A morbidly obese two-year-old has become the youngest person in the world to have weight loss surgery.
The child, from Saudi Arabia, had a body mass index of 44.1 before the bariatric surgery at the Prince Sultan Military Medical City in Riyadh.
Although only an indication of health, a normal BMI is between 18.5 and 24.9. Between 40 and 44.9 is considered morbid obesity.
Doctors performed a laparoscopic sleeve gastrectomy on the boy, where a large portion of his stomach was removed to help him lose weight. The procedure is often used on children and adolescents, but is not generally performed on very young children.
Writing in the International Journal of Surgery Case Reports, the authors said the boy was suffering from obstructive sleep apnea, where he stops breathing during the night, and bowing of the legs.
They wrote: "LSG was performed after investigations ruled out hereditary or genetic causes of obesity. The procedure was well tolerated without any complications and two months post-surgery, the obstructive sleep apnea decreased substantially.
Long term follow up essential
"The child was followed up for two years. At the last follow up BMI was drastically reduced from a pre surgical value of 41.1 to 24 at 24 months post-surgery."
Prior to this surgery, the authors said the youngest child to have weight loss surgery was a five-year-old from Saudi Arabia, although it was recently reported a four-year-old boy had also undergone LSG in India.
The authors concluded: "We observed LSG to be safe and effective in reducing obesity and related co-morbidities in a two-and-a-half-year-old child.
"The results suggest that LSG can be a safe and effective alternative for weight control in morbidly obese children even of less than 3 years of age. However more studies and long-term follow up is essential for monitoring the growth and development of children subjected to LSG."
Obesity is a growing health concern in Saudi Arabia, with around 35% of the population considered obese.
This was recently highlighted when King Abdullah ordered a plane to take Khalid Mohsin Shaeri, who is one of the heaviest people in the world, to hospital for treatment.