BUFFALO GROVE, Ill. - Sam Fabrikant is a few minutes older than his brother, Charlie. But he's always been the quieter of the two, the follower - even when he didn't necessarily want to be.
Take, for instance, the matter of their weight. Charlie started putting on extra pounds in first grade, and eventually dropped out of sports because he couldn't keep up. In fifth grade, Sam started to see the effects of his own weight gain. And by their teen years, the fraternal twins were - in their words - "morbidly obese."
"It wasn't good," says Charlie, who's 5-foot-10 and weighed 350 pounds about this time last year. Sam, who's 5-foot-7, was hovering around 290.
That's when Charlie decided to do something drastic and controversial: He had gastric bypass surgery, performed by one of only a few doctors in the country who'll do the procedure on teens. Now a high school junior, he underwent months of physical and psychological screening before the surgery and has since lost about 130 pounds. He also no longer suffers from ailments related to his obesity, such as sleep apnea, joint pain, severe heartburn and asthma.
The results prompted Sam, who'd been hesitant about the surgery, to follow suit. Last month, doctors rerouted several feet of his small intestine and stapled his stomach to reduce its capacity from football size to that of a golf ball.
"Surgery, for me, was my last option," says Sam, who continued to try and lose weight over the last year through diet and exercise, with minimal results. "The big motivation for me is to lead a healthy life."
Watching his brother go through recovery - and feel better in the long run - also helped calm Sam's fears about the procedure, though it ended up being much more difficult for him than Charlie. Among other things, Sam developed a blood clot in a lung and spent several days in intensive care.
Though doctors agree that obesity is a major health problem, many say that gastric bypass is a procedure teens are both physically and emotionally too young to handle. They also note that, because the surgery is relatively new, the long-term effects are unknown.
Still, Dr. Chris Salvino, the Chicago-area doctor who did the twins' gastric bypasses, believes some teens - namely, those whose severe obesity causes them to suffer from diabetes, high blood pressure, sleep apnea and other ailments - are good candidates for the surgery. In the last two years, he and fellow surgeons in his practice have done the procedure on more than two dozen teens.
He also believes that the health benefits resulting from the surgery outweigh the risks, which include everything from the chance of infection and stomach leakage to staples coming undone, requiring further surgery.