Dying to Be Thin

Like other "super morbidly obese" people, Marc Patterson would do almost anything to slim down

At five feet, eight inches tall, Marc Patterson weighed 570 pounds, more than 3 1/2 times his recommended weight. The 46-year-old Fort Myers man could not fit his morbidly obese frame into a midsize car or standard plus-size clothing. He could not browse through a bookstore without the ridicule of those openly scornful of his appearance.

Patterson was, by his friends' accounts, battered by employment discrimination, public humiliation, and physical exhaustion from the gravity of his own body mass.

But he thought he had found the path to a new life through surgical weight reduction.

His friend of 15 years, Michael Pineau, 41, of Fort Myers, remembers the drive last December across Alligator Alley to Holy Cross Hospital in Fort Lauderdale. Pineau had to rent a large Buick Fifth Avenue to accommodate Patterson's girth.

"I slapped him on his belly and said, 'This is our journey, and when you return to the other side, you're going to be a whole different man,'" Pineau recalls. Patterson had been planning the surgery for more than a year, but Pineau wasn't apprehensive about the risks until that trip. "There was a 1 percent risk factor. What if he was the 1 percent? Is the risk worth it?"

Just three days after undergoing Roux-en-Y stomach bypass surgery on December 6, 2002, Patterson died from complications in the intensive care unit at Holy Cross. His case sheds light on the lonely humiliating struggle against obesity, which is often viewed as a character failure rather than a disease.

As the nation watches celebrities such as weatherman Al Roker, singer Carni Wilson, and actress Roseanne seemingly melt away after undergoing surgeries to transform stomachs into tiny pouches, how many Americans hoping for a quick fix end up, literally, dying to be thin? According to the International Bariatric Surgery Registry, the death rate within a month of surgical treatment for obesity is actually only 0.3 percent, or three of every 1,000 patients (about average for major surgeries). Most of these deaths are caused by pulmonary embolism, respiratory failure, or gastrointestinal leakage.

Risky or not, the Journal of the American Medical Association reports that the market for bariatric surgery, which aggressively changes eating patterns by reducing the capacity of the stomach to about 1/8 of a cup, is huge: an estimated 6 million morbidly obese people in the United States. According to the American Society for Bariatric Surgery in Gainesville, about 103,200 bariatric surgeries will be performed this year, a disproportionate number of them in this state. Executive Director Georgann Mallory says roughly 6,600 will be performed in Florida, where 55 of the society's 860 active surgeon members reside. Statistically, 18 of those Florida patients will die.

One such surgeon, Samuel Cox, points out that the stomach bypass he performed on Patterson -- and about 100 other people last year -- is not a simple cosmetic procedure. He said his patients are counseled in detail about the risks and the required permanent lifestyle changes. "It's entirely devoted to providing for the patient's health," he says. "It's a major commitment on their part. Many, many health problems are corrected as byproducts of the surgery -- diabetes, hypertension, joint wear, sleep apnea, asthma."

In addition to orientation programs, Patterson had to undergo a battery of tests from cardiologists, pulmonologists, psychologists, and more, all of whom recommended the surgery. Cox said Patterson, who consumed four gallons of Coke a day, had a higher potential for death even without the surgery because he was "super morbidly obese," meaning more than 200 pounds overweight.

Despite Pineau's apprehension, Patterson was not put off by the possible complications, including leakage, ruptures, and organ failure. The morbidly obese "look at a piece of paper, and all they see is the reflection of what they want to become," Pineau says. "He was excited and nervous. He said, 'Can you imagine me at 180 pounds?'"

But that moment of triumph was not destined to be.

Immediately after the surgery, Pineau says, Patterson actually felt more discomfort from his long-time back pain from a car accident than from his stapled stomach. "He went from the bed to a chair," Pineau says. "His back pain was so severe he was ready to go out of his mind. So they had to move him back into the bed. It took four to five very strong men to move him."

Patterson was given more pain medication, and soon after, doctors were concerned about his dropping blood pressure and kidney failure. By midafternoon of the second day, Patterson was on dialysis, his blood pressure continued to drop, and he developed a fever. He stabilized enough on the third day to go back into surgery to deal with leakage and infection from intestinal contents spilled into his abdomen.

"He came out of surgery and was recovering," Pineau says. "Three or four hours after surgery is when -- it was a spooky thing -- I was in the family waiting room. I knew I needed to give him time to come through. I walked up, and just as I pushed the big button and the doors started to open, the monitors went off. It was code blue. It was like a movie."

After doctors tried for more than 20 minutes to revive Patterson, he died from cardiac arrest. He had developed one of the most common complications from the procedure: a rupture.

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