Having Weight loss surgery is not a quick fix. Those wanting a lighter body have an uphill struggle afterwards

WHEN Vanessa Feltz was fitted with a gastric band back in June, she joked that in no time at all, she'd be performing as Cheryl Cole's body double. Less than three months later – and still a long way from being mistaken for the X-Factor judge – she was confessing to having squeezed a cupcake through the band.

Proof, were it needed, that bariatric surgery is far from the quick-fix it is sometimes portrayed to be.

And while there are celebrity success stories – from Fern Britton and Roseanne Barr to Anne Diamond and Diego Maradona – there are one or two cautionary tales. Sharon Osbourne, for instance, who lost more than 100 pounds after surgery in 1999. But in 2006 she announced she had gained weight and was having the band removed.

Some estimates claim around five per cent of weight loss surgery patients regain the weight. For the rest, it's a life-changing procedure that is growing in popularity. A recent British Medical Journal report found the number of people in England undergoing the surgery on the NHS had increased tenfold in under a decade, from 238 a year to more than 2,543 in 2007.

However, in Scotland, despite the fact that 40 per cent of the population who have a BMI over 35 are both eligible and willing to undergo surgery – that's around 24,000 people – only 300 procedures a year are available and only half of these are available on the NHS.

A Scottish taskforce has been set up to address this shortfall. Called Severe and Complicated Obesity Treatment Service, or SCOTS, the group is led by Duff Bruce, a bariatric surgeon based in Aberdeen who claims bariatric surgery is the only effective long-term treatment for severe obesity and, by curing associated conditions such as type 2 diabetes, heart disease and cancers, it could save the Scottish health service more than 171 million a year.

Carol Bowen Ball underwent a gastric bypass in November 2009, after she had seen her weight soar to 17 stones over a period of 30 years. "Weight loss surgery is the last thing you ever do," she admits. "It is a very serious operation. The work doesn't start until you have the surgery because that is just the tool to help you. Life afterwards, to begin with, is more difficult than it was before."

Post-surgery, patients have to get used to a new way of eating. First, it's fluids, then soft foods like porridge and scrambled eggs, then foods they will eat for life. "But they're very different to what you would have been eating before," cautions Bowen Ball. "You have to make sure they're high in protein, low in fat and sugar. People will have between 600 and 1,000 calories a day, but they have to pack in about 70g of protein which means food has to be highly nutritious. You won't find that in a ready meal."

She maintains that the advice available varies enormously. "If you think it's a magic wand and all you have to do is eat half the amount you used to eat, my goodness me you're mistaken. There are ways of putting weight back on. You have to have major lifestyle changes and most people struggle. They come from hospital, stand in front of the fridge and think: now what?"

Aware of the difficulties many face, Bowen Ball founded the UK's first bariatric cookery website, which has now become the UK's first bariatric cookery book. The recipes start with smoothies you can take post-surgery, followed by soft foods like souffls before moving on to high-protein foods for life.

Now weighing around 11 and a half stones, she says: "The one thing surgery did for me is get rid of the diet police in my head. I do weigh myself, but if one day it happens to be higher than another, it doesn't worry me."

More than that, however; it has given her a new zest for life. "It's made a difference in that I get up in the morning having had a good night's sleep. I can walk to the wardrobe and pull out anything and know it will fit. Just being able to get out and about."

But she admits it's a learning curve all the time. "When you start losing weight, there's a terrible temptation to go back to old eating habits. And I have been told if you were that way inclined you could stretch the pouch. You can bypass the band by pureing things – we've heard about people melting chocolate – but why you would want to sabotage your chances I don't know. The band just gives you the tool to get it right but if you still have issues with food you can work round it.

"There's a huge responsibility on GPs to inform patients about everything," she adds, "but it's your own duty to find out absolutely everything you can. This is not a bus you get on and two stops later you get off. This is for life. It's a big deal."

Return To Slender by Carol Bowen Ball, 9.95, www.bariatriccookery.com

• This article was first published in the Scotland on Sunday on September 26, 2010