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In one part of the special, the Ervie family, from Marceline, Missouri spoke to Oprah about their controversial decision to give their 13-year-old daughter bariatric surgery and then weight loss medication based on the American Academy of Pediatrics updated guidelines on treating childhood obesity

Free fatty acids from either adipose tissue (fat), or from the conversion of excess carbohydrate intake, accumulate in the liver cell resulting in oxidative stress, inflammation, and liver injury

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