Ever since she can remember, Micaela Chapa says her weight has been an issue for her.
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"I would wear dark, baggy clothes because I just didn't like how I felt and I tried everything to lose weight my entire life. I was in weight watchers when I was 9 years old," she said.
As co-captain of her water polo team, Micaela fought off weight gain with every new diet. No luck.
By the time she was 17, she was pre-diabetic, suffered from sleep apnea and had high blood pressure.
Desperate to do something, Micaela asked her doctor about weight loss surgery.
Dr. Matias Bruzoni, a pediatric surgeon from Lucile Packard Children's Hospital at Stanford, said Micaela was a good candidate for a bariatric procedure.
"She was one of those patients that was super motivated from the get-go and that shows you that once you get to a certain level, no matter how motivated you are, all other ways of losing weight are going to be inefficient," he said.
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To be eligible for bariatric surgery, teens have to have a BMI of 35 or higher, have diabetes, high blood pressure and sleep apnea. But because this surgery requires lifestyle changes too, not every obese teen qualifies.
Adults usually undergo full gastric bypass surgery, but teens often opt for less invasive laparoscopic sleeve surgery called gastrectomy. That's where doctors remove about 75 percent of a patient's stomach.
"These patients actually don't have much of an appetite after surgery and that helps with this whole recovery," Bruzoni said.
But experts caution that gastric sleeve surgery isn't a "fix it and forget it" kind of procedure.
When a teen patient asks their pediatrician about surgery, doctors look at a number of factors. These include whether a teen is at least 14 years old and near adult height with more than 100 pounds of extra weight to lose, is healthy enough to handle surgery, or has problems, like sleep apnea or diabetes, that may improve after surgery.
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And while an operation can be costly and has treatment risks, studies in adults have found that weight loss surgery can have long-term health benefits
Since her surgery four years ago, Micaela has lost 165 pounds and kept it off.
She follows a strict diet and eats small meals every four hours.
"I was no longer shrinking down, hiding myself. I was able to be this effervescent, boisterous person I've always wanted to be," she said.
And now, she's not letting anything hold her back.