Alexis Shapiro, a 12-year-old girl from Cibolo, Texas, underwent weight loss surgery after her weight surpassed an unhealthy 200 pounds. Her weight gain was due to an uncommon case of medically induced obesity.

The surgery was performed at the Cincinnati Children's Hospital Medical Center. Shapiro was scheduled for full gastric bypass surgery, but due to complications, doctors had to change plans on the fly. According to the Liberty Voice, due to her significant weight gain, Shapiro’s liver became enlarged. That forced doctors to give her a sleeve gastrectomy instead, which shrunk her stomach to around 25 percent of its original size.

Shapiro and her family decided on surgery because of her diminishing health condition. According to CTV News, her weight gain started two years ago after she had brain surgery to remove a tumor. Shapiro’s condition, called hypothalamic obesity, causes her to have constant hunger and limits her production of adrenaline so she cannot burn calories at a normal rate.