Emily Sperry's fight with obesity has been a challenge since birth.

Last year, at age 17, she thought she'd be overweight the rest of her life. Around 290 pounds, she saw a grim future, laden with increasing health risks that eventually could kill her.

Already, Sperry's obesity was causing her body to become insulin-resistant — a precursor of diabetes. Her triglyceride levels were high — an indicator of future heart disease. She suffered from sleep apnea, and that led to fatigue.

Diets hadn't worked. Exercise hadn't worked. Sperry was diagnosed with hypothyroidism, which slows metabolism. Medication helped balance that, but it didn't eliminate her continual weight gain.

Sperry said doctors offered little help and didn't always understand her suffering.

"I had tried everything," she said. "I was considering a gastric bypass, but my mother was concerned about the negative side effects."

Gastric bypass is a surgical procedure in which a doctor uses staples to create a small stomach pocket, then redirects the flow of food absorption to a lower point in the small intestine. Though it can be successful in helping morbidly obese patients lose weight, it also has a 1.5 percent mortality rate, according to the American Gastroenterological Association.

Sperry said it became depressing to consider the options.

But a television commercial she saw late one night last year offered hope: A newer procedure offered similar weight loss without many of the side effects of gastric- bypass surgery.

Using a device called the Lap-Band, instead of stapling the stomach, doctors cordon off a small section of the stomach. As the patient loses weight, the band can be adjusted by injecting saline into it through a port under the skin.

Sperry told her mother, Jaynee Sperry, about the procedure, and the two ended up at the Northwest Weight Loss Surgery center in the South Everett area.

Though the federal Food and Drug Administration (FDA) has approved the Lap-Band only for adults, the Everett-area center is one of a few nationwide studying the potential for expanding its use to adolescents. Emily Sperry qualified for the study and underwent the procedure.

Almost four months after surgery, she has lost about 35 pounds, leading her to believe that one day she'll reach 130pounds, the medically suggested weight for her 5-foot-6 height and medium frame.

Already used abroad

Lap-Band surgery has been used in Europe and Australia for years. But it's been slow to catch on in the United States, as is often the case with new medical procedures, said Dr. George Fielding at New York University's Program for Surgical Weight Loss.

Fielding said he had performed dozens of Lap-Band surgeries on adolescents in Australia. Since joining NYU, he's been pushing to have the procedure approved for much more than its current limited use.

"Gallstone surgery is the most commonly performed surgery in America today," Fielding said. "[Lap-Band surgery] is far safer, and a much bigger population needs help with it."

Fielding said the minimally invasive Lap-Band surgery is less traumatic than gastric bypass, but because the procedure uses a medical device, it needed federal approval, which requires that studies be done.

"There was a lot of resistance to it, partly because people equate weight-loss surgery with gastric bypass and its mortality rates," he said.

"It took more than a year to get our study approved, but since then, it's gone very well."

The FDA approved the procedure for adults in June 2001.

By this year, it was all Drs. Kevin Montgomery and Brad Watkins, weight-loss-surgery specialists, wanted to perform.

"We sat around one day saying we would never let someone in our family have gastric-bypass surgery performed on them, so why were we still doing it?" Watkins said. "With gastric bypass, you have to stay overnight in the hospital, and [Lap-Band surgery] is done laparoscopically as an outpatient procedure."

The two recently opened the Northwest Weight Loss Surgery center, performing Lap-Band surgeries on adults. Seeing the problem of obesity in children, the two decided to join NYU, the Minimally Invasive Bariatric Center in Chicago and other facilities in conducting studies on youths.

The idea, Watkins said, is to persuade the FDA that the Lap-Band is safe enough to use in children and can prevent problems with diabetes, sleep apnea, heart disease and joints.

"I see 20-year-olds in here who already are very unhealthy," Watkins said. "There's a tremendous need for adolescent obesity surgery."

The two doctors joined the study in conjunction with Evergreen Healthcare's hospital in Kirkland, which helped develop criteria for adolescent surgeries and appointed an internal-review board that helps guard patient safety.

"The [review board] at Evergreen is in place to see that no harm is done, proposals are followed and proper consent is obtained," said Dr. Mitch Weinberg, the vice president of medical affairs for Evergreen Healthcare and a Woodinville pediatrician.

The board at Evergreen consists of doctors, nurses, lawyers, administrators and spiritual leaders, Weinberg said.

The Northwest Weight Loss Surgery center will conduct up to 50 surgeries on youths 16 and 17 who have a body-mass index (BMI) of 40 or higher, or a BMI of 35 with a serious health problem related to obesity. The index is a height-to-weight ratio that provides a rough estimate of body fat. A normal BMI is about 25.

The center expects to perform the operations on youths over three to five years. Locally, though most adult Lap-Band surgeries are completed at the center, one requirement of the study is that all adolescent procedures be completed at the Kirkland hospital.

To date, the center has done fewer than five on youths. Sperry was one of the first.

"Anytime you're dealing with adolescents and child safety, there's a whole heightened awareness of risk," Weinberg said. "Yes, the procedure is low-risk and reversible, but the bigger concern relative to the selection criteria is that this takes a motivated person with a family committed long-term."

Long-term concerns

Fielding and Watkins are quick to extol the virtues of the Lap-Band, but the FDA has had its concerns.

A year before the agency approved the device for adults, an advisory panel had rejected it. Though early U.S. studies on adults indicated that people with Lap-Bands were losing weight and experiencing minimal side effects, the FDA advisers said not enough long-term data existed.

Last year, the FDA reported saline leakage in Lap-Bands as one of its "top problems" during the previous fiscal year.

Though the device can be removed should a person no longer want it, most patients will have the Lap-Band for life, occasionally returning to medical offices for an adjustment. FDA advisers questioned whether the device could hold up for so long. The device hasn't been around long enough to know.

Watkins said the materials used in the Lap-Band are no different from those used in many joint-replacement surgeries and shouldn't pose long-term problems. Also, the Lap-Band can be replaced in a little more than an hour, if the need arises.

Review boards at NYU and Evergreen raised similar questions.

A major concern for patients is that most insurance companies don't cover the $15,000-to-$20,000 cost of the surgery. At the Northwest Weight Loss Surgery center, the procedure and follow-ups total about $17,000.

At NYU, an anonymous donor contributed $2 million to get the study running.

"But not everyone has access to a wealthy New Yorker," Fielding said.

Jaynee Sperry cashed out a retirement fund to pay for her daughter's surgery.

No quick decision

If adolescent studies are successful, the Northwest Weight Loss Surgery center and others will ask the FDA to lower its minimum age for patient eligibility for the Lap-Band procedure. Such a decision could take more than a year.

Jaynee Sperry, who acknowledged she initially had feared negative results, is hopeful that her daughter's weight loss will lead to a healthful lifestyle. Already, she said, she's seen more energy in Emily's step after her loss of the 35 pounds.

"I want to go up to every overweight person I see and tell them about this," she said.

Emily Sperry had trouble holding down food right after her surgery — an expected adjustment to a smaller stomach — but has suffered no ill effects since then.

She knows she must continue to watch her eating habits and maintain an active lifestyle.

But the young woman, now 18 and willing to live with the Lap-Band for life, said it's already easier to shop for clothes.

"I no longer have to come to terms with being an overweight person," Sperry said. "Now, being overweight is only temporary."

Christopher Schwarzen: 425-783-0577 or cschwarzen@seattletimes.com