For Carol Poe, obesity is the most painful problem in the world. She has tried everything to lose weight: from dieting to bariatric surgery, without success. Tired of being morbidly overweight, Poe volunteered for the most radical treatment ever devised for obesity -- brain surgery.
In March 2009, she became the second person in the United States to undergo deep brain stimulation, or DBS, for weight loss. In this experimental treatment, electricity is introduced to specific parts of the brain believed to control particular behaviors, in Poe's case, feelings of hunger and satisfaction.
Doctors inserted needles into "the part of my brain that controls the food," said Poe, 62, before her surgery last year. Doctors then threaded wires under her scalp, down each side of her clavicle, to a battery pack. Since the surgery, doctors have been experimenting with sending electrical voltages to her brain, attempting to find a setting that will help her lose weight. At 5 feet 4 inches, Poe, a married mother of two, said that at her heaviest she weighed about 490 pounds. When she underwent the surgery, she weighed 285 pounds.
In an exclusive report, Nightline was with Poe eighteen months ago when she underwent the procedure. Did it work? And is deep brain stimulation the answer to the obesity epidemic?
"When you're heavy and you walk down the street ? everybody looks at you and they're snickering and they're laughing," said Poe 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 targeted Poe's brain, rather than 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 Health Sciences Center 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, chief 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."
Only patients who've tried every other treatment, including bariatric surgery, qualify for the study. And all must undergo a detailed psychiatric evaluation.