When Gemma Long was almost 20 stones she feared that she wouldn’t live to see her daughter grow up. Today she is nine-and-a-half stones after undergoing a gastric by-pass operation, has a second daughter and a new, dramatically different, life. HILARIE STELFOX reports
YOUNG MUM Gemma Long is so petite that it’s difficult to imagine her as someone who once weighed an astonishing 19st 11lbs.
But just five years ago her body mass index was over 50 (up to 25 is normal and 30 is considered obese) and she wore size 28 clothes.
Today she is a tiny size 8.
However, her journey from morbidly obese to slender has been long, at times painful, and far from simple.
Gemma, 26, who lives in Mirfield, is one of the growing number of British people opting for what is known as bariatric surgery – gastric banding and gastric by-pass–- to beat their chronic weight problems.
According to endocrinologist Dr Chinnadorai Rajeswaran, who has a special interest in obesity, there has been a dramatic rise in such patients during the past five years.
He runs NHS obesity clinics for the mid-Yorkshire region, which includes Dewsbury and Huddersfield, and is chairman of the National Diabesity Forum that tackles issues surrounding obesity and associated diabetes.
“Obesity,” he says, “is putting a big burden on our resources. It also causes lost man hours in industry with associated back pain, depression and the problems of diabetes. We are not far behind America.”
However, Dr Rajeswaran believes that the problem should be approached sympathetically. “We should not criticise,” he says. “We should help everyone. People know that they should eat less and exercise more, they are not stupid. But the problem for health care professionals is to understand why someone is overeating in the first place.”
Gemma, who is one of Dr Rajeswaran’s patients, says she always had a weight problem, from early childhood and still doesn’t fully understand why. “I got bullied at school for being overweight and that made it worse, I’d eat more. It was a vicious circle,” she says.
Her weight ballooned so much in her teens that she put herself on a slimming club diet and lost six stones. At the age of 19 when she married husband Simon she says she was a relatively ‘normal’ size.
However, during her first pregnancy, with daughter Abigail, all the weight piled back on. “I ate a lot, I can’t say I didn’t,” she admits. “I liked Chinese food and takeaways. I could eat a whole packet of biscuits in one go.”
By spring 2006 she was well over 18 stones, depressed about her size, and made a momentous decision: “I didn’t want to wait until I had diabetes and complications. I had to do something.”
“I had heard about stomach stapling and asked my doctor about it. I thought it seemed very drastic,” said Gemma. “I thought there might be a wonder diet or a pill but my doctor said the only thing that was going to help was a by-pass. I wouldn’t have been a good candidate for a gastric band because I had too much weight to lose.”
And so in spring 2006 she saw a consultant surgeon at Dewsbury Hospital and a few months later underwent a gastric by-pass.
“I did it for Abigail because I didn’t want to die,” explained Gemma. “I was getting palpitations and I didn’t want to be one of those mums who can’t run around with their children. I didn’t want Abigail to get bullied at school for having a fat mother. I also wanted another baby and knew that my chances of getting pregnant were affected and that being pregnant and so much overweight was a big risk factor. ”
The operation itself – see separate panel – went well but it was discovered that Gemma had an allergy to morphine and other effective painkillers. Consequently, post-operative pain relief had to be withdrawn. “I was in a lot of pain but just had to get on with it,” she says. “I was in hospital for a week and you can’t eat at all for the first five days – I lost nine pounds in the first week. Then you can only eat soft foods like yoghurt with no lumps, gradually moving on to things like mash with gravy
“I still can’t eat properly now.”
In fact, the by-pass operation means that patients have to adopt permanent changes to their diet and lifestyle. Because their stomach is just one tenth of its original size, patients can only eat small portions and find it impossible to have a drink with a meal.
“If you eat too much you just throw up,” said Gemma. “Even a cup of tea fills you up. It takes away your choices, which is a good thing. I have had to educate myself and think very carefully about everything I eat.” She also has to have regular vitamin B injections because the by-pass puts her at risk of deficiency.
Unfortunately, Gemma has developed a condition known as ‘dumping syndrome’, which can affect by-pass patients.
It occurs when foods that are high in sugar get passed too quickly from the stomach to the small intestine. This attracts fluid into the gut, causing it to stretch painfully.
Symptoms of the syndrome include abdominal cramps, nausea, fainting and vomiting.
Gemma now has to avoid high-sugar foods of certain types, including tomato ketchup, concentrated orange juice, salad cream and even cornflakes.
However, there can be no doubt that the gastric by-pass has ‘cured’ Gemma’s obesity. Most of her excess weight dropped off within a year of having the operation.
Our photograph (top left) shows her at Disneyland in Paris, four months after the operation, by which time she had already lost some of the weight. After slimming down, Gemma had her second daughter, Isabel, now a year old
Last week Gemma had a further operation to remove loose abdominal skin, completing the transformation. “I feel to have so much more confidence now. People used to stare at me and it made me feel awful.
“I don’t regret having the operation at all,” she says, “but I couldn’t have done it without the help of Dr Rajeswaran and my GP Dr Chandra. They’ve really looked after me.”
Although medical professionals were there to advise and support her, Gemma, who is a carer for her elderly grandfather and works part-time at Blockbuster, says that she is now considering setting up a self-help support group for those who have had bariatric surgery.
To those thinking about having surgery she advises: “Do a lot of research and ask yourself whether you can live the life it gives you afterwards. It’s all very well being thin but it affects your life in so many ways. It was frightening learning to live again.”
Anyone who would like to form a support group with Gemma can contact her through me at firstname.lastname@example.org