Weighing the Risks

updated 03/10/2003 AT 01:00 AM EST

originally published 03/10/2003 AT 01:00 AM EST

The before-and-after shots are astounding: a svelte Carnie Wilson or a slim Al Roker floating within the ample circumference of their old pants. The pictures are so remarkable, both appeared on the cover of PEOPLE. Last year an estimated 63,000 of the 9 million severely obese Americans underwent gastric-bypass surgery, up from 36,700 in 2000. "It's becoming the new miracle," says Daniel Richards, 26, whose brother Brett, 24, weighed 450 lbs. before his surgery in April 2002. On average, patients lose an impressive one-third of their preoperative weight the first year; after 15 years the majority of them have kept at least half their excess weight off. "But," says Richards, who saw Brett die from complications after his stapled stomach leaked, "there's another side."

Indeed, as many as one in five will endure side effects ranging from unpleasant (vomiting, dehydration) to serious (ulcers, hernias) to potentially fatal (intestinal leakage, blood clots in the lungs). The death rate is about one in 300 but may be as high as 7 percent for those with complications from their weight. "Any time you put a 400-lb. patient on an operating table," says Dr. Arthur Frank of George Washington University, "you're going to have more problems."

"It's not Jenny Craig—I'm not trying to make people look good," cautions Dr. George Kerlakian, a Cincinnati surgeon who has performed about 150 bypasses, including Brett Richards's. "I'm trying to control their diabetes, hypertension, sleep apnea, cardiac morbidity and cholesterol."

Because of these and other weight-related health problems, obesity remains the leading cause, after smoking, of preventable death. By opting for surgery, says Kerlakian, "you're taking an immediate risk—and hopefully improving your long-term survival."

LAURA LEE TURNER AFTER FOUR OPERATIONS, 'I'M VERY LUCKY TO EVEN BE HERE'

While pregnant with daughter Tawnya, now 10, Turner put on 64 lbs. With her son Bruce Jr., 8, she gained 72. At 243 lbs., says the Moyock, N.C., homemaker, "my back hurt, my knees hurt, I had no energy." After friends told her about their gastric-bypass surgeries, Turner, 37, sought the help of Dr. Robert Brewer in Virginia Beach, Va. Wanting to be thin and "able to do more with my kids," she underwent the operation in December '96.

In just a year the 5'8" Turner dropped to a rail-thin 98 lbs. "I was very tiny, looked hollow, and my hair came out in patches," says Turner, who by then needed a feeding tube to stay alive. A new doctor found bleeding ulcers and a hole where her stomach was stapled; two corrective surgeries also failed. While Turner was out with Tawnya in the fall of 1998, her feeding tube broke, she says, spilling the contents of her stomach onto her.

Her marriage suffered, and in September 2001 she and her husband, Bruce, divorced. She now lives with auto mechanic John Winall, 28, who saw her through a successful fourth surgery last July. Turner, who today weighs 126 lbs., won a $550,000 settlement from the hospital where her second and third surgeries took place. With skin hanging around her middle due to due to weight loss, she says, "I need a tummy tuck." But a fifth surgery isn't likely, she adds: "I'm scared of scalpels."

JESYCA MURPHY SHE LOST 112 LBS.—AND HER ARM

Thanks to gastric-bypass surgery, Murphy isn't obese anymore. Yet she still attracts unwanted attention from strangers. "Before, I thought everyone was thinking, 'There goes that fat chick,' " says Murphy, who at 5'5" once weighed in at 267 lbs. "Now they're staring at my arm."

That's because the part below her left elbow had to be amputated after a series of postsurgery infections resulted in gangrene. Murphy, 31, a teacher and cheerleading coach from White Lake, N.Y., who endured the nickname "Moose" in high school, signed up for gastric bypass after researching it on the Internet. "They had all these before-and-after pictures," she recalls. "I thought it was magic." But after her May 2002 surgery, she was jolted into reality by severe strep and staph infections in her left lung, which caused it to collapse, and in her abdomen, a particular risk for gastric-bypass patients. Six weeks later she lost her arm. "I can't believe I did this to myself," she says.

Claiming doctors did not sufficiently warn her of the potential risks, Murphy is considering a lawsuit. Meanwhile, coaching teens keeps her positive. "I tell them, 'Smile and fake it and eventually it'll become real,' " she says. "I'm hoping eventually I'll catch it myself."

LISA ROSS 'I'D GIVE ANYTHING TO BE MY OLD FAT SELF AGAIN'

Ross vowed to shed 100 lbs. from her 5'5", 240-lb. frame before donning a wedding gown. "I was happy with the way she looked," says her fiancé, Steve Mangold, 35, a machinist. "But she was set on losing weight." In April 1996 Ross signed up for a $30,000 gastric bypass performed by California surgeon Dr. Mathias Fobi—whose past patients include Roseanne—who gave Ross a "Fobi pouch," essentially wrapping an elastic band around her new small stomach to further slow the passage of food.

Ross, 36, once an active hiker, came out of the surgery a different person. Chronically nauseated, she started coughing up saliva and dropped to 97 lbs. by January 1997. Though she should have felt full after eating, "I felt absolutely starved," says Ross, who later had reconstructive surgery and the band removed. Ross received an $875,000 settlement after suing Fobi, but says the money can't replace what she has lost. Now 110 lbs., Ross has osteoporosis and is often too fatigued to leave the Long Beach, Calif., home she and Mangold share. Worse, doctors say she won't be able to sustain a pregnancy. In a grim, ironic twist the woman who once loved eating is now forced to eat all the time—every 20 minutes, all day. "I don't enjoy any of it," says Ross. "I'd rather be 600 lbs."

KATE PARSLEY TREATED 'LIKE CATTLE'

Just before her 39th birthday, Parsley promised herself she wouldn't start her 40s in an overweight body. In June 2002, after attending a Houston seminar with Dr. Ramesh Srungaram, the 5'8", 300-lb. Parsley scheduled a gastric bypass. "I wanted it," says Parsley, "and I wanted it quickly." But soon things were moving too fast. The day before she was to have the surgery, Parsley says, she received a call from the company that had sponsored the seminar, saying they wanted to operate that morning. She claims the hospital then hurried through her preoperative tests. "I just remember rushing, rushing," she says. "And there were others waiting to get the surgery after me."

Her recovery, however, turned out to be long and arduous. Right away, says Parsley, infectious fluid leaked from her intestines, damaging her lungs and making it difficult for her to breathe. After four more surgeries, says her mother, Anita, Parsley was given a 20 percent chance of survival. If not for nine doses of an experimental antibiotic (which cost $90,000), the single mom might not have come home to son Dakota, then 3.

Now suing Srungaram (who declined requests to comment), Parsley, a materials coordinator at a Houston oil company, has resumed most normal activities—except smoking, a habit she kicked in preparation for her surgery. "Someone at work asked me how I quit," says Parsley, now 200 lbs. "I told her, 'Girl, you don't want to do it the way I did!' "

Allison Adato, Galina Espinoza
Reported by: Giovanna Breu, Kimberly Brown, Susan Christian-Goulding, Mary Hart, Caroline Howard, Angela Koenig, Joy Sewing, Melody Simmons

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