Seven members of the same Queensland family across three generations have had obesity surgery, collectively shedding hundreds of kilograms in weight.
Anna-Rose McGinn, a fourth-year veterinary science student at James Cook University in Townsville, is the youngest and most recent member of the McGinn family to have a gastric bypass operation.
The 21-year-old has shed almost 60 kilograms since having the procedure in July — tipping the scales at more than 160kg at her heaviest.
Her father Daniel McGinn, grandparents Keith and Anne McGinn, aunts Amanda O'Reilly and Michelle McGinn and cousin Connor O'Reilly have also had the weight-loss procedure.
Anna-Rose said the surgery had been life-changing after spending her adolescent years "yo-yo dieting" to try and keep her weight down, only to see the kilograms pile back on.
"I go with my friends to the gym a lot more now because I feel more confident to be able to go and do all those things and going out with my friends a lot more," she said.
"I'm not embarrassed by my size as much. People in society look down on obese people so much."
She said for her shopping for clothes is more fun now she can go with friends without having to visit plus-size shops.
'I lived life in pain'
Anna-Rose's father Daniel was the first of the McGinns to have gastric bypass surgery in 2016. He weighed about 185kg at the time and seven years later, is 80kg lighter.
The 50-year-old has lost the most weight of any of his family after having the operation.
"I really doubt I'd still be alive if I didn't lose that weight," Daniel said.
"I lived life in pain in my knees and ankles. When the weight came off, there's no issues with them whatsoever."
The McGinns were keen to talk about their weight-loss stories to reduce the "stigma" surrounding bariatric surgery, finding no shame in improving their quality of life.
"I didn't want to tell anyone that I was getting surgery done," Anna-Rose said.
"But now I'm wanting to advocate for it because it has changed my life for the better. Everyone's coming up to me going: 'Oh my god, Anna, you look so amazing. What's your secret?'
"I have told my friends and everyone's been so lovely and supportive about it and I was really scared to tell them originally. But I do have a great group of mates around me. That definitely helped."
Life in a 'calorie-rich environment'
The McGinns' Brisbane-based surgeon Rob Finch, of St Vincent's Private Hospital, Northside, said the gastric bypass operation, which normally lasted about an hour, involved stapling the top part of the stomach, reducing its volume, and resulting in patients feeling full much sooner than before surgery.
The stomach pouch that is created is then connected directly to a mid-section of the small intestine, which means the gut absorbs fewer calories.
Dr Finch said while it was rare for gastric bypass patients to reach "a normal body weight", most lost about 70 per cent of their excess fat within 12 months, staying in the "slightly overweight" range.
He described obesity as a complex chronic illness, driven by genes, hormones and psychological factors, as well as the environment.
"There's definitely a genetic predisposition to obesity," Dr Finch said.
"Cynics will say genes haven't changed in the last generation, but the rates of obesity have dramatically increased and that's entirely correct.
"But people who have genes that predispose them to obesity now live … in an environment where we don't have to utilise as much energy. We're also existing in a calorie-rich environment.
"We shouldn't stigmatise."
Amanda O'Reilly grew up with sister Michelle and brother Daniel on parents Keith and Anne McGinn's dairy farm in the Samford Valley, in Brisbane's north-west, all of them piling on the kilos after it shut in the 80s.
"We worked physically hard all our young lives," the 53-year-old said.
"We weren't eating bad food, just too much good food, and felt compelled to eat it all because we didn't ever waste good food.
"We were served up a big meal, we ate a big meal, but we worked hard. We weren't fat kids, but we were really strong kids. When the farm closed down, we all started putting weight on."
'A lot more energetic'
Amanda, who has lost about 30kg after her surgery, is an intensive care unit (ICU) nurse, frequently spending 12-hour shifts on her feet.
"My joints were copping a caning," she said of life before having the gastric bypass.
"At the end of the day, the end of the shift, I ached terribly.
"I'm a lot more energetic than when I was really fat."
She had a gastric bypass after years of watching obese patients in ICU struggle with respiratory failure and other problems after big operations.
Obese patients are at a higher risk of infection, as well as respiratory failure and wound complications following surgery.
Dr Finch said morbidly obese patients were increasingly being referred for weight-loss surgery as a bridge to other procedures, such as hip and knee replacements, and for the management of other problems, such as type 2 diabetes.
Hip and knee replacements tend to wear out more quickly in people with obesity.
Surgery not without risk
Dr Finch said bariatric surgery, as with all operations, was not without its complications.
"Because we're dividing and joining bits of bowel together, there's a small chance of that leaking," he explained of the gastric bypass operation.
Amanda's son, Connor O'Reilly, developed an ulcer in his small bowel after the surgery, which perforated, requiring a further "urgent operation" to have that repaired.
"He'll be on medication lifelong to switch off the acid in his small, remnant stomach, to try and prevent the risk of that in the future," Dr Finch said of the "rare" complication.
He said the benefits of the gastric bypass operation were well established.
For example, new Queensland-based research of more than 200 morbidly obese patients with type 2 diabetes who had undergone either a gastric bypass or sleeve gastrectomy, an alternative weight-loss procedure, found clear health improvements 12 months later.
Professor Paul Scuffham, director of Griffith University's Menzies Health Institute Queensland, said almost half of the patients were able to discontinue all diabetes-related treatment following the surgery.
Professor Scuffham, one of the authors of the study published last month in the journal PLOS ONE, said that after one year, the patients' body weight had decreased by almost 24 per cent, on average, and blood glucose levels had improved by about 24 per cent.
The incidence of high blood pressure, non-alcoholic fatty liver disease and kidney impairment decreased by 37 per cent, 66 per cent and 62 per cent respectively.
"I think the improvement in quality of life is a game changer for these people," Professor Scuffham said.
