Surgeon Dr. Mal Fobi revolutionizes weight-loss surgery with ‘Fobi-Pouch Operation for Obesity’ – Medicine
Margena A. Christian
“American Idol” TV fans will see a new judge when they tune in for its third season in January. Randy Jackson, the bulky critic of the three arbitrators, will be more than 50 pounds slimmer!
He has Dr. Mathias A.L. (Mal) Fobi to thank. As one of Fobi’s patients, several months ago Jackson underwent the doctor’s innovative gastric bypass procedure, the Fobi-Pouch Operation for Obesity.
Jackson isn’t alone. Tony Award-winning singer-actress Jennifer Holliday, former “Family Matters” TV star JoMarie Payton, legendary gospel siblings Andrae and Sandra Crouch, blues diva Etta James and acclaimed comedian-actress Roseanne Barr have all slayed their battle of the bulge after each received the Fobi Pouch.
His list of famous clients has earned him the title “surgeon of the stars.”
“I’ve done my share of celebrities,” he chuckles during an interview with JET. “I don’t want to be arrogant, but I popularized obesity surgery in America. For awhile it was not accepted. Because of my work it was well accepted in the media when I did Jennifer Holliday in 1989. Others later went public after I did the surgery. That’s what brought the notoriety.”
Fobi is one of the nation’s leading obesity surgeons. He is the medical director of the Center For Surgical Treatment of Obesity in Hawaiian Gardens, CA.
A board-certified general and bariatric surgeon, Fobi’s contributions to the field of obesity has led to numerous technological advances in bariatric surgery, including the development of his inventive Fobi Pouch.
Surgery for obesity is not new. What Fobi did was make three modifications to an operation that is a little more than 100 years old.
His procedure involves dividing the stomach in two and then reattaching it in different areas. A small stomach pouch is created, which will hold about 1 ounce of food instead of the 50 to 80 ounces normally contained in the stomach. This limits the person’s food intake.
“I cut the stomach in two. Before that time, stapling the stomach to divide was used,” he says. “But staples can open. I introduced the band since the stomach would stretch. The band protects you if your stomach stretches. I also put a marker in the stomach so doctors could find it by X-ray. If you don’t put a marker there, you would never be able to check that stomach again. Those three things make the Fobi Pouch unique.”
He says that “most doctors have adopted the first change. Forty percent are using the band and 30 percent are using the marker. Things are catching’ on gradually. Most are using my protocol of treatment.”
The surgery normally takes 2 hours to perform, depending upon the patient and his or her condition. It restricts the amount of food a person can eat. So the control is taken out of the patient’s hands, he says.
“You feel fuller and your body lives on extra energy that you stored as fat over the years. You don’t have to worry about calories. I tell patients that since the quantity that you’ll eat is so small, try to eat a nutritious, well-balanced diet. You have to work with a multidiscipline routine.”
Since formally opening its doors in 1981, the Center For Surgical Treatment of Obesity has treated more than 8,000 patients. Three surgeons work in his group. They total 500 procedures a year.
Obesity is a medical condition, Fobi reiterates. He says that it’s not a cosmetic condition and that the Fobi Pouch shouldn’t be viewed as a “quick fix” by onlookers.
“When you’re overweight and having surgery, it puts you at a greater risk. There is a 1 percent instance of death from complications. No one will take a 1 percent chance to die. Nonsurgical weight loss results in 98 percent failure. Patients gain more weight. Very few people who come to us will not tell you 10 things they haven’t done.”
Patients lose weight and sacrifice important nutrients as well, he says. “You’re being deprived of vitamin B 12, Thiamine, vitamin A,D,E, iron and calcium. You have to take these supplements and be monitored by the doctor to get those supplements.”
And, regaining some weight after the surgery is “always a possibility,” Fobi says.
“Surgery is effective if used as directed. You’re free to eat whatever you want, but you must eat only three times a day. When you eat three times a day, you feel full. Don’t nibble. Increase activity level in terms of exercise. Attend support groups. You must be reminded that you have a different genetic makeup. Don’t mix with people who eat all day long. Get regular checkups.”
It was never Fobi’s intention to work in this area of medicine. The native of Cameroon, Africa, had his sights set on a surgical career in trauma and oncology. He calls it “serendipity” when his life was changed in 1977.
Fobi met a 39-year-old woman who was dying of complications from an intestinal bypass surgery when he taught at the King/Drew Medical Center in Los Angeles. Doctors recommended that the once 349-pound woman reverse the surgery, which would mean a certain weight regain. Fobi says the woman would have rather died than to go back to being fat.
“She said that the only person who knew she was that way was the doctor,” he explains. “She said the rest of the world accepted her as a human being. She had a job, could date and no one stared at her. When she was fat, she didn’t have any of that. She made me appreciate that fat was not only medical and dangerous, but it also had a lot of psycho-social economic problems.”
That same year he offered to help the woman by not reversing the surgery and instead doing gastric bypass surgery. It was a success.
“She maintained her weight loss at a predominantly Black hospital,” he recalls of his Caucasian patient.
Fobi says that the same year a long line of White women who had this intestinal bypass surgery in the ’60s and ’70s were coming to see him because they had many complication. Big medical centers told them they had to reverse the intestinal bypass surgery, but they found out that he could give them another operation. One where they could maintain their weight.
“By 1980 I was being flooded with so much demand, I quit academic practice and went into private practice,” he says. “I had so many people waiting in line for this surgery. No one on the West Coast was doing this.”
Today he travels the world to address the global epidemic of obesity. His lectures have included countries such as Israel, Brazil, Venezuela, Mexico and Saudi Arabia.
The average age of his patient is 41; the youngest patient he’s ever performed the modified procedure on was a 13-year-old girl who weighed 347 pounds and was 5 feet 6 inches tall. Sixty-six percent of Fobi’s patients are Caucasians. A little more than 25 percent are African-American, 7 to 9 percent are Latino, and 2 percent are Asian-American.
“In the U.S. obesity affects more African-Americans than any other race. Most might be limited to coming because of the accessibility of care in terms of health coverage,” says Fobi, who reveals that many of his patients pay out of their pocket. The cost is between $35,000-$40,000 for the operation and its follow-up care.
Fobi would like to see more Blacks in this area of medicine, especially since Blacks have a higher rate of obesity. He recalls that years ago he was the only Black for about four or five years when he used to go to conventions.
When he went to a meeting in June, he says there were about 22,000 surgeons doing this work. Still, only 1 percent was Black. “In the ’80s there were about 60 (bariatric surgeons) in America. There is still a small number of African-Americans. It’s kind of disappointing. There are only about 25 or 26. It’s something I’m working on.”
COPYRIGHT 2003 Johnson Publishing Co.
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