By Megan Lane
BBC News Magazine
Bethany and her mother
Teenage years can be hard enough without the trauma of being overweight. So when insults pushed "morbidly obese" Bethany Walton to eat even more, she saw only one solution: surgery.
Diets are hard to stick to at the best of times. But when you face daily insults from strangers about your size, the urge to comfort eat can be over-whelming. Which is why Bethany Walton has instead turned to risky stomach surgery.
Fewer dieters are as honest about their weakness as Bethany. "It's will-power. I tried all the diets with the help of the hospital."
As she needs to lose at least 20 stone (127kg) to reach a healthy weight for her 5'6" (168cm) frame, that requires an awful lot of will-power, strenuously applied over a number of years.
"You lose your will-power really. Food comforted me; it made me feel better. When you are feeling low, and something makes you feel better, you're going to want to keep doing it," explains the soft-spoken 19-year-old from her Lincoln home.
"Sandwiches and bread were a big thing for me. Sandwiches with cheese. I'd maybe have a salad and sandwiches for lunch at college. But it wouldn't be a tossed green salad - it would be pasta mayonnaise with cheese on top."
One in 40 children is severely overweight. Obesity levels have trebled in 20 years - now almost one-fifth of Britons are obese. This week, the government unveiled its so-called "fitness minister", Caroline Flint, ahead of publishing new figures which are set to show that obesity has risen by 38% in adults since 2003.
Bethany has always been a big girl. Weighing more than nine pounds when she was born, her mother Julia says Bethany grew into a "chubby toddler".
But what the family dismissed a "just puppy fat" kept piling on. Most children gain about half a stone a year; Bethany was putting on double that. By the age of eight, she was eight stone - almost twice the average weight for a girl her age.
"I'd be having larger portions - that's the problem with me, I was having portions that were far too big for me. I'd throw a tantrum if mum didn't give me extra food. I couldn't understand why my brothers - who were 10 years older than me and doing manual jobs - were having a dinner twice the size of me."
After her much-loved grandmother died - a woman more like a second mother after her father left when she was little - the only thing that made 12-year-old Bethany happy was eating. So food became a comfort. She gained eight stone (50kg) in a year; at the age of 13 she weighted 23 stone (146kg).
It was only after she underwent weight-loss surgery in April that Bethany felt full for the first time - that was after eating a small pot of yoghurt.
The average human stomach can usually hold about a litre of food, and can expand to hold up to four times that amount. Bethany's now holds just 200ml after undergoing a sleeve gastroectomy. "It reduces the stomach to about the width of your thumb," says her surgeon, Simon Dexter.
One patient in 100 dies from weight-loss surgery, so it's a risky procedure. Bethany decided it was a risk worth taking after her doctors warned her that without it, she'd most likely be dead by the age of 30.
The operation is starting to have an effect, but still Bethany's weight is killing her. Her heart is overloaded, her periods have stopped as her body overproduces oestrogen, and she risks developing a raft of diseases such as diabetes. She doesn't go to the cinema because she can't fit in the seats. "I'm all right with doorways but I still worry about it - what if, you know?"
Four months on, she's already lost four stone and wants to lose a further 10 stone in the next year. She then hopes to have her stomach re-trimmed to help her hit her target weight. How does she describe herself post-surgery? "Not as fat as I was, but still morbidly obese - that's the label the doctors put on it. I'm a size 34 now. Unrealistically I'd like to be a size eight. Realistically a size 16."
Just because food makes her feel better doesn't mean that Bethany subscribes to the "fat is fabulous" movement: "I hate the way I look. I hate my body. I hate my clothes," she says. (It's telling that her voice lifts and brightens when we get off the topic of her weight, such as when she speaks of her hopes to be an artist).
Most teenage girls are self-conscious about how they look - and a recent survey for a teen magazine found that 92% are unhappy with their bodies - but at four times the size of the average teenager, Bethany says she has never felt pretty. She's self-conscious about walking or exercising, finding it embarrassing that others can hear her getting out of breath.
Nor is this helped by the stares and catcalls that accompany every outing - Bethany's size has made her public property.
"People stare at you, you get glares, you get children saying 'Mummy, why's she like that?' They just chuck everything at you - throw abuse from across the street."
"If someone had been particularly horrible to me, like a drunken person across the street shouting 'Oi you fat bitch' [she giggles to take the obvious sting out of the memory], I'd feel so low that I'd just go to the corner shop and buy two or three packets of sandwiches, a packet of crisps and a fizzy drink."
