After decades of unsuccessful dieting, TV presenter Jay Hunt, 44, opted for a radical gastric bypass. One year on she has lost more than five stone and gone from a size 22 to a 12-14. But her journey into ‘thin world’ was far from easy, as her diary reveals...
30 JUNE 2008 17 stone 8lb
Tonight is the London premiere of the Mamma Mia! film. My best friend Judy Craymer is the producer, so I’m going along to support her, yet all I can think about is how fat I’ll look on such a big night out. My outfit is a Lanvin black silk dress that, if worn without the belt, hides my huge stomach well, and I’m teaming it with chunky Prada wedges that should narrow my lower leg. I’m taking an oversized Balenciaga clutch, as big accessories are supposed to make body parts look smaller, but even after all that spending and fat-disguising I don’t feel great when I look in the mirror…in fact, I feel wretched.
Leicester Square has gone Greek and hordes of people are clamouring for a glimpse of Meryl Streep, Pierce Brosnan and the Abba boys. I clamour to see if there are any other fat people on the red carpet (there aren’t). Keely Shaye Smith manages to pull off her voluptuousness in a sex-kitten way, and judging by the way her husband Pierce looks at her all night he clearly adores her curves. Why can’t I ever feel that extra weight equals extra sexiness?
Wherever I go, whoever is there, whatever the occasion, fat finds its own sinister way of ruining my life. I am convinced of two things: a) Judy has a mega hit on her hands, b) I am definitely going to pursue weight-loss surgery.
Having spent over 30 years trying to hide my weight, today is different. I want bariatric surgeon Shaw Somers not just to acknowledge my fat, but to be positively alarmed by it. I want to be fat enough to be in his club – fat enough for him to help me. My body mass index (BMI) is 35. I feel overwhelmed by my weight problem, and angry when friends say I am just big boned. Are they blind?
To prove a point, I wear a Dries Van Noten dress that I’m bursting out of. Nervously I approach his Harley Street clinic. This Dr McDreamy is a gentle, quietly spoken man who calls my name and ushers me towards his very large sofa. Then he asks me the one question I just can’t answer - why exactly am I so fat?
This seemingly obvious question is so simple yet so overwhelming. I feel emotional and extremely vulnerable as he takes notes - notes on me being a fat child, notes on my being adopted and having a different body shape to my non-biological family, notes on my teenage torment about being fat (looking back I wasn’t doing too badly, but why did nobody tell me then?), notes on my unhappy 20s spent angrily overeating, my 30s when I lost five stone after a break-up and therapy, and my diagnosis of hypothyroidism (just like Oprah).
More notes on how I get fatter every year, on diets I have done, money I have spent buying weight-loss drugs Xenical and Reductil on the web, on Harley Street doctors who have injected me with vitamin B12 to help with weight loss, nutritionists I have met and cash wasted on colonics and metabolic potions.
The changes will affect how and what I eat for the rest of my life
It’s a quiet conversation - no nurses, no assistants, no scales and no easurements. Just an assurance that this empathetic, slim stranger believes me. He respectfully acknowledges the efforts I have made and then tells me that he is going to help.
I sit crying as he talks in a whole new language of absolutes. No mention of willpower or deprivation, no discussions of food groups and blood types. For me he advises the
non-reversible bypass, because among other things I have a sweet tooth. Unlike the gastric band (which can be reversed) the bypass makes most people feel sick if they eat sugar or too many carbs, as the body can no longer tolerate them.
He guarantees around five stone will be gone in a year, getting me into the ‘normal’ weight bracket for a woman of my height (5ft 10), between 10 stone 7lb and 12 stone 7lb. But, he says, I need to realise that I’m putting myself at risk on his operating table because I’m incapable of managing my own weight problem.
Am I? It’s the million-dollar question. He makes sure that I’m aware that the changes he will make are permanent and will affect how and what I eat for the rest of my life. I have no doubts as I don’t feel there are any other options. I look at slim women and feel angry that I have to go through all of this to have a body that they seem to take for granted. I am booked into the Clementine Churchill Hospital, Harrow, on 5 August.
