Despite the fan mail and her aversion to watching herself on TV, Star says the ultimate decision to have gastric bypass surgery was made for her health. Between her 40th and 41st birthday, Star says she gained 75 pounds. "I was dying," she says. "I now know I was very depressed. I was lonely, and I didn't know how to say, 'I'm lonely.' That's one thing that I have learned in doing a bunch of research and self-analysis—we in our community are ashamed sometimes to admit that our emotional health needs some help."