So what does she do now to make herself feel better? "I hug my mum. That helps."
34 Stone Teen will be shown in the UK on BBC Three on Monday 28 August at 2100 BST.
Below is a selection of your comments.
I am proud to be teaching exercise classes where I do indeed have obese people along - with just about everyone else in terms of age and ability. What is noticeable is that everyone supports each other and that size, age or ability are not an issue - to my understanding this is rare. It is great to see a group of people pulling together and being positive - that is what it all should be about and hopefully Bethany will eventually have this experience somewhere.
Linda Kanninen, Caldicot, South Wales
I lost 150 lbs 8 years ago (70kg). I did it on my own and with my own program. Unless the dynamics of her family change, the surgery will be of no use. And the issue with health insurance is complicated. I was denied health insurance for losing weight. The insurance company told me that losing weight implied illness and that the loss thru diet and exercise was not acceptable from an insurance point of view.
Kara Tyson, Mobile, AL USA
It's heartbreaking that people should be so cruel and ignorant as to shout abuse like "Oi, you fat bitch!" in the street. And sad that they should have been brought up to have so little respect for others and themselves that they feel it is acceptable to behave in that way. Hats off to Bethany for her resolve - I really hope your weight loss brings you happiness.
The worst thing about this is the reactions this poor girl gets from members of the public - how can people be so cruel? Her self-esteem must be rock bottom and that isn't going to help her lose the weight, she needs to feel good about herself to care about her health.
Go Go Girl! Well done so far, long way to go. Just remember next year you'll be a different person. Book that holiday you've always wanted. Keep looking forward. I lost five stone two years ago, never looked back.
Miles Campbell, London
I wish Bethany all the best in reaching her ideal weight. I have been overweight most of my life and have been subjected to all sorts of comments and insults. But now I have decided "enough is enough" and have decided to tackle my weight problem. My strategy is nothing as drastic as stapling my stomach - just a change in my lifestyle. And I needed a doctor's whack to push myself into changing my lifestyle. And yes, it requires truckloads of will-power. My motivation is that slinky black dress I bought myself and am hell-bent on wearing by spring 2007. But I wonder, when I see kids gorging on fast food, working mums too busy to cook food at home, singles (like me) surviving on takeaways, we are moving away from the fresh food our parents used to have and filling ourselves with synthetic stuff and empty calories.
Shanta, New Delhi, India
Why hasn't Bethany been treated for an eating disorder the way other eating disorders are treated? People who comfort eat need to learn a different way of thinking - why isn't this encouraged rather than diet after diet?
Claire, people like Bethany are physiologically different from the onventional population. That's why she was nine pounds at birth and was obese in infancy. The notion that these folks just have to learn a different way of thinking is profoundly flawed. What's more, the abuse she suffered in childhood and adolescence because of her obesity DID teach her a new way of thinking. She grew steadily to have an absolutely hateful self-image. She's a real survivor. GO, BETH!
Nick English, Raleigh NC US
Bethany, it must be difficult being big in a society that demands perfection. We both know how difficult it can be to deny yourself the luxury of food and how depressing the thought of exercise can be. However, we feel that you are more than capable of achieving your goals and wish you all the best in the future. We are sure that there are thousands of Britons who wish you well in your struggle and also believe that REAL beauty comes from within.
Bronson & India, Glasgow
I think Bethany is a very brave girl. I am only 22 and weigh 22 stone and I find it hard to be confident due to my weight. I was bullied at school, got comments from strangers etc. Bethany I hope you have supportive friends if not then I would be proud to be called your friend, you go for it girl and hold your head up high.
Natalie Sandford, Birmingham
I do really feel for Bethany, but it's even sadder that surgery proved to be the answer. I am about the same height, also weighed over 9lb at birth and was a large toddler. But my average weight as an adult has been about eight stone, so there's obviously far more going on here than "started big, therefore meant to be big". Bethany probably would have benefited from more disciplined parents, or therapy to help her become aware of why she comfort ate to that extreme, and healthier ways of managing her feelings.
Clare, Bradford, West Yorkshire
It is a difficult thing to suggest where the responsibility sits - is it the parents fault or should we be screening children in schools to ensure that they are active enough to prevent surgery like this? It must be costing the NHS loads.
Stay strong and don't let the insults of the ignorant discourage you from exercising. For every two or three people that might laugh or heckle you, there may be one or two that see that you are really out there doing it and working hard to help yourself. Then you may even be an inspiration to them, to show them that if you can do it, so can they.
Roy, Halifax, Nova Scotia