But West Sussex Primary Care Trust (PCT) is refusing to pay for the removal of excess skin left behind after the operation. Reuben is now challenging the decision and has spoken of his struggle for a normal life.

Doctors told Reuben (also known as Darren), who at one stage was unable to walk up the stairs of his home in Bennetts Road, Horsham, to lose weight or die. But diets failed to work and illnesses he suffers made exercise difficult.

Bariatric surgery reduced the size of his stomach in November last year but when he applied to the PCT for funding for removal of excess skin, he was told he was a 'low priority in terms of competing demands for limited resources'. He is awaiting the results of an appeal.

A spokesperson for West Sussex PCT said: "The National Institute for Clinical Excellence (NICE) has issued guidance which covers the eligibility criteria for morbid obesity surgery. The guidance does not address plastic surgery to reduce skin flaps.

"The position of the local health economy is – plastic surgery to reduce skin flaps is not funded unless there are exceptional health reasons for this surgery."

Always a 'chubby' child, Reuben said he and other members of his family were naturally big.

Aged about 14, he started having mental health problems and 'eating for comfort and loneliness'.

He weighed 26 stone nine and a half pounds. But a turning point came as his 40th birthday approached.

He had the inspiration of his sister, Tracy, who had lost weight, support from family and friends and the help of Slimming World to lose two stone – and then he saw a TV programme about gastric surgery. A bariatric surgeon at the University College of London made him see a psychiatrist and dietician.

Read the full story in the County Times.

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