Is Gastric Bypass Necessary?

Last year Marie Johnson and her daughter Ruthie Rooks both decided to have gastric bypass surgery. Johnson, who weighed 365 pounds, had the operation first; her daughter, who weighed more than 500 pounds, followed a few weeks later.

Correspondent Bill Lagattuta reports on the results and the controversy over this procedure.

After Rooks' surgery, Dr. Mathias Fobi was optimistic.

"In six months she will lose about 150 pounds very easily," he said. "It may even be more than that."

Two weeks after her surgery, Johnson almost had to learn to eat all over again, adjusting to her new, tiny stomach. She found it strange. A typical meal: two crackers and a couple of forkfuls of yogurt. Afterward, Johnson was stuffed.

"A couple of times I thought, 'This is crazy,'" she said.

Some experts say that weight-loss surgery creates more problems than it solves. Among the critics is Jennifer Mann, an eating disorder specialist in Los Angeles who has treated several clients who have had gastric bypass surgery.

"I've seen massive infection," she said. "I've seen people hospitalized for malnutrition. I've seen people obsessed with food. I've seen people unable to stop vomiting."

"I've seen people develop massive eating disorders," she continued. "I've seen people who are terrified of gaining weight. Terrified. It runs their lives."

According to Mann, gastric bypass surgery is a bad idea for most people. "This is a permanent prison, in a sense," she said. "You are choosing to make your stomach a different size. And while it is possible to go back, it is very rare and very risky. This is permanent."

Experts say there's little data available on how the procedure affects patients 10 years afterward. Even Dr. Fobi doesn't deny that the surgery carries risks and that it may cause difficulties later.

Fobi markets the procedure via commercials; he also gets endorsements from his patients, who praise gastric bypass in his support groups. Overweight people who hear about the results often forget about the risks.

The sales pitch is working. Gastric bypass surgery can cost patients - and their insurance companies - as much as $45,000, but that price tag isn't scaring everyone away. Last year an estimated 20,000 people had surgery to treat their obesity.

Some of them may not seem obese at all: Christina Schefcick, for example. A mother and grandmother, Schefcick is in her 40s, weighs 220 pounds and measures 5 feet 4 inches tall. She underwent gastric bypass surgery.

Why did she want to take the risk? "It's not an extraordinary risk," she said. "If you look at Dr. Fobi's success and his mortality rate, it's not an extraordinary risk."

Schefcick said she tried to lose the weight without surgery and is "absolutely certain" that she gave it her full effort. She doesn't eat that much, she says: "I don't eat an extraordinary amount during the day. And that's why it's so frustrating."

Without surgery, she would face a slew of other medial problems related to her weight, including lower back arthritis, asthma and migraine headaches, she said.

Schefcick and her husband Rick fought insurers and doctors for nearly a year until she was finally approved for surgery covered by insurance. On Oct. 25, 1999, she had the procedure.

Eleven weeks after surgery, Schefcick had lost 43 pounds. And for the first time ever, she went shopping at Victoria's Secret.

And now when she weighed in seven months later, she is a trim 155.

"I feel great; I feel normal," she says.

Marie Johnson and daughter Ruthie Rooks also are pleased with the results of their surgeries.

After initially losing 84 pounds, Johnson said, "I'm just having a ball."

"I think I'm the sexiest thing around, she added. She was wearing slacks for the first time in 16 years. As she continued to lose weight, she had to replace one pair with a smaller size.

And now, 10 months after 48 Hours first met Johnson - who at the time couldn't wal to the mailbox without getting out of breath - she's down almost 150 pounds. "I feel wonderful," Johnson says.

Observes Dr. Fobi: "Blood good, respiration great, weight loss fantastic."

"I catch myself smiling all the time," she says. "I...just feel so good."

The only reason she runs out of breath now is because she's constantly on the go. Now she'll walk a mile to her sister's just to have a cup of tea.

"I feel like I've been let out of prison," Johnson observes.

"And I feel like my daughter has, too," Johnson adds. "That's the only way I can explain it."

"I knew my daughter wasn't going to live long," Johnson says about her gastric bypass operation. "And I would have done anything to save her. And a mother will....And in the meantime I saved myself, too."

Three months after daughter Ruthie Rooks' surgery, she had lost 101 pounds. For the first time in two years, she could wear high heels. "My clothes are starting to get baggy, which is cool," she said. "I've never had baggy clothes."

And nearly a year later, Rooks, who weighed 525 pounds when 48 Hours first met her at age 19, has lost more than 150 pounds.

"You've lost a whole person, Ruthie, a whole chunky person," says a nurse.

"You're a different young lady now," Dr. Fobi says.

Rooks' life has been completely transformed. "Last month I had a date," Rooks boasts. "I'm telling you I'm getting sexy."

And for the first time in her life Rooks has a real job, at a Pizza Hut.

"For 19 1/2 years I lived in my room; I wasn't able to do things," she says. "I wasn't able to go out and play.... Now I'm getting ready to play softball."

This woman who could barely walk just one year ago is now running bases.

"I'm having a life; I'm out of prison," Rooks says.

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