I have a consultation with Hala El-Shafie, the bariatric dietician from the Harley Nutrition Clinic who comes as part of the package. She tells me that I am going to have to go on my last ever diet for a week before my operation.A diet!
She explains that my liver needs to be reduced as much as possible as it sits over the bits of me Shaw needs to get to, and that unless I stick to the pre-surgery diet they cannot operate. I will be on holiday so I call the beach lodge about my eating requirements. I stress that I’m not some faddy size 10 worried about a few carbs spoiling my figure - this is a serious pre-surgery requirement.
I have told my partner Margot, Judy, my friend Claudia Winkleman and three other friends about my surgery. I don’t have the energy to tell anyone else.
5 AUGUST 17 stone 2lb
I arrive at the hospital, pay £10,950 and sign the consent form. Margot looks very worried as I’m wheeled to the operating room. I feel excited, like a child on Christmas Eve.
When I come round two hours later I’m on a drip, with a tube in my nose and a drain coming out of my side. My abdomen is sore from where they have ‘stapled’ the top part of my stomach and re-routed the intestine to my new ‘egg-sized’ stomach.
I have five small incisions which have dressings on and about three stitches in each one. My mouth is parched but I have to wait until the next morning for my first tiny 10ml drink of still water. I’m not hungry - not anything really, just enjoying the fact that the fat police in my head have been silenced.
After three days living on consommé, sugar-free jelly and water, I am ready to go home. I have a booklet from Hala to guide me through my postoperative eating plan. I can’t eat anything solid while my stomach and intestinal tract heal: just nourishing liquids for the first two weeks (mostly milk-based), then purées (ie, smooth yoghurts and soups).
Some women tell me I’ve chosen ‘the easy route’ or feel threatened by my getting thinner
Then I can move up to mashed food, then soft food, and after six months it’s normal food again, hurrah! But all in tiny portions. I probably won’t be able to tolerate sugar as my restructured intestines can’t deal with a big hit of it (Shaw calls it ‘dumping syndrome’) and my tiny stomach may have problems with bulky foods such as pasta, meat and bread. Everything I eat right now has to count nutritionally.
I am given vitamin recommendations and will need to take supplements for life and have regular blood tests to check I’m getting all the nutrients I need. Hala reminds me to sip two litres of still water a day, to start doing some walking, and to call her if I am in trouble.
Home. Claudia brings her children to visit and a tall Starbucks. I drink half and am full. Margot has coq au vin for supper; I have a mug of the gravy and two teaspoons of yoghurt, which feels like a lot. I spend my first week sucking apple and mango sugar-free lollies. Margot is a brilliant nurse and serves up gravy or consommé suppers with egg custard or jelly for pudding.
Hala calls to ask if I have been to the loo (I have!). I tell her drinking is hard. Sipping my two litres has become a full day’s work. Gulping is now off-limits as my body can’t – and never will be able to – cope with that much volume.
I tell Hala I have ‘head hunger’, which she says is normal. I see food on TV and long for it. I dream of Sunday roasts and fish and chips. Hala says this can last for 12 weeks (mine, luckily, lasts only four).
September 15 stone 12lb
I write a goal list:
- Buy designer jeans from Donna Ida
- Take up riding again
- Feel confident in a swimsuit
Don’t let the food police come back.
I finally weigh myself. I’m so programmed to fail at dieting that I can’t believe I’ve lost 16lb. I cry with relief. Spend hours rubbing Bio Oil into my stomach in the (vain, as it turns out) attempt to avoid loose skin later on.
I go to the supermarket and feel overwhelmed by so much food around me, most of which I can’t eat. I’ve moved on from liquids to scrambled egg, and am pureéing shepherd’s pie and cauliflower cheese in child-size portions, but it’s enough. I am really tired and after a trip to town am in bed by 6pm. I’m surprised by how much
the operation has taken it out of me, plus eating so little means I tire easily.
I tell more people about the surgery. One friend asks whether a band would not have been a less drastic option (possibly, but I took the advice of my surgeon), and another I have known since I was 18 sends me a strongly worded text to tell me she is shocked to the core that I have had surgery.
