Young Ever Williams hears a negative voice every day in her head, telling her just how fat and disgusting she is. Ever is the heroine of Skinny, Donna Cooner's new novel for young adults — and "Skinny" is the name she gives that awful voice. Navigating high school is difficult for most kids, but Ever has an additional challenge: She weighs 300 pounds. Her classmates taunt her cruelly, and the boy she likes ignores her.

Even members of Ever's family don't appear to be all that interested in her and her struggles. They don't provide much comfort and support for her. Ever apologizes for the very space she occupies because of her weight, and like many who struggle with obesity, she tries every possible diet in an effort to be thin, so sure that being smaller is the only real way to happiness.

Ever reaches a crisis point at a school ceremony — she's there to receive an award, and onstage, in front of her entire class, her chair breaks under her, and she crashes to the ground. Full disclosure: I've been there. I felt for Ever when that happened, because I too have broken furniture publicly, and I know all too well the horrible feeling of shame and the nasty comments people make.

This humiliating moment spurs Ever to look into weight loss surgery, which I have some perspective on: Like Ever, and her creator, Cooner, I am also a weight loss surgery patient. And I understood Ever's decision to have the operation. But I was uncomfortable with how quickly she made it.

Ever's story is aimed at a young adult audience, and with the increase in childhood and young adult obesity, weight loss surgery patients seem to be getting younger and younger. But surgery shouldn't be the first option offered to young people, nor is it for everyone. Why? This surgery is emphatically not the easy way out. In fact, it's one of the hardest things an overweight person can do. I just don't think I would have been prepared to deal with it when I was Ever's age, or really have understood what I was getting into.

Ever's transition to surgery seemed to go far too fast — she went from the initial doctor visit to a group support meeting, and then she had a surgery date within what seemed like mere weeks. It took me over seven years to arrive at my decision, and insurance approval for my surgery was granted through a program that took an additional six months. And what about ongoing nutritional, pre- and post-surgery, and mental health counseling? Ever didn't seem to get any. I'd have loved to see more pushback in the book from her medical team, and more of what's really needed to prepare for surgery and to maintain the weight loss afterward. And I'd really have loved to see Ever's parents step up to form a support network for their daughter.

After her operation, Ever has a few minor side effects, and soon she's off to the mall for a new wardrobe. But it's important to understand that there can be complications, even fatalities, because of this surgery. And there can be some rather unpleasant side effects too. You might not want to hear this, but I can now outbelch a 12-year-old boy. I'm thankful that not only does my husband not mind, he even offers to burp me whenever I need it! But I understood that possibility before I went into the operating room, and I am able to deal with it.

You have to be informed when you make this choice. Maybe future editions of Skinny can include a reference section at the end of the book, for organizations like the American Society for Metabolic and Bariatric Surgery, or the Weight Control Information Network, or any of the resources that are out there for people considering surgery.

Ever eventually loses over 100 pounds, and she does get healthier. Her relationships change; her outlook on herself changes. She even banishes that negative Skinny voice in her head — but Ever's journey is far from easy, and far from over. She learns that just because you become thinner, sure, you can shop in different stores, but that doesn't mean your problems magically go away. You have to learn a whole new way to cope with them — one that doesn't involve overeating.

There haven't been very many young adult books that deal with weight loss surgery, and I applaud the author for her choice of story. I hope Skinny can start a conversation for young people who are thinking about the surgery, so they can be prepared for the major physical and mental transition it brings.

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Source: NPR