'A Frontier of Medicine': Brain Surgery for Weight Loss

March 9, 2009— -- For Carol Poe, obesity is the most painful problem in the world. She tried everything from dieting to bariatric surgery to reduce her body weight. As these methods continued to fail, Poe, tired of being morbidly overweight, underwent the most radical treatment ever devised for obesity -- brain surgery.

Poe is the second person in the United States to undergo deep brain stimulation for weight loss. In deep brain stimulation, electricity is introduced to specific parts of the brain that are believed to control specific behaviors, in Poe's case, feelings of hunger and satisfaction.

"So what they're going to do is ... insert needles into the part of my brain that controls the food," Poe, 60, said before the surgery. "And then they'll put wires underneath my scalp, and it'll go down on each side of my clavicle, [where] I'll have a battery pack."

Now 5 feet 2 inches and 230 pounds, Poe, a married mother of two, said that at her heaviest she weighed about 490 pounds.

"When you're heavy and you walk down the street … everybody looks at you and they're snickering and they're laughing," she said at her home in Morgantown, W. Va. "When you go on an airplane and everybody looks to see if you're going to be able to sit in a seat … the weight has just taken over my life."

During the surgery, the team of doctors would target Poe's brain as opposed to her stomach.

"I've just known in my heart that there had to be something else. That there had to be something," she said before the procedure. "I've tried everything else. I've tried all the fad diets. I've tried liquid protein. I've tried Redux, Fen-Phen. I've had a stomach bypass. I've tried the Atkins diet. I've tried them all. And it's not coming off. So I really believe that it's got something to do with the brain."

Deep brain stimulation has already proved successful in the treatment of neurological conditions such as Parkinson's disease and epilepsy -- eliminating or reducing the tremors and ticks. Surgeons believe the procedure is effective in treating behavioral problems, such as obsessive compulsive disorder and depression, and now hold hopes about using it to fight obesity.

Neurosurgeons from West Virginia University Hospital are leading the way with a Food and Drug Administration approved study of deep brain stimulation for the treatment of obesity.

"This is not for overweight patients. It's for obese patients," said Dr. Julian Bailes, chairman of West Virginia University's department of neurosurgery, acknowledging that currently two-thirds of the American population is overweight. "Remember that obesity itself will reduce your life expectancy maybe 20 years. It's associated with many other diseases: diabetes, heart disease and others. So it's a real problem. ... We think our responsibility as physicians who maybe have a better understanding than most is to look at the potential and sort of the intervention of the brain."

Brain Surgery: 'Best Chance' for Some Obese People

Only patients who've tried every other treatment, including bariatric surgery, qualify for the study. And all must undergo a detailed psychiatric evaluation.

"She has a good profile," Bailes said of Poe. "She's failed the best surgery that we know of, which is gastric surgery. ... So I think it is the best chance for them, for her."

Skeptics may wonder if deep brain stimulation is a drastic medical treatment for a behavioral problem, but Bailes believes "there is a medical issue of obesity."