I ask why she feels so negative about such a positive change in my life and she does not answer. It’s confusing as she has seen me struggle over the years. It’s my first experience of an unsupportive friend. Hala says it’s normal for others to have strong reactions. I realise why Fern Britton kept quiet about her gastric band.
OCTOBER 14 stone 10lb
Go to Los Angeles and enter a restaurant for the first time in months. I can now eat soft foods if I’m careful and chew them a lot. I survive on sushi and egg-white omelettes. In the land of the size zeros, I still feel fat. I buy a cardigan in medium not large from Fred Segal - a great moment. Some women tell me I have chosen ‘the easy route’ by having a bypass, and others feel threatened by my getting thinner. My theory is that women are supportive until you get to their dress size, then it’s war. My close circle remain resolutely positive and I thank God for them.
NOVEMBER 14 stone
At my three-month check-up, everything is on course. My scars have healed, I have the energy to work out and I have not had problems with meat or foods such as bread and chocolate that some people find intolerable after surgery. I moan to Shaw and Hala about the multivitamin and calcium tablets I will have to take for the rest of my life. They seem so big and when you can’t gulp them with a large mouthful of water it hurts. New favourite soft foods are Nigella low-fat stews and thick vegetable soups. Trying to eat slowly to avoid overloading my system, but it’s hard for a lifelong fast eater.
I am starting to do my treadmill routine again, as exercise helps with the weight loss, and to try to tone up my skin, which is in danger of going saggy. My old gym kit is gratifyingly baggy, though.
DECEMBER 13 stone 10lb
My hair is falling out and it’s quite drastic. Shaw warned me that the body can shut down nonessential functions when you can’t get enough food into it in the early months, but I never thought it would happen to me.
Christmas drinks bring out questions. I get asked how Margot (size 12) will cope if I get thinner than her, whether our relationship will survive post-surgery (many don’t) and whether I am about to transfer my food addiction to alcohol. I’ve been teetotal all my life and it’s just not me to want a vodka and tonic at 11am.
A fat friend shares her fears that she is losing me, but I reassure her I don’t feel different even if I look it. I wear a DKNY size 16 dress on Christmas Eve and my appearance is talked about openly. Everyone has a view on how I look. Being the centre of this kind of attention is quite unpleasant.
JANUARY 2009 13 stone 7lb
For the first time in 30 years I don’t start the new year on a diet. I am in such a wonderful head place compared to the dark years of fat misery.
Cheryl Cole is in Vogue saying how depressed she was wearing size 29 jeans and I realise it’s all relative. In Selfridges I spot a size 14 suit in the Chanel sale. I try it on for a laugh and nearly die when it fits. I know Liz Hurley thinks being above a size ten is obscene, but this sale purchase is one of the best moments of my life. Suddenly dull old January is a joyous month.
FEBRUARY 13 stone 2lb
Doing more running, which I hate but my stomach and hips are still hefty. Margot says it is like living with a different person in that I am much less angry. My hunger has come back but this is all so easy compared to life on endless diets. I eat what I want now but I just eat about a third of what I used to and then magically I am completely full.
I give up chocolate for Lent as it has been creeping back into my diet. I’m unusual in that I haven’t had a twinge of sugar-induced nausea for quite a while. I am one of the ‘lucky’ ones who can still jam in a Galaxy Ripple, but I mustn’t get complacent - Hala explains that the weight can easily go back on and that my lack of symptoms from ‘dumping syndrome’ could be disastrous!
MARCH 12 stone 10lb
The weather is better, so tried running outside and hated it. Felt the fattest person in Battersea Park and I just feel furious I have to do all this and my body is still fatter than people who, from where I’m standing, do no exercise. From now on, I am only going to run indoors on my treadmill watching Grey’s Anatomy.
APRIL 12 stone 7lb
Tried on some old clothes and many don’t fit. I found it really freaky to have to say goodbye to some wardrobe staples - a great Marni black jacket, the Lanvin ‘fat’ dress, a Thomas Wylde maxi dress. I am mourning the old ‘fat’ me. Being thinner makes me feel more vulnerable. My fat was a protective layer against so many things and now it’s gone I feel naked.
