December 29, 2014 12:00 PM

It’s lunch period at Elaine S. Schlather Intermediate School in Cibolo, Texas. Alexis Shapiro, 13, gingerly takes a tray from the stack, purposefully selects chicken for her entrée and scans her ID at the register before facing the cacophonous cafeteria and looking for her classmates. It’s the first time she’s bought her lunch instead of bringing it from home— and it’s a big deal, explains her main teacher, Steffanie Lane. “Most of the kids at school go through the lunch line,” she says. “So it’s that feeling of being like everybody else.”

Alexis hasn’t felt like other kids since 2011, when surgery to remove a benign brain tumor left her with a condition known as hypothalamic obesity. Over the next 2½ years she put on a staggering 151 lbs. as a malfunctioning pituitary gland slowed her metabolism and caused insatiable hunger. “No matter what she did for diet or exercise, Alexis gained,” said her mom, Jenny Shapiro, 35, who had to barricade the kitchen to prevent Alexis from sneaking snacks. And the extra weight took a toll on Alexis’s 4’7″ body. “When I walk, my back, feet and legs hurt,” she told People when we first visited her in January 2014. At 203 lbs., Alexis had developed type 2 diabetes, her liver and pancreas were under a tremendous amount of stress, and she was being homeschooled because she could no longer sit at a desk all day. As a last resort, her parents researched weight-loss surgery and started a crowdfunding campaign when their insurance company refused to pay for treatment. (It later reversed its decision, and the Shapiros used the $68,000 they raised after fees for travel expenses, bills due to missed work and other costs.)

In the months since Alexis underwent gastric sleeve surgery on March 21 at Cincinnati Children’s Hospital Medical Center, she has lost nearly 60 lbs. “And we have seen major improvements in her overall health,” says Dr. Thomas H. Inge, director of surgical weight loss programs for teens, who led the surgical team. “She has a reduced hunger drive, and her type 2 diabetes went into remission.” Alexis has also learned to eat small, protein-heavy meals every few hours, such as yogurt for breakfast, a chicken wrap with fruit for lunch and turkey meatloaf for dinner. She also keeps a cheese stick in the school nurse’s office for a back-up snack. “She’s still hungry more than everyone else is, but the amount of food she can eat is so small because of the sleeve,” says Jenny, adding that Alexis is extremely disciplined. “If the nutritionist says something, she does it by the book. She has put so much effort into making the surgery successful.”

While Dr. Inge is optimistic—”The weight loss appears to be continuing”—he notes, “There will be a point at which she stops losing weight.” The damage done to her hypothalamus still affects her weight regulation, he explains. “She can eat very little and yet not burn very much energy.”

Still, her life postsurgery has drastically improved. “The biggest thing is her energy level,” says her dad, Ian, 35, an insurance claims representative. “And her attitude—she laughs and plays.” Over the summer she was back in a bathing suit for the first time in a year, swimming with her siblings Kayley, 10, and Ethan, 8. “But it’s also the little things,” says Jenny, “like being able to sit cross-legged on the floor, putting on her shoes, getting herself dressed. All those things she could hardly do before.”

Even with the weight loss, Alexis still faces serious health challenges. She’ll need hormone-replacement therapy for the rest of her life, because the tumor and subsequent surgery caused an adrenal insufficiency. (That means her body is unable to calm itself down when it faces stressors or a potential injury.) “For Alexis, pretty much anything that can scare you or hurt can cause a crisis,” says Jenny. Alexis takes small doses of oral steroids at the first sign of symptoms like severe sleepiness, headaches or nausea, but in extreme cases, she must be injected with the drug Solu-Cortef to prevent her organs from shutting down. The school staff has been remarkable about welcoming Alexis and making her feel safe, says Jenny. “The nurse researched the condition and sent Alexis’s teachers the symptoms to look out for. School has been the best thing for her.”

After a year of homeschooling, the transition to a classroom in August was understandably rocky—Alexis was shy and missed her mom. But these days she’s opening up to the kids in her special-ed class (Jenny says Alexis has always had a developmental delay and has slipped farther behind because of her health crisis) and with her teachers—especially P.E. coach Rachelle Hirsch, who walks laps with her at lunchtime. Alexis even joined Coach Hirsch’s after-school exercise club, which introduces kids to activities like karate and yoga. “Out of all the clubs,” says her mom, “she joined one that’s physically active.” Jenny, a part-time dog groomer, says, “I see Alexis walking down the halls and doing all this stuff by herself, and I’m like, ‘She doesn’t need me anymore.’ But that’s great! The whole point is to teach her to be independent.”

Of course, there are still plenty of mother-daughter moments to be celebrated—like shopping. After being forced to wear men’s XXL T-shirts, Alexis is finally fitting in girls’ clothes. Jenny describes a recent trip to Justice, Alexis’s favorite tween chain store: “In the past trying things on would make her upset and sad. But she started putting things on—oh my gosh, the bright smile on her face! When we left she was like, ‘Thank you so much, Mommy!’ I will never forget it.” Besides clothes, Alexis’s Christmas list includes a new iPad. “I have Pinterest and YouTube and Netflix and Facebook. But I still don’t have Instagram,” she says. “I always ask my mom, and she says, ‘Let’s talk about it tomorrow.’ And I’m like, ‘Come on, people!’ ”

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