A Co Antrim woman whose obesity contributed to a cancer diagnosis has undergone radical gastric by-pass surgery in Lithuania to lose weight and protect her health.
Elaine McClenaghan (49) from Glengormley says she feels like a new person since coming through the operation last April when she had her stomach taken away, leaving her with a tiny 30ml pouch.
Overeating was the reason why Elaine's weight ballooned to over 20 stone at her heaviest before the procedure.
Since surgery she can no longer eat full portions and uses a toddler's plate at meal times.
However she has lost over six stone in a year, dropping from 20 stone 8lb to 14 stone 3lb, and says she has never felt better.
More importantly though for Elaine, she has reduced her risk of cancer coming back, a real prospect because of her weight that terrified her and led her to take such a drastic step.
She says: "I had my annual cancer review last week and my consultant didn't recognise me.
"He was delighted that I had lost so much weight.
"He told me that he would be signing me off and giving me the all-clear a year early because I had reduced my chances of the cancer coming back so much by having the surgery and losing the weight.
"I feel like a different person in every way. At first I thought I might be embarrassed telling people I had the surgery but I didn't do it for vanity reasons, I did it for my health.
"Not only has my health improved physically but it has been great for my mental health as well and I am a much happier person. People have told me they can see the old Elaine back as I had lost all my confidence because of my weight."
Elaine, who works as a finance officer, was just married a little over a year to David (51), a warehouse team leader, when she was told she had womb cancer.
She took excruciating pains in her stomach and was bleeding heavily and her GP referred her as urgent to Antrim Area Hospital where she was diagnosed in November 2015.
She underwent a hysterectomy in January 2016 and required no further treatment. However, her gynaecologist did leave her in no doubt that her weight was a major contributor to her cancer diagnosis. She was also informed that unless she lost weight she was at a high risk of cancer returning.
Luckily David loved me the way I was but I could see it wasn't just ruining my life but his life as well
Her anxiety led to her eating more and she actually put weight on.
As a newly-wed she wanted to look forward and started to research surgery to see what options were available to her.
She recalls: "All my life I have been battling my weight and it has gone up and down. I have tried every diet going but my problem is I comfort eat.
"I would look in the mirror and see how fat I was and that depressed me and so I ate to make myself feel better.
"In my teens and 20s I would have been 13 stone and when I married David in June 2013 I was 17 stone. Last year before I had the gastric bypass I was at my heaviest of 20 stone 8lb.
"When I was diagnosed with cancer I was told by the consultant that being obese was a main factor and that really frightened me.
"I was 17 and a half stone and I was putting on more weight and I knew that if I didn't do something I wouldn't see my 60th birthday. I could hardly walk with my weight and the pain in my knees and back.
"Luckily David loved me the way I was but I could see it wasn't just ruining my life but his life as well.
"I started to research gastric bypass and looked into having it done here but it's not done in Northern Ireland.
"I saw my gynaecologist and asked if he would send me to get it done in the Republic of Ireland or England and he looked into it, but said they didn't have the money to cover it."
In the course of her research, Elaine came across a leading surgeon in the field who works between Dubai and the Nordbariatric clinic in Kaunas, Lithuania.
Last year, the clinic experienced a 50% influx of British patients, with around 20 patients from the UK undergoing the surgery every month.
The clinic says the demand is due to the vast experience of the chief surgeon Dr Almantas Maleckas who has carried out more than 6,000 gastric bypass and gastric sleeve surgeries.
It was Dr Maleckas who first drew Elaine to the clinic. She says: "When I realised I couldn't get it done on the NHS I started to look further afield as a last resort.
"I came across this consultant online and saw how many years he had been doing it and I contacted the clinic for information.
"They referred me to a Facebook page of patients who had been through it which I found really useful. One girl from here had had it done and she talked to me and reassured me."
Elaine had no money to pay for the surgery and took out a loan.
The total cost, including flights and hotel accommodation, came to around £5,700 which included five years of aftercare. This involves the consultant being available for appointments via Skype as well as access to a nutritionist when needed.
With her mind made up and feeling she had no other choice, Elaine booked her operation for April of last year.
Gastric bypass surgery involves removing the stomach and leaving a pouch of 30ml in its place. The procedure is carried out through keyhole surgery.
She arrived in Lithuania on April 7 last year and went through the operation on April 10, returning home four days later. She says: "It has been absolutely amazing. I have gone from a size 26 to a size 18 and although I would like to lose some more weight, I am happy as I don't think I will ever be a size 10.
I am so glad I got it done. I have more energy and my mental health has really improved.
"I was grand after the surgery. I had five small wounds where they did keyhole with two stitches in each which dissolved.
"I wasn't in any pain or discomfort. The first couple of weeks were the hardest because all you can eat is liquids so I lived solely on soup and protein shakes.
"Then for week three and four I had to eat pureed food and soft foods like scrambled eggs and mashed bananas but after six weeks I was able to eat anything I wanted."
While no foods are banned she was advised to give up her favourite fizzy drinks and her portion sizes had to be dramatically reduced.
As someone who became obese through overeating for comfort, she hasn't found her dramatically reduced intake of food hard to deal with.
She says: "You can't eat and drink at the same time, there has to be 20 minutes between each. You do run the risk of stretching your pouch if you eat too much so I eat little and often and it takes very little to make me feel full.
"If we go out for a meal I have a starter as a main course and at home I put my food on a baby plate. I could have two pieces of broccoli, one potato and less than half of a chicken breast in one meal.
"For breakfast I have one Weetabix and at lunch I would have a yoghurt and a piece of fruit. Sometimes I do want to eat more but I don't want to put the weight on so I am able to control it now."
As well as the weight loss, Elaine has seen a major improvement in her overall health.
She has been able to cut down on blood pressure medication and antidepressants which she was dependent on before her weight loss.
She is also physically fitter and has for the first time in her life discovered a joy in exercising. She regularly goes to her local gym, attends a boogie bounce exercise class weekly and is hoping to start swimming this month.
She walks more often and says overall she feels like a different person.
She adds: "I am so glad I got it done. I have more energy and my mental health has really improved.
"In 2018 I went to Belgium on holiday and had to get an extended seat belt on the plane and I was mortified. I cried the whole journey home.
"This year for my 50th birthday in June we are planning to go to Dubai and I wouldn't have contemplated it if I hadn't lost the weight.
"I do feel like a totally new person and the doctor told me that I have added so many more years onto my life.
"I couldn't speak highly enough of the clinic and how professional they were. They have been fantastic and I couldn't have done it without my husband, family and friends."