Rooks was what doctors call "morbidly obese," but she didn't need a doctor to tell her that her weight was going to kill her.
"I would be lucky to see 30," Rooks said at the time.
Rook's mother, Marie Johnson, understood her daughter's plight. She was 370 pounds herself and found she was losing her breath just walking.
It was a desperate situation, and it called for what seemed like a desperate solution. Rooks and Johnson both had obesity surgery. Dr. Mathias Fobi turned each woman's normal, 50- to 80-ounce stomach into a tiny, 2-ounce pouch in a procedure called a gastric bypass.
In such surgery, the stomach is separated from the intestine and divided into two parts. The larger part becomes inactive. The smaller part is made into a pouch, reconnected, and becomes a tiny, new stomach, capable of holding only two ounces.
Starving, their bodies started shedding pounds.
A year ago, one year after their operations, 48 Hours went back to Yucca Valley, Calif., to see how the two women were doing.
At that time, Rooks weighed 322 pounds; she had lost 204 pounds in the year. Johnson had lost 170 pounds, almost half her original weight.
"Now I like to walk fast," she said, "and when someone's walking with me, if they can't walk fast, I'd just as soon walk by myself."
Losing 200 pounds had given Rooks a new life. She was able to work for the first time, she wore normal clothes and she even went on dates. She was happier, and healthier.
Today, Rooks weighs 310 pounds; she has only dropped 11 more pounds in the last year. She still is consdered morbidly obese.
"I don't think my body's gonna lose anymore," she says. "It's plateaued. It's pretty much stayed the same."
Rooks has also experienced emotional problems more common to a young teen than a 21-year-old woman.
"Last year, the first guy that came up to me and said, 'I love you,' I was ready to jump," she says. "I moved across the country, I left in the middle of the night, and it ended up being the worst mistake of my whole entire life"
Johnson thinks her daughter could use some counseling; Fobi thinks she could use more surgery. He wants to remove the hanging skin caused by Ruthie's massive weight loss, and he wants to revise the original gastric bypass so Ruthie can start losing weight again.
The new surgery would bypass more of her small bowel so the body would absorb less food. But there are risks involved. Her body would practically starve itself on fewer than 800 calories a day, risking malnutrition - a huge gamble Ruthie seems willing to take.
"Even though I know where I've been and what I've lost," she says, " a lot of people don't and they still look at me as overweight."
The price tag to get thinner is steep: $10,000. Rooks has no insurance so she sold her new car to pay for the surgery.
Suddenly, on the morning of her surgery, Rooks changes her mind and leaves the hospital.
"I got scared, spooked," she says. "I just sat there and I thought, 'Why am I gonna do this?'"
Fobi says she is at risk for developing some health problems from being 300 pounds in weight.
"I've come a long way," she says. "I went from being a sideshow to being healthy. If you see my tests, there's nothing wrong with me, and it was out of vanity that I wanted to have a tummy tuck and my arms done."
In the end, Rooks says, "I was put on this earth as a heavy girl, and there's nothing wrong with a heavy girl. Heavy girls can be beautiful. It shouldn't really matter what I look like. It matters who I am."
July 2002 Update
Ruthie has maintained her weight. She is considering surgery to remove excess skin, but not until after she gets married. There are no marriage plans on the horizon, although she does have a live-in boyfriend. Ruthie's mom, Marie, has put on 15 lbs and is working now on taking the excess weight off.
© MMII, CBS Worldwide Inc. All Rights Reserved