In An Endless Quest to Slim Down, Image-Obsessed Americans Try Surgery, Pills and Starvation—Sometimes with Fatal Results
In his sprawling La Habra, Calif., home Ruben Fernandez is surrounded by reminders of his late wife, Judy, especially the furnishings she traveled widely to buy—Spanish statues, a grand piano, crystal chandeliers, Oriental rugs. "Everywhere you look, you'll see detail," says Fernandez. "She wanted everything to be right." That included her figure. At 47, the mother of three decided it was time for lipoplasty, commonly called liposuction, a procedure that siphons fat from strategic areas. "She had gained a few pounds," recalls Fernandez, now also 47. "She was just looking, let's say, for maintenance."
Instead, on March 17, 1997, Judy Fernandez died following extensive cosmetic surgery, a casualty of the all-too-common pursuit of the perfect body. "The premium for women on physical beauty over intelligence is on the order of 100 to 1," psychologist Dr. Rex Beaber says bluntly. "A woman with an IQ of 180 who is not lovely is likely to marry ugly, be paid modestly well and secretly despise herself until the day she dies. A woman with an IQ of 100 and beauty in the 99th percentile is likely to marry a physician or an investment banker, have a maid and be admired by all her neighbors." Strong words—however, according to the American Society of Plastic Surgeons, their board-certified members treated more than 1 million Americans last year. Liposuction was by far the most popular surgery: More than 230,000 procedures were performed, almost 30,000 of them on men, a 350 percent rise since 1992.
And therein lies a cautionary tale, for Judy Fernandez was no fluke. A 1998 study showed that over the previous four years the fatality rate for liposuctions was one in 5,000. "To put it in perspective, the incidence of death from liposuction is two to three times higher than that of dying from a normal pregnancy," says Dr. Robert del Junco, former president of the California State Medical Board. "Liposuction is the only cosmetic surgery with this level of risk." Most fatalities occur in doctors' offices or unaccredited outpatient clinics, which are not held to the same standards as hospitals, and are generally caused by blood-clotting, complications from anesthesia or errors by practitioners who may be doing cosmetic surgery only as a lucrative sideline.
Indeed, in many states a medical license entitles a doctor to practice any kind of medicine. "Can a psychiatrist take a weekend course and on Monday start doing cosmetic surgery?" asks del Junco, who helped spearhead efforts in California to tighten regulations on outpatient procedures. "The answer is yes."
Of course liposuction is but one potentially fatal manifestation of the cult of thin. According to the National Association of Anorexia Nervosa and Associated Disorders, roughly 7 million American girls and women and 1 million boys and men struggle with eating disorders. The mortality rate from anorexia—estimated between 10 and 20 percent—is the highest of any mental disorder. Plus, there are diet pills that offer another supposedly quick and easy way to lose weight. In August a federal judge approved a $3.75 billion settlement of claims stemming from 9,000 lawsuits against American Home Products, the maker of fenfluramine, part of the diet drug fen-phen, which was pulled from the market in 1997 after a study linked it to heart-valve damage.
In addition, the U.S. Food and Drug Administration is studying the herbal supplement ephedra, a stimulant used for weight loss that some studies have tied to strokes and heart attacks. (In 1994 Congress rendered the FDA essentially powerless to regulate herbal supplements unless the agency conclusively proves them dangerous.)
Horror stories notwithstanding, it is unlikely that Americans will renounce their desire to look good in a bathing suit. "Whenever human beings weigh the risks of something that might give them happiness," says Beaber, "they tend to ignore the risk." On the following pages are the stories of six people who, like so many, were consumed by the battle to lose weight. Three sought help from liposuction, two took pills, one starved herself—and all paid with their lives.
JUDY FERNANDEZ
'The easy way' proved to be deadly
When Cuban émigré Ruben Fernandez met Judy Blum in 1981, he fell fast and hard. "If you look at any of the pictures, it's the smile," he says. "She was just a very bubbly, lighthearted personality. She looked at life through undamaged eyes." Both divorced, with five children between them, the couple lived together for three years, then married in 1984 and built a thriving business refurbishing and reselling electric forklifts. Life was good. Still, at 47, Judy didn't like the signs of age she was seeing in herself. There were more and more new wrinkles, and at just 5'3", she weighed 147 lbs., about 30 more than when she'd met Ruben.
Then she saw a magazine ad for board-certified Irvine, Calif., plastic surgeon Dr. William Earle Matory Jr. "She liked the ad and then the people in his office, who were very friendly," recalls her husband. Judy put down $20,000 and signed up for a face-lift, brow lift and liposuction to her stomach, back, arms and legs.
"Why don't you just go to the gym?" Ruben asked. But Judy was comfortable with cosmetic surgery, having had her breasts enlarged years before. "This is the easy way," she replied. And so at 5:45 a.m. on March 17, 1997, they arrived at Matory's office. Ruben was concerned about the extent of the surgery but says that anesthesiologist Dr. Robert Hoo assured him, "Don't worry, it's within the ballpark." Just before 7, Ruben kissed his wife and left for work. "Honey," she said, "next time you'll see the new me."
As the day wore on, Ruben called several times to check on Judy, and each time, he says, he was told everything was going well. Only later would he learn through medical records that as early as 9 a.m. her blood pressure had dropped sharply. By afternoon her kidneys had shut down. At 5:30 Ruben, having been told Judy was in recovery, arrived to pick her up. An hour later Matory came out. "He looked at me very calmly, very peacefully and said, 'Ruben, the operation was a success. I just have a little concern about volume.' " Judy's blood had been dangerously diluted with several kinds of fluids.
At 8 that evening, Matory said they needed to take her to a hospital, at which point Ruben burst into the operating room and received a horrific shock. "She was dripping fluids from various parts of her body," he says. "She was swollen to about twice her normal size. She was a see-through color, the color of death."
At 10:20 p.m., Matory walked out of the ER at Irvine Medical Center, hands over his face. "Sorry," he told Ruben, "but we lost her." Judy's cardiovascular system had shut down—a consequence, according to medical records, of massive blood loss. Immediately Ruben filed a complaint with the state medical board, which investigated the case and in November 1997 revoked Matory's and Hoo's licenses. Ruben also settled a civil suit with the two doctors for an undisclosed sum. Matory's attorney Lloyd Charton calls his client "a victim," noting that Matory was not the one responsible for monitoring Judy's vital signs. "Should Hoo have spoken up? Absolutely," says Deputy Attorney General Steven Zeigen, who helped prosecute the doctors for the medical board. "But should Matory have said, 'By the way, how much fluid have you put in? We've been doing this for 12 hours'? Damn right."
Today, Ruben Fernandez keeps a gold-framed photo of Judy on his bedroom wall, a constant reminder of the brilliant smile that he will cherish for the rest of his life. "I don't know about that word a lot of people use, 'closure,' " he says. "If someone was part of your life, how do you close it? She'll still be part of me. It's just that I'll carry her in a different spot."
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