"I don't think altering the human digestive tract is a solution to the problem of excess weight," said Joanne Ikeda, a nutritionist emeritus at the University of California, Berkeley. "It's one of these quick-fixes that isn't a fix at all."

Doctors, she said, still know relatively little about the long-term effects of such operations on the very young.

The federal Agency for Healthcare Research and Quality released a study in July that said four in 10 weight-loss surgery patients develop complications within six months. Among adults, mortality rates among gastric bypass patients remain at between 1 in 100 and 1 in 200 patients.

Laparoscopic gastric banding has been shown to have a much smaller death rate - about 1 in 1000 patients - but complications do occur.

Of the patients who participated in the NYU study, two needed a second operation to adjust a slipping band; two developed hernias; five got an infection; five suffered mild hair loss and four had iron deficiencies related to their new diet. After the study was complete, one patient asked to have her band removed because of discomfort, said Evan Nadler, a pediatric surgeon and co-author of the study.

Nadler said those complications were minor compared to the chronic diabetes and cardiovascular disease teens would face if they remained that heavy into adulthood.

"These are people who have tried everything they could possibly try," he said, noting that their mean weight at the study's start was 297 pounds. "Once they reach this level of morbid obesity, the vast majority go on to be obese adults," he said.

Thomas Wadden, an obesity expert at the University of Pennsylvania School of Medicine, said surgery can be of immense benefit to some teens, especially those already experiencing health problems.

But he also advised caution.

Egged on by TV shows and commercials expounding the benefits of weight-loss surgery, adult patients have begun showing up at Penn's Center for Weight and Eating Disorders demanding an operation as an easy first step to thinness.

"When we ask them, 'What have you done so far to lose weight?' The patients say, 'Nothing,'" Wadden said. "They're going right to a $25,000 operation for which they are ill-prepared."

It would be tragic, he said, to see the same phenomenon repeated among children.

"They have to be selected with caution to make sure that this aggressive step is absolutely necessary."

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