A two-and-a-half-year-old morbidly obese boy has had drastic weight loss surgery.
The Saudi Arabian toddler weighed 33kg and had a Body Mass Index (BMI) of 41 before he was operated on.
Scroll down for pictures of the boy after his surgery
The procedure was carried out at the Prince Sultan Military Medical City in Riyadh.
It was deemed a success and his progress was followed for two years after surgery, with his weight dropping to 24kg and his new BMI of 24 putting him within the "normal" range.
Prior to this, the youngest child to undergo the procedure was a five-year-old, also from Saudi Arabia, the report states.
In Britain, the NHS offers surgical weight loss procedures only to those suffering with potentially life-threatening obesity, and when other treatments, including lifestyle and dietary changes have not worked.
Guidelines state weight loss surgery will only be considered to treat obese children in exceptional circumstances, and only if the child is physically mature. It classes this as the age of 13 for girls and 15 for boys.
During a sleeve gastrectomy, the surgeon cuts into the abdomen before removing the left side of the stomach.
This can reduce the volume of the stomach by up to 75% and is usually performed via keyhole surgery.
The remaining part of the stomach is pulled upwards and resealed with stitches, creating a much smaller, longer stomach shaped like a banana.
According to the report, which was published on 13 September, the two-and-a-half-year-old boy was of a normal weight until he reached the age of six months.
As he became heavier, his parents eventually sought the advice of doctors. The patient had no family history of morbid obesity or genetic abnormalities and a CT scan of his brain showed no other causes of obesity.
The child was put on a diet but it is uncertain whether his parents complied fully “mainly due to the different socio cultural habits and the absence of the practice of calculating the calorific value of the diet.” Eventually it was decided to operate on him.
The case has been described as “shocking” and “very unusual”, by one expert.
"It's rather like the other day when we saw one of our spacecrafts going out of our solar system into the dark regions of space, it's going into unknown territory," said obesity expert adjunct professor Paul Zimmett, from Australia’s Baker IDI Heart and Diabetes Institute.
Speaking to News.com.au, he added: "We have no idea what effect this may have on the child's growth and unless he has proper follow up he may suffer vitamin deficiencies."
Globally, in 2010 the number of overweight children under the age of five was estimated to be over 42 million. Close to 35 million of these are living in developing countries, World Health Organisation statistics state.
In Britain, Department of Health figures released in March this year claim 61.3% of adults and 30% of children aged between two and 15 are overweight or obese.
People who are overweight have a higher risk of getting type 2 diabetes, heart disease and certain cancers. Health problems associated with being overweight or obese are estimated to cost the NHS more than £5 billion a year.Suggest a correction