Health News

New Weight-Loss Surgery Gains Ground

Aug. 11, 2000 -- For those fighting obesity, the "Fobi Pouch" sounds like the greatest thing since (low-cal) sliced bread. The comedienne Roseanne swears by it. Inquiring minds want to know ... what is it?

The technique, developed by California surgeon Mathias A.L. Fobi, MD, is a modification of a procedure that's been around for decades: stomach bypass surgery. The basic premise is that your stomach gets smaller, you eat less, and so you lose weight. Fobi says that his version of the procedure keeps patients from regaining the weight, a complaint that many have had about the traditional surgery. Some who have had that surgery gain as much as 25% of their weight back.

Critics say they're not sure Fobi's technique is any better than the traditional type of stomach bypass. But don't tell that to Georgia Sarantapoulos, one of Fobi's office assistants. She had the surgery in 1992, when she weighed 315 pounds.

"I was 22 years old. I had been obese all my life, but between 19 and 22, it just crept up on me," she tells WebMD. "I went from size 18 to 26. Doing simple things, tying shoes, making the bed, I had to stop and take a breath," she remembers. "My little sister loved to go to the mall, she always wanted to go, but I was always so embarrassed to see my image. ... There are all those mirrors. ...It was very, very depressing to me."

She tried diets like Jenny Craig and Weight Watchers, as well as diet shots and water pills, even hypnotherapy: "I would lose maybe five or 10 pounds, no big deal." When she heard about the Fobi surgery on TV, Georgia was sure it was her answer. "I wanted the procedure, I wanted to take care of the problem," she says emphatically. "But my parents said, 'Oh, no, it's too drastic.' The family doctor was totally against it. I said, 'I don't care.'"

Indeed, any kind of stomach bypass surgery has risks, and it remains a controversial method of losing weight. But the Fobi procedure worked for Georgia. She lost more than 150 pounds, and today she's still at her new weight of 165 pounds -- give or take 10 pounds, depending on whether she's been exercising or not.

Says Fobi: "It's the best obesity operation that exists, and I'm not blowing my trumpet. I've been doing obesity surgery since 1977. The [stomach] bypass procedure is a very good procedure but it has some shortcomings. With the Fobi pouch, I have corrected those shortcomings."

Here are the details:

• In a traditional stomach bypass procedure, surgeons create a smaller stomach by stapling off a large section. The new stomach is called the "stomach pouch" because of its tiny size (about a heaping tablespoon), Fobi explains. When food is eaten, whatever doesn't fit into the pouch bypasses the upper part of the intestines, and thus cannot be absorbed into the body. Excess food goes straight through the gastrointestinal system and is eliminated.
• A problem with the traditional procedure is that the staples can break down, causing the stomach to regain its original shape -- and patients to start gaining weight again. Also, the stomach opening that leads into the intestines, which in surgery is made smaller to allow less food to pass through, often stretches as the years go by.
• With his technique, Fobi has eliminated the staples; he cuts the stomach into two parts, then hand-sews them to maintain the separation. He also adds a synthetic band around the stomach opening, to keep it from stretching.