Brothers Juan Luis and Pedro Vanegas Bravo in a swimming pool with their father and a friend.
Brothers Juan Luis and Pedro "Poncho" Vanegas Bravo spent most of their childhood dealing with obesity. Now 17 and 20 years old respectively, they've overcome their weight issues by being the first minors to receive gastric bypass surgery in Mexico.
The surgery didn't come without its risks. Doctors told the brothers that one in every ten patients faces complications, and that two in every 100 dies. On the other hand, the death of their father—Juan Manuel Vanegas—in 2005 due to complications related to his morbid obesity served as a morbid reminder that not addressing their own obesity could be just as devastating. Juan Manuel had suffered from diabetes. When a perforation in his colon was detected, doctors were unable to reach it and heal his wound. He went through eight surgeries before dying at the age of 42. Pedro was 12 and Juan Luis was eight at the time of his death.
"I realized that if I didn't lose weight, I was going to end up like my dad," Juan Luis told me when I first visited his home, in the northwest Azcapotzalco borough of Mexico City. "We had to try hard to get the surgery, though—I was underage at the time, so government-run hospitals wouldn't admit me," he said. "Then we met Francisco José Campos Pérez, a well-known specialist in gastric bypass surgery. He was researching the complications of such a procedure on teenagers at the time, and I ended up being his guinea pig."
Pedro at eight years old (on the left) and 14 years old (on the right).
According to a 2012 National Health and Nutrition Survey, obesity in Mexico affects 32 percent of girls and 36.9 percent of boys between the ages of five and 11. That adds up to around 5,664,870 children around the country. This number increases in teenagers and adults. Almost catching up with obesity levels in the United States—the fattest of the world's developed countries—69.5 percent of the Mexican population above the age of 15 are overweight or obese, according to the Organization for Economic Cooperation and Development.
Diabetes, the disease most commonly associated with obesity, is the primary cause of death in Mexico—deadlier than homicides, heart diseases, or vehicular accidents. In 2012, authorities counted more than 80,000 Mexicans who died due to diabetes (that’s basically the sum of every execution related to the drug war in the past six years) and there are more than 10.6 million Mexicans living with it today. Even worse, according to government estimates, 16.3 million Mexicans are expected to have the disease by 2030.
There are numerous reasons for this, and Mexicans know them well: the refrigerator and the street-corner bodega, the fried food we love, the proliferation of McDonald's restaurants and other fast-food chains, and the world-famous Mexican Coca-Cola, which uses real cane sugar rather than artificial sweeteners. Additionally, certain social customs that could be described as quintessentially Mexicano encourage us to eat more and more: offering heaps of food to guests (to demonstrate hospitality), asking for more food (to demonstrate familiarity), and eating more food when it is offered to you (to demonstrate gratitude).
Juan Luis at home.
From what their mother—Mrs. Juana—told me, Juan Luis and Pedro started getting fat when they were each three years old. "There was a lot of eating," said the 51-year-old at a barbeque we'd been invited to at her home. "I started getting worried, so I took them swimming, to soccer practice, tae-kwon-do, anything. My mistake was having a duplex refrigerator and filling it with cold cuts every 15 days. Anything you craved, you could find it in our fridge."
In pictures from those days, the brothers look happy and active, but you can definitely see the mood shift as their weight increases year after year. They are a unique pair. Juan Luis is dark-skinned and the pictures exhibit a love for performance from an early age. On the other hand, Pedro has fair skin and hair, is slightly more reserved in his pictures, and it's clear he’s loved sports since he was little. Now he plays center in an American football league.
By their teenage years, the Vanegas brothers were huge—their bodies filled every bit of space in family portraits. "You don’t realize how fat your children are," said Mrs. Juana. "Every year they went to school, I had their trousers custom-made. I didn't realize they were a size 38 when they were six, or 40 when they were ten. And I didn't know how to reverse it when I [realized]."
Pedro dressing himself for American football practice in his bedroom.
At the most critical point of his condition—at 15 years of age—Juan Luis weighed 320 pounds. Pedro reached 304 pounds at 14. It was clearly time to do something. After their father’s death, the Vanegas brothers and their mother started looking for help. There were consultations, interviews, waiting lists, and specialists-in-everything.
