Before: 535 lbs.
After: 235 lbs.
Program Used: Gastric-bypass surgery

Ellen Kelley still lives in Chattanooga, Tenn., where she was born 42 years ago to Ralph and Barbara Kelley, during an era of turmoil and sometimes terror over civil rights. But Ralph Kelley, then the mayor of Chattanooga, helped it escape much of the violence that ravaged other parts of the South. In 1963, rather than wait for the riots and decrees that shook places like Birmingham, Ala., he defied local segregationists and declared the city's public facilities "open to all."

Growing Up and Getting Heavier

Yet Ralph seemed powerless to help his obese daughter Ellen (the second of three girls, sandwiched between Laura, now 46, and Karen, 40). As his little girl got bigger, Dad prodded Ellen into fad diets, fat camps and other weight-loss gimmicks. Her childhood was a bewildering parade of regimes ranging from cabbage soup and grapefruit through broccoli and shakes and trips to doctors. On one humiliating visit, she was ordered to "stand naked in front of a mirror" so she would be "shamed" into not eating.

Nothing worked. Ellen got fatter and fatter. By adolescence, she felt almost smothered in flesh, "like in wintertime, when your mom makes you put on three sweaters, an overcoat and two pairs of thick pants." At 16, she gave up swimming. "When you reach the low 300s, you've passed the tipping point," she says. "You can't exercise anymore — you really can't move." Her mom, who had taken up marathon running as an antidote to her baby weight, urged her to join in, but even walking had come to seem like an Olympic event to Ellen.

Ellen's high school boyfriend, teased by his friends, broke up with her. She got superb grades but abandoned her dream of going to medical school. "I just couldn't rationalize being a doctor and weighing 400 lbs. while advising patients about their health," she says. She went to UTenn at Chattanooga — because the dorm had elevators. Her interest in medicine stayed strong; in 1988 she got her R.N. Then she went to work in a cardiothoracic ICU; she knew it wouldn't entail a lot of walking.

When she was 22, Ellen's father said despairingly, "I'm going to have to come to grips with the fact that I'll never know you as a normal-size person."

"Daddy," said Ellen, "I know you love me, but you don't love all of who I am."

Dying Slowly

When you're four times the weight of a normal woman, "you get used to not having access to things and places," says Ellen. At one point, the 5-foot-7 Ellen weighed 535 lbs. She couldn't fit through the doors in many public toilets. She chose doctors not according to their credentials but by the construction of the chairs in their waiting rooms. Her car? A Ford Bronco, the only model with sufficient space behind the wheel. Then she discovered heart disease, diabetes and cancer weren't the only factors that put an obese woman at risk: The dealer didn't sell seat-belt extenders long enough to fit her.

After she passed 500 lbs., she was diagnosed with metabolic syndrome, a collection of conditions that includes high blood pressure and triglycerides, insulin resistance and risk of stroke and heart attack. Told to go on a high-protein diet, she dropped 100 lbs. and met a man who wanted her despite her size. They married in 1990 "because my self-esteem was so low," Ellen says. But it wasn't the basis of a lasting relationship; five years later, Ellen was alone again. And, at 429 lbs., her weight loss had stalled.

Then Ellen read about singer Carnie Wilson's 1999 gastric bypass, prompting her to research surgical options. The prospect was scary — a family friend had nearly died after weight-loss surgery — but she finally decided to undergo the bypass known as Roux-en-Y. Her father went with her to consult with Willie V. Melvin III, M.D., at Vanderbilt University Medical Center in Nashville, Tenn. "What's the worst that could happen?" he asked. "She could die," said Dr. Melvin.

When a nurse said Ellen's surgery would be the first Roux-en-Y operation Dr. Melvin had performed unassisted, Ralph begged her to back out. "I'm dying slowly as it is," Ellen answered. "I'd rather die trying to get healthy."

Shedding Her Skin

She entered surgery on Dec. 18, 2001. The operation was successful: Ellen's flab fled at a rate of 10 lbs. a week. She's now cured of metabolic syndrome and in better health than ever before. She had met a new man not long before the surgery; they were married six months later.

But as she shrank, giant rolls of skin remained. In December 2003, she underwent a massive removal of the saggy inner tube of skin encasing her. "The gastric bypass gave me back my health, but the plastic surgery gave me back my life," she says.When she returned, weighing 228 lbs., her father burst into tears. "I'm so happy to see you healthy," Ralph cried.

The moment, however, was bittersweet: He had recently been diagnosed with non-Hodgkin's lymphoma. Ellen's father died in 2004, but not before seeing his daughter recover her health and self-esteem. "The weight-loss surgery was like having brain surgery," says Ellen. "All of a sudden I was treated like I had a brain."

She quit nursing for a much better paying job as a manager for a medical products company. Though the freedom-bestowing surgeries played a role in ending her second marriage, she has no regrets. Putting her father's fears to rest before he died, she says, "meant everything to me.

So many things have changed: She's closer than she used to be to her mom and sisters. She no longer dreads going to restaurants where she might shame her family as onlookers gape at the fat woman eating. She takes her mom to church and musical events. And in 2006, her sister Laura, who had also gained a lot of weight, decided to get bypass surgery as well.

Now a size 14-16 and about 235 lbs., Ellen is hugely grateful for her new freedom — so grateful that if she finds herself on a plane next to an empty seat, she offers to switch with any morbidly obese person on board. She knows how rare it was to experience kindness when she was a size 38. "I'll always be passionate about having tolerance for people — no matter who they are or what they look like," she says.

Daddy would be proud.