MAY 12 stone 7lb
I haven’t lost anything in a month, and feel fine about it. Hala says it’s normal. She says after 18 months, the window of opportunity to lose weight goes as your body gets used to its new bypassed system, so I must keep on track. The hairdresser says my hair is starting to grow back - hurrah.
JUNE 12 stone 5lb
Margot and I book a holiday and I look forward to it for a change. I try on bikinis and although I still look like a fatty bon bon in the tummy department, I don’t look obese. The sales assistant in Harvey Nicks tells me they don’t do large sizes when I ask her for a size 14. I ask her what she thinks is normal - an 8, a 4 or even size 0? I tell her I have had surgery and to be size 14 feels normal and she needs to rethink her sales patter. Leave feeling glad I gave her an earful.
JULY 12 stone 2lb
Packing for holiday is so easy at this size. A couple of bikinis, cut-off denim shorts and T-shirts and a few dresses and I am done. All those years putting outfits together to hide my fat were hard work, and I love having a simple capsule wardrobe. I think people have been surprised that I don’t want to go on mad new wardrobe sprees, but it feels liberating having less weight and fewer clothes. I realise how expensive it was being fat and always having to find things to feel good in.
AUGUST 12 stone
A year on and five stone two down - Shaw was right. I have my final consultation and feel tearful. This time I cry with gratitude about my weight and the fact that I’ve got my head straight about food. I get the feeling Shaw has seen this all before.
I know this surgery is a tool and I will always have to keep an eye on what I eat. For the first time in my life, I feel in control of food, rather than it controlling me, and I don’t feel like I’m on any kind of diet.
In the past year I’ve seen how some women find weight loss, and indeed new-found happiness, in others extremely threatening. It has also made me value my friends for their positivity about my life change and made me realise that living in ‘thin world’ for the first time ever is just as wonderful as I ever thought it would be.
GASTRIC FACT FILE
Shaw Somers is consultant surgeon at Portsmouth Hospitals NHS Trust and co-founder of Streamline Surgical, which specialises in obesity surgery (streamline-surgical.com). Here he explains the gastric bypass procedure.
What is a gastric bypass?
An egg-sized pouch is created by stapling the upper part of the stomach. Food is diverted through this into the small intestine where digestion begins. The keyhole surgery takes 1½ hours. About six half-inch cuts are made around the upper tummy. Patients usually go home after two to three days; recovery may take two weeks. Surgery is available on the NHS but criteria may vary depending on where you live. Private surgery costs from £10,000.
How is it different to a gastric band?
A gastric band (costing around £7,000) also restricts how much you eat by placing a band around the upper stomach, turning it into an hourglass shape. Food is held in the upper section and passes slowly into the stomach, making you feel full for longer. Unlike a bypass, which suppresses the ‘hunger hormone’ ghrelin, a band doesn’t significantly alter your appetite.
Who is a gastric bypass right for?
Patients with a BMI of 35 or more, who are at least 18 and may have obesity-related medical problems such as Type 2 diabetes. After age 60 recovery can be harder. The average weight of my patients is 140kg (22 stone), and most can lose 75 per cent of their extra weight.
What can you eat after surgery?
Most patients start off on a three- to six-month dietary rehab eating soft foods. The swelling at the new ‘join’ where the intestine is attached to the now smaller stomach has to reduce. After six months most people can eat normal food, but feel full after smaller amounts. Eating too much or eating tough or lumpy food (eg, bread, cold meats) may lead to bloating or sickness. Patients often experience ‘dumping syndrome’ - sickness with symptoms including shivering - when sugar hits the intestine, which then can’t cope with it.
It’s essential to see a specialist bariatric dietician for nutritional advice before and after surgery to limit potential side effects. Alcohol is not banned, but as it is absorbed into the bloodstream more rapidly it is more potent.
How long do the effects last?
Patients will always eat small portions but as the years pass the effects are less drastic, allowing weight loss to stabilise just above ideal weight. A bypass is not a ‘quick fix’ and weight gain can recur if lifestyle changes such as exercise and eating sensibly are not adhered to.