In 2009, Juan Luis had a gastric sleeve applied in the Rubén Leñero General Hospital in Mexico City. This surgery reduces the size of the stomach between 60 and 85 percent, leaving a "sleeve"-shaped stomach that can't store nearly as much food as a normal stomach. At first, it appeared to work—Juan Luis dropped to 231 pounds. But then his body rebelled. The capacity of his stomach adjusted to the surgery, Mrs. Juana told me. It grew again and he began to regain the weight he'd lost.
In 2012, Juan Luis went underwent a gastric bypass surgery in the same hospital. This procedure was more complex—it involves dividing the stomach into two, one section bigger than the other. The intestine is then modified in order to enclose the bigger part, reducing the space the body tries to fill with food.
In August of 2010, Pedro underwent his own surgical operation to combat obesity. He had a balloon inserted into his stomach, which—once inside—is expanded so there's less room for food. "I got authorized for the surgery one day after I was accepted into a technical college," Pedro told me. "I wanted to go to school, but I had been waiting for the procedure for three long years. I had practically no friends because I was a gordito [a nickname for 'cute little fat boys']."
Pedro at the doctor's office.
Unfortunately, Pedro's operation led to complications: pneumonia, then infections and, later, even more infections driven by antibiotics. "I remember hearing voices and telling them [the doctors] to do something because I felt really bad," he said, recalling a hard day at the hospital. "I felt that I died for a few minutes."
Pedro eventually recovered after spending 73 days in hospital. At the moment, he weighs around 162 pounds, but the significant reduction has created a whole new problem—excess skin.
I accompanied Pedro to a routine check-up with his doctors and nutritionists in Mexico City. In a tiny doctor’s office, I watched as a specialist measured his waist. His stomach, of course, is the first thing you notice when he takes his shirt off. The section of skin that used to cover a significant surface is now wrinkled and loose. Pedro himself was relaxed and calm, smiling at everyone while he stood there in his underpants.
"Let them see me," he said, "I don’t give a crap." In the future, his doctors tell him, he will have to consider a different surgery to remove the extra skin, which, compared to the other problems he's faced in the past, will be relatively stress-free. Pedro later told me he thinks that his father would be proud of him, saying, "Maybe he would have gone through the surgery himself."
Pedro has traveled to Puebla, Chihuahua, Chiapas, and other states with his football team. He's a fan of the NFL Steelers and, in particular, their defense safety, Troy Polamalu. He's still attending his business course at the Instituto Politécnico Nacional and, in his bedroom in Azcapotzalco, he's got a drum set and posters of girls in bikinis hanging on the walls.
Juan Luis putting on one of his dance costumes.
Juan Luis has slightly different interests to his brother. His main passion is practicing a form of belly dance that he refers to as "gothic." He has frequent appearances on stages in the city, where he performs in costumes he makes himself, sometimes also using props like flaming batons or fake swords, as I witnessed myself one Sunday in a community theater in downtown Mexico City. It was quite startling to see a man of his size moving so flexibly.
But watching him, I realized he's fully guided by his artistic vision. "When I perform, I am free," he said. "I transform into what I am wearing. If I'm wearing my light blue outfit, I dance cheerfully—I feel I'm in the desert dancing in an oasis. When I do a gothic number, I imagine myself in the woods listening to owls and crickets, and I feel part of that sad scene. It is magical."
Juan Luis applying make-up before a performance at the Teatro del Pueblo, Mexico City.
Juan Luis explained to me that he identifies himself as effeminate but not gay. His mother says that she supports her son’s art, but that she still finds it difficult to accept. Talking at her home, her voice cracked a little when we approached the subject of Juan Luis’ dancing. "Within the society we live in, it is not very acceptable for boys to do girls' things," she said. "That has caused me a lot of trouble, because I don’t want him to get hurt."
This year, Juan Luis entered a nutritional sciences program at a local university and moved away from home to be closer to his campus in southeast Mexico City. The afternoon we met to grill burgers in the garden, he was visiting and had invited over several of his friends from high school. The burgers, Juan Luis told me, could come with bacon, ham, pineapple, peppers, mustard, mayonnaise, cheese—anything I wanted. But he was only going to eat half a burger, he said.
We ate and drank soda and beer, with Mrs Juana’s permission of course. The boys looked happy. Their mother said the struggle against overeating is one her family faces every day. "If you don't take care of yourself," she said, "you lose the most valuable thing you have: life."
Translation by Jose Luis Martínez Limón.
Check out more of Bénédicte's work here
More from VICE Mexico
WATCH – The Subway Gangs of Mexico City