phenomenon is medically known as LEPTIN RECEPTOR ANOMALY. Leptin receptor deficiency is a condition that causes severe obesity by triggering extreme and insatiable hunger. The food Ibrahim used to eat did not get converted into energy, leading to excessive fat accumulation in the first few months of life. Child obesity under the age of 10 is usually genetic & hormonal, whereas obesity above 10 is hormonal & lifestyle disorder.

Dr. Sanjay Borude	Dr. Prashant Patil
Bariatric Surgeon/td>	Paediatric Endocrinologist
- Robotic surgery - Obesity surgery - Microsurgery - Bariatric surgery - Growth problems - Childhood obesity - Diabetes	- Thyroid disorders - Puberty (Maturity) related problems

Post-surgery, Ibrahim has been put on a special diet to decrease his weight over the years gradually. He is now under close monitoring by the clinicians.

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