When Jenni Murray had gastric sleeve surgery, she'd tried everything else. Nothing had worked, yet she was still scared to undergo an irreversible procedure that reduces the stomach to a sleeve roughly 15pc of its natural size. It had taken her 64 years to realise that she had run out of options - but the effects were immediate, and positive. Shortly after the op, she had tickets for Wimbledon. "I didn't even miss the strawberries and cream," she remembers.. "I just didn't fancy them."
Eight weeks after the op, she was able to eat normally, the crucial difference being she stopped eating the second she felt full.
"I began to feel a bit hungry at mealtimes, but was soon satisfied," she says. "The weight loss began immediately."
Soon, she was going out for dinner with friends, ordering starter portions: "Finally, I was listening to my appetite."
Her journey to surgery was long and arduous, beginning in childhood where food equalled love, but fat equalled shame: "The number of times I've been called fat cow, fat bitch, fat c-word," says BBC broadcasting legend Jenni Murray, who has been presenting Radio 4's Woman's Hour since 1987.
She has a velvet voice beloved of her global audience, and a body that was, until 2014, dangerously obese. Deeply fed up with everything associated with obesity, from the damage to her own health to society's perceptions and treatment of people who are obese, it was a worried comment from her adult son that prompted her to finally go for what she terms metabolic surgery in 2014, aged 64.
Walking her chihuahuas in a park, with her usual frequent stops to sit down, an even more obese woman passed them on a mobility scooter, with her own small dogs tied to the handlebars.
"That'll be you soon Mum," her son said anxiously. Instead she had gastric sleeve surgery, lost eight stone in a year, and has just published a book, Fat Cow, Fat Chance: The Science & Psychology of Size.
As well as a memoir of her own tortured relationship with food and the diet industry, it is also a polemic, demanding that we rethink our attitudes to obesity, and to see it as a chronic progressive disease rather than a lifestyle choice. And to stop being so squeamish and tight-fisted around funding bariatric surgery for those whose lives are blighted by it.
"What really prompted me to write this book was when I was sitting in a conference and a young surgeon was saying how hate speech covers race, gender, sexuality, religion, disability, but not obesity," she says. "A lightbulb went off inside my head. There are already a lot of excellent books out there about obesity, but I wanted to tell people my story - how can a highly educated, intelligent, successful woman end up 24 stone?"
Murray's efforts to manage her comfort eating began in the '60s at university with a doctor's prescription for slimming pills which turned out to be Black Bombers (speed).
Since then she has tried slimming clubs, horse riding, yoga, the Atkins diet, the Dukan diet, the cabbage soup diet, the 5:2 diet, psychotherapy, CBT and fat acceptance. She tried to be fat and happy. She read and reread psychotherapist Susie Orbach's seminal Fat is a Feminist Issue. She lost weight, she regained weight, she lost it again, regained it again.
"It had become a major health issue - I was absolutely miserable because I couldn't get around properly," she says. "I have no doubt my obesity contributed to breast cancer in my 50s and a double hip replacement, and I was a dead ringer for Type 2 diabetes."
She thought she wouldn't make it out of her 60s. But she did, turning 70 last May. Her surgery was a resounding success.
Fifteen months ago, aged 51 and weighing 15 stone (I'm 5ft 4in, and at my heaviest was 17 stone) I had the same gastric sleeve surgery as Murray. Like Murray, I'd tried everything. Twenty years of weight gain, weight loss, weight regain. Not to mention all the cash and frustration spent on trying not to be obese. Nothing worked until the gastric sleeve - finally, a metabolic 'off' button. If I'd known how easy it would be, I'd have done it years ago.
I travelled to Estonia, alone, because it was half the price of the UK and Ireland. The experience was painless and straightforward, with virtually zero side effects other than sustained weight loss. I can eat whatever I like, just in much smaller portions, and my weight remains stable at just over 11 stone. There is no hunger, no cravings, no obsession - just physical and psychological freedom. My hips and knees are delighted. I can cycle up hills.
Obesity research from University College London shows how for women with a BMI over 35, only 1 in 340 dieters maintain their weight loss - the rest of us regain. For those with a BMI of 40, it's 1 in 740.
"Metabolic surgery makes both humane and financial sense - research has shown that it pays for itself within three years [in terms of long-term health-care savings]," says Murray. "It's a no-brainer."
So why are more people not being offered surgery? "One can only assume cost and stigma," she says. "And the mistaken belief that we shouldn't be spending money on people who've brought their problems on themselves."
Ah, stigma. Obesity remains the elephant in the room - in Murray's case, she says it was her mother's vicious and life-long fat-shaming, calling her daughter "a baby elephant", while insisting she finished everything on her plate (arriving home from university, fatter than when she'd left, her mother laid into her: "She was truly ashamed of me and my heart was breaking"). And so the cycle continued. "Depression brought on by stigma has a powerful influence on eating habits."
Stigma means that non-obese people feel entitled to have opinions - often loudly and publicly, like Piers Morgan - about what is quite literally a crippling condition involving genetics, hormones, the microbiome, the environment, the food industry, the diet industry, and, significantly, poverty.
Obesity stigma is baked in, beginning with negative stereotypes in children's literature from Billy Bunter to Piggy in Lord of the Flies, Tweedle Dum and Tweedle Dee to Augustus Gloop, Miss Trunchbull to Ursula in The Little Mermaid, all the way to the fat bullies Dudley Dursley, Crabbe and Goyle in the Harry Potter books.
And let's not even talk about what obesity stigma does to your sexuality, because I'd run out of page.
The common assumption, says Murray, is that calling attention to people's weight in a negative context ("Fat cow!") will somehow motivate an obese person to action.
Research shows the opposite is true. According to Professor Rebecca Puhl of the Weight Stigma Initiative at Yale University, "Weight discrimination is a legitimate and prevalent societal problem. It inflicts pain and suffering, causes financial harm and impairs quality of life. It should be banned, just like other forms of invidious discrimination."
Or as actor James Corden puts it: "If making fun of fat people made them lose weight, there'd be no fat kids at school."
Jenni Murray would like to see obesity shaming added to the hate crime list.
But what about fat acceptance? Murray grew up in a post-war environment that fetishised food, while simultaneously being taught that being fat was "ugly and immoral".
She became a successful feminist broadcaster and journalist via radio and print. Before writing her book, she had "never spoken to anyone, friends or family, about my shame and self-loathing or about my size", preferring instead to "hide away under loose-fitting clothes and a carapace of indifference".
Yet in our current fatter world, there is far more fat visibility: think model Tess Holliday, of the #EffYourBeautyStandards hashtag, on the cover of Cosmo; the singer Lizzo, a glorious embodiment of self-celebration. So where does feminism, self-acceptance, empowerment and effing the dominant beauty standards stop, and serious health issues begin? "With age," says Murray.
Like any other chronic progressive disease, left untreated, we are less able for obesity as we get older. The body buckles under the strain. We understand that with other chronic progressive diseases, the individual needs medical help, but with people who are obese, we laugh / sneer / ignore / dismiss / call them 'fat c***', or tell them to go on (another) diet.
Such advice only works if you're trying to lose a few pounds for a special occasion; for people living with obesity, it's bigger than that. Literally.
We need to stop judging, and start treating.
WHAT IS COMPULSIVE EATING?
⬤ Eating when you're not physically hungry
⬤Feeling out of control around food, either dieting or gorging
⬤Spending a lot of time thinking / worrying about food / fatness
⬤Obsessing over the latest diet info
⬤Feeling awful about yourself and out of control
⬤Feeling awful about your body