THE fairground rides always looked fun, but just two years ago the dodgems and the big wheel were the last thing Elaine McLoughlin would have dreamed of going on.
"I'd stand and watch but I'd never have been able to join in because I wouldn't have been able to fit in the seat," she explains.
Yet at the weekend she joined the crowds at Leith Festival Gala Day and, at the age of 43, enjoyed her first fairgrou
nd ride since she was a little girl.
As it turns out there have been many firsts in the 18 months since she shed an amazing 12 stones, dropping from a size 30 to a shapely size 14.
Things like shopping in "ordinary" shops for clothes she might actually be able to fit into, going on long walks – "I've nearly walked the paws off my two dogs," she grins – and having the confidence to walk into a pub or restaurant without feeling like everyone was staring at the "fat lady".
Yet her new slimline shape – she is 5ft 6ins and dropped from 25 stones to 12st 8lbs – has come at a hefty price.
"It cost me £8000," she explains, referring to the gastric band surgery she underwent 18 months ago at Edinburgh's privately run Spire Murrayfield Hospital.
"My family helped me out because they knew how much it meant to me to have it done and because my weight was affecting my health – I had high blood pressure and Type 2 diabetes, both of which have now gone.
"I've got to pay them back but it's made such a difference to my life."
Elaine, of Hermitage Park Grove, near Leith Links, paid to become the private hospital's first gastric band patient rather than join the growing queue of people waiting for NHS surgery to overcome their obesity problems.
The reason was simple, she explains: "I didn't want to die waiting."
But it's clear that the number of those who do wait for – and get – NHS surgery is increasing.
Lothian Bariatric Surgery Service launched at Edinburgh Royal Infirmary last year and is already believed to be dealing with around 600 referrals from GPs.
There has also been a dramatic rise in NHS surgery for obesity-related issues across Scotland, with surgeons' workload soaring to more than 400 cases last year, at a cost of £3.5 million.
Gastric bypass operations – which make the stomach smaller and bypass part of the intestine to make the digestive system shorter at a cost of £11,000 – rose from just 22 in 2005 to 178 last year.
The number of £8,000 gastric band operations, which involves using an adjustable band to make the stomach smaller, went up from 73 to 111 – an increase of 52 per cent.
Meanwhile, tummy tuck procedures, which involve removing excess skin and fat from the abdomen at a cost of about £6,000, have increased from 91 to 115.
On top of that, the number of body contouring operations which include liposuction is currently running at just over 650, at a cost of around £1,500.
It's thought the weight-loss surgery trend is partly fuelled by celebrities paying for quick weight-loss fixes – last year This Morning presenter Fern Britton admitted she had had a gastric band fitted, while Kerry Katona has undergone liposuction.
As going under the knife to shed the pounds becomes more acceptable, Scotland's NHS boards have been asked to look at their own budgets to see how they might provide for future demand from obese patients.
It could all leave the NHS in Scotland having to slim down itself – cutting back on some services to help pay for our ever-expanding waistlines.
Duff Bruce, a bariatric surgeon who is chairman of Scotland's Severe and Complex Obesity Treatment Service, believes there could be as many as 100,000 Scots who could benefit from weight-related surgery.
"For specific patients, who have associated illnesses and are unlikely to be able to change their weight on their own, this surgery offers significant benefits," he argues.
While some say NHS weight-loss procedures can pay for themselves within three years due to the reduction in prescribing costs linked with obesity-related conditions, others insist it can place an unbearable – and unjustifiable – strain on the service.
Tam Fry of the National Obesity Forum warns that the notion of free NHS surgery for lifestyle inflicted conditions – including obesity and smoking – has to be carefully debated to ensure it's not at others' expense.
"A lot of people who have so indulged themselves as to become obese really should pay for this surgery from their own pockets," he says. "The NHS shouldn't be there for 'cosmetic' operations.
"It takes up NHS time, a surgeon's time, nursing staff, operating theatre to cut someone up because of their own indulgence when someone else who really does need the surgeon's time for a lifesaving operation might miss out.
"We have to start to think the unthinkable – in terms of bariatric surgery, if you want it, you should pay for it."
He fears demand will be fuelled by patients who simply can't be bothered trying to lose weight using traditional methods.
"It's crucial that people are aware it's not a quick fix, this surgery requires a major lifestyle change and there's a lifetime ahead of watching what you eat."
While the Scottish Government stresses weight-loss surgery is rare and based on patient's needs, it prefers a preventative approach aimed at reducing the nation's obesity levels.
Last month it announced it was ploughing £1.4m into launching fat fighting communities – Armadale and Blackridge in West Lothian are among them – in a bid to tackle our expanding waistlines.
With around one in four men and one woman in five in Scotland classed as obese – only America has a worse record – weight-related medical conditions such as hypertension, some cancers and Type 2 diabetes are already costing the NHS around £171m a year.
Success story Elaine, however, warns simple good advice doesn't always turn around everyone's obesity issues. And in her case, even though her weight gain was making her ill, she couldn't stop it.
"The weight crept on in my early 20s after my father died and I got married," she explains.
"I was eating man-size portions, takeaways three times a week, multi-bags of crisps in one sitting – it was like an addiction.
"I tried everything to lose weight – slimming clubs, slimming tablets, but nothing helped. Even when I was taking 11 types of medication for blood pressure and diabetes, I had depression and could hardly walk 100 yards without having to stop, I still couldn't control my eating."
She was on the verge of losing her job as a nursing assistant at an NHS geriatric unit – where her uniform had to be specially made in size 38 to fit her – when she decided to undergo the operation.
Now she is helping to support other Spire Murrayfield patients as they wait for their surgery.
"Going through this isn't a quick fix," she warns, "it's still really hard and there have been days when I've had to get support to see me through.
"I've been left with nearly a stone in weight of loose skin and face further surgery to take it away.
"But it's still been such a positive experience. I've got my life back again."
To find out more about Spire Murrayfield bariatric surgery go to www.spirehealthcare.com/edinburghWEIGHING UP THE ARGUMENTSCHRIS Oliver knows the weighty issues surrounding bariatric surgery from both sides of the operating table.
He works as an orthopaedic surgeon at ERI and had gastric band surgery in 2007 after his weight hit 26 stone.
The 48-year-old father of two from Greenbank has since shed ten stones.
"My life has completely changed – I now do a lot of sport and exercise, I've done three triathlons. These are things I wouldn't have been doing if I hadn't had surgery."
He believes bariatric surgery should be available via the NHS. "Obesity isn't a cosmetic surgery issue. There are a lot of complex reasons why people gain weight ."
