Steve Mellon, Post-Gazette Josh Gee, center, clowns around with Courtney Wood, left, and Victoria Chase during lunch at Seneca High School, near Erie. The 18-year-old graduating senior lost 136 pounds after undergoing gastric bypass surgery last year. Click photo for larger image.

WATTSBURG -- Josh Gee has lost 39.3 percent of himself, but he feels comfortable in his own skin, even if some of it is sagging around his waist like a wobbly beer gut.

In the cafeteria of Seneca High School just outside of Erie, the 210-pound senior is all smiles on a recent day, sitting at a table surrounded by girls. He sets off a chorus of giggles by giving them hot sauce to slather on their pizza.

"Josh rocks," says Courtney Wood, a freshman prom date who describes herself as "just a friend."

"Josh is, like, my hero, " says Victoria Chase, a freshman in a Tigger T-shirt. "He's funny and he brings us food."

Josh's new friends are underclassmen who never knew the 346-pound Josh, the Josh who was once teased so badly that he thought about taking his own life. They didn't know the obese boy who used to eat lunch with a few male friends off at some side table, the Siberia of high school cliques.

It's not as though shedding 136 pounds through gastric bypass surgery has let the 18-year-old graduating senior migrate to a popular senior table. But it has been easier to make friends and blend in.

"People who used to know me haven't changed much," he says. But he made friends with Courtney, a slight 15-year-old with blue eyes and flowing brown hair. And now Josh is friends with all her friends, too. "A lot more people say 'Hi' to me."

Josh was the subject of a Post-Gazette story ("Erie teen is the third generation of his family choosing gastric bypass to escape obesity, " October 12, 2003) in October on the growing and controversial practice of teenagers undergoing gastric bypass surgery. A year ago, at the age of 17, he underwent the Roux-en-Y gastric bypass operation, just as his mother, Michelle, and his grandfather, Ken Pulos, did before him. Dr. Philip Schauer operated on all three generations of the family by stapling their stomachs to the size of a walnut and creating a bypass to the lower part of the intestine so that less food is absorbed.

Critics wince at the idea of teenagers having their innards rearranged to help them control their eating.

Steve Mellon, Post-Gazette ABOVE: At 17, Josh Gee weighed 346 pounds before his gastric bypass surgery in May 2003. BELOW: Since having the size of his stomach reduced, Josh's shirt size dropped from 4X to Large while his waist size went from a 48 to a 36. Click photo for larger image.

"It is a horrible comment on society that we are willing to let teenagers, children -- and it is being pushed down to 14-year-olds -- have a procedure done where their stomach is mutilated and they are never able to eat normally again," says Paul Campos, a University of Colorado law professor who is the author of a new book, "The Obesity Myth." "Not only are there serious risks [to surgery], but we know nothing about the long-term consequences. The question with a 17-year-old is this: What are the consequences of this 40 years down the line? It is quite clear the answer is: We have no idea."

Schauer, Josh's surgeon, counters: "It would be a horrible comment on society to allow an adolescent to suffer the consequences of having an extra 150 pounds on their body and develop diabetes, hypertension and even a heart attack, when society has a tool that we know is extremely effective at resolving these problems and allowing these adolescents to grow up to have a relatively normal life. How can society withhold or deny Josh that life-saving therapy? It would be like denying someone bypass surgery because they smoke cigarettes."

Schauer is thrilled by the changes in Josh, whose hypertension is gone and whose blood sugar levels have come down to normal. His joints no longer ache. Schauer said Josh's life expectancy would have been about 15 years less without the surgery.

The changes on the outside are dramatic, too. His slightly round face is unrecognizable from the puffy face of a year ago. He has gone from a 4X to a Large shirt size, and his waist size has dropped from a 48 to a 36.

The changes go beyond his appearance. His grades improved from Bs and Cs to As and Bs. He no longer takes the anti-depressant Wellbutrin now that people no longer shun or tease him. Nevertheless, sometimes it upsets him that people treat him so differently now.

"It is sort of disgusting. You should not be judged on how you look on the outside, but everybody does it."

Occasionally someone taunts Josh by saying, "You are still fat," says longtime friend Max Duryea. "But five other people will step in and say, 'He just lost 100 pounds. He's doing good. So shut up.' ''

One vestige of the old Josh is the excess skin that hangs on his stomach "like a movable beer gut. It tends to move around, but it stays all together," he says smiling boyishly. "What was holding it to me is gone. It's like a whole new species."

Within a year, he expects to have an abdominoplasty, a removal of skin around the stomach and tightening of the abdominal muscles.

With his rearranged anatomy, Josh will never be able to pig out the way he used to without risking severe nausea. He doesn't miss eating, except for an occasional craving for peanut butter cup ice cream. For breakfast, he eats cereal from a kid's Scooby-Doo plastic bowl.

During lunch before the last day of school, he was nibbling on a few chicken nuggets and a few baked Doritos while other students shoveled in pizza, fries and a chicken salad drenched in dressing.

	Steve Mellon, Post-Gazette Sixteen days after his gastric bypass in May, 2003, Josh Gee returned to school, 28 pounds lighter. At lunch he could take only a few spoonfuls of peach yogurt. Click photo for larger image.

His dainty bites sometimes attract notice. "People think you are weird when you are not eating a lot."

Sometimes his friends even forget that he had surgery and offer him junk food until he reminds them why he can't eat it.

Victoria, one of his new freshman friends, was shocked to see a photo of the old Josh at his house. "That's not Josh," she says incredulously.

Victoria admires Josh for his operation. "He is an inspiration to me," she says. "Look at what he has accomplished."

Victoria, who is not fat, says she has begged her mother to get her own gastric bypass operation. "My mom said we can't afford it."

"I think my whole family should do it," says Danielle Hartman, a freshman whose mom told her she is too thin for it.

Josh's family did do it together. His mother went from 322 to 190 pounds after undergoing the surgery in February 2002. His grandfather slimmed down from 372 to 195 pounds and is such an enthusiast for the operation that he goes up to obese strangers and tells them they should get the surgery, too. Often people are receptive, but recently a man he approached in a store became angry, telling him, "Get away," Michelle Gee says.

Michelle says she had some trepidation about letting Josh get the surgery at such a young age. But he had failed on every diet he tried. He was so depressed in middle school when boys taunted him with names such as "Shamu" that he handed her a note telling her he didn't want to live anymore.

Getting around also was a chore. He used to have trouble walking up two flights of stairs in the high school. But now he bounds around energetically.

Josh, who hopes to get down to 180 pounds, exercises only about once a week, although Michelle urges him to do more. She also monitors his diet. If he eats a few cookies one day -- the sugar-free type his body tolerates -- she lets it go. But if he does it a second day, she reminds him, "You can gain it back."

"This is not a done deal," says Michelle, who gained back 10 pounds this winter. She will continue to monitor Josh's diet at college in the fall because he will be commuting to Edinboro University of Pennsylvania to study criminal justice.

He has had one complication, a painful infection of the belly button that came about six months after surgery. Usually such infections come right after surgery. "It is pretty strange," Schauer says. "It kind of puzzled me, but he took antibiotics and it cleared up."

Josh doesn't bring up his surgery unless someone asks him about it. "I am not like my grandpa, walking around with a giant poster saying, 'Look at me.' "

Librarian Margaret Clark notices the change in Josh as he banters with her inside the school library. "He smiles. He didn't used to do that."