More children should be having weight loss surgery, Harvard University researchers are now advising.
A new study sought to quantify how many obese children, teenagers and young adults undergo this type of surgery and found that the numbers are very low - coming to less than one per cent.
Of the 20.6 per cent of children between 12 and 19 who are obese, many will join the 38 percent of adults who suffer through the condition later in life.
In New Zealand, 11 per cent of kids are obese and a further 21 per cent are overweight.
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The study authors said that operations like gastric bypass are "underutilised" and call for more children to undergo the surgeries in order to keep them from a lifetime of severe obesity.
"We can't have pediatric cancer go untreated," she says by way of comparison, "it can lead to death," says study author Dr Fatima Stanford of Massachusetts General Hospital.
"Obesity is the same, but we see it as a lifestyle choice rather than a disease condition," she says.
Obesity has become America's biggest medical battle in recent years, as an epidemic sweeps up a third of the nation's citizens - of all ages.
New Zealand has the third highest rate of obesity in the OECD behind the US and Mexico.
Children who are overweight or obese are five times more likely than other children to become overweight or obese adults, significantly raising their risks of type 2 diabetes and heart failure, among nearly every other common illness.
The US has ramped up some public health initiatives to combat childhood weight issues in recent years (though the government has rolled back others, like the Obama-era plans for healthier school lunches), but the efforts seem to have hardly made a dent so far.
Nearly one in five school-age children is still obese, according to the Centers for Disease Control and Prevention (CDC).
These children will not only likely face related health problems as adults, but while they are still growing may suffer from sleep high blood pressure, skin infections, sleep apnea and other respiratory issues.
Currently, the CDC recommends that families, doctors and schools help children to avoid or address obesity by encouraging and taking part in healthy diets, good sleep habits and regular exercise.
But for those with severe obesity - marked by a body mass index score of 40 or over - these lifestyle changes may not be enough, the Harvard endocrinologists say.
If we have an excess of 12 inches of snow, would it be appropriate to go about shoveling it with a teaspoon? No. We want to use the appropriate tool for the size of the problem
According to research published earlier this year, 1.9 per cent of children between two and 19 are severely obese (falling into the 'Class III' obesity category established by that study).
The new Harvard research, presented at the annual meeting of the Endocrine Society today, estimated that 0.7 per cent or more than 18,000 of the 2.5 million young patients whose medical data it analysed were severely obese.
The national guidelines to make someone eligible for weight loss surgery require that other methods have failed and that they either have a BMI over 40, or over 35 plus a weight-related complication like diabetes or sleep apnea.
If a person meets those criteria, the most common weight loss procedures are gastric bypass, gastric band or gastric sleeve surgeries.
Of these 14- to 25-year-olds, between 0.4 and 21.5 per cent had such an operation at one of five hospitals included in the study.
Surgery is "by far the best treatment for those that have moderate to severe obesity to bring about more weight loss," says Dr Stanford.
"The problem is that clinicians as well as the lay-population are not educated [about] the utility," she says, and, as a result, rates of these surgeries have remained steady over the years, even as obesity has surged in the US and worldwide.
Weight loss operations do come with risks like gastrointestinal links, malnutrition and so-called dumping symptoms, which have stoked fear around the surgeries.
But Dr Stanford says that the bigger issue is our own bias.
She says that this is biased and based on an incomplete impression of the people who get these surgeries.
"I would not recommend this for someone who has not made those lifestyle changes. As a doctor, I need to provide a tool for a patient that struggles even after making those changes," Dr Stanford says.
The Boston doctor says: "If we have an excess of 12 inches of snow, would it be appropriate to go about shoveling it with a teaspoon? No.
"We want to use the appropriate tool for the size of the problem and ... for those with severe obesity, we are most likely to promote longevity with early intervention."