Speculation about what the world will look like twenty years from now are in no short supply — flying cars, faster-than-the-speed-of-light missiles, and storm trooper-like soldiers outfitted with armour similar to that seen in movies and video games.

And while some may seem a bit far fetched, one prediction is almost certain to be realized if a 2008 study is correct — nearly every American will be either overweight or obese by 2030. But what if we were to start influencing tomorrow’s world today? Could we gain control of our obesity epidemic by allowing teens to have weight loss surgery?

A new study suggests that the clinical trial, published in the Journal of the American Medical Association, found that gastric band surgery produces significantly more weight loss in obese teens than diet and exercise alone. Over two years, the surgery group lost an average of 76.2 pounds, while the lifestyle intervention group lost 6.6 pounds. In other words, 84 percent of the gastric band group lost more than half of their excess weight, compared to just 12 percent of the lifestyle group. Senior study author Dr. Paul E. O’Brien called the results “highly successful,” explaining that a loss of more than 50 percent is considered good by weight loss surgeons.

For the trial, 50 Australian teens aged 14 to 18 with a body mass index (BMI) greater than 35 (a BMI of 30 and above is considered obese) were randomly assigned to either gastric banding or to lifestyle intervention and followed for two years. Participants also had obesity-related medical problems, such as high blood pressure, back pain, asthma, physical disability, or psychosocial issues like low self-esteem. Twenty-four of the 25 teens in the surgery group and 18 of the 25 in the lifestyle group finished the study.

For those in the surgery group, O’Brien’s team used the gastric band known as Lap-Band, which is a hollow silicone band placed around the upper part of the stomach, creating a small pouch capable of holding only a small amount of food, creating feelings of fullness sooner. The participants received detailed instructions on correct eating, for example eating slowly, chewing well, and having three or fewer small meals a day. They were also encouraged to get 30 minutes or more of formal exercise every day and to keep active during the day.

Teens in the lifestyle intervention group were instructed to reduce their caloric intake to about 800 to 2,000 calories daily, depending on their weight and age, and increase activity, with a goal of more than 10,000 steps a day on the pedometer and at least 30 minutes of physical activity daily. Television and other screen time were limited to two hours per day and each teen was provided a personal trainer for a six-week period. Parents were involved in the lifestyle changes and education. At the end of the study, the lifestyle intervention group had lost 1.3 BMI units on average and only four of the 10 who had metabolic syndrome—a combination of medical disorders that increase the risk of developing cardiovascular disease and other ailments—at the start had it at the end.

However, the surgery group had not only lost an average of nearly 13 BMI units, but none had metabolic syndrome although nine had it at the beginning. O’Brien said that the gastric band group also showed significant improvements in self-esteem after undergoing the surgery. “To take somebody from being crippled by a problem at age 15, and have them at age 17 outgoing, confident, educated and looking with optimism to the future, I think that’s money well spent,” he said.

In the U.S., Lap-Band is currently approved for use in weight reduction for severely obese adults 18 years of age or older, though the FDA is considering broadening its standards on gastric banding to include adolescents 14 to 17. Professor Susan Sawyer, co-author of the study, said that while lap-band surgery was not a quick-fix solution, it should be more readily considered for severely obese adolescents. “Adolescents are as deserving as adults when it comes to accessing clinical interventions that work,” she said. “Until we can find more successful behavioural and medical approaches to treat those with severe obesity, the results of the study unequivocally favour lap-banding in terms of weight loss and therefore are really suggesting that it needs to at least be considered.”