Obesity isn't that simple

Weight-loss surgery is this week's "scandal," with some specialists claiming that doctors are "skirting around the rules" to give their patients access to these procedures.

Radio and TV news programme shock headlines have also served to fuel the usual uninformed abuse that passes for chat-show debate.

The underlying assumptions are that weight-loss operations are simply a form of cosmetic surgery made necessary by either gluttony or weak-minded refusal to change one's lifestyle.

The chat shows have vented predictably bigoted comments, portraying those who access surgery on the NHS as unworthy compared with cancer patients denied expensive drugs by Nice or "our boys in Afghanistan."

Add to this the view that such "self-indulgence" should be purchased in the private sector rather than being made available by the NHS.

These attitudes ignore the huge health problems linked to morbid obesity, which is on the increase, and the benefits for both individuals and society if it is tackled.

Conversely, where patients have had stomach surgery, a gastric bypass or a gastric band fitted and lose weight through pursuing a healthier lifestyle, including diet and exercise, this is often reflected in reduced risk of strokes and heart attacks linked to diabetes and hypertension.

This not only extends and improved individuals' lives but also saves the NHS financially.

Offering someone surgery is not a magic potion. If there isn't a change of lifestyle, there will be no lasting reversal of obesity. Such cases exist.

But just as one person's reversion to alcohol after receiving a liver transplant would not invalidate the need to offer recovering alcoholics with acute liver problems a transplant, the same applies with regard to weight-loss surgery.

Of course, it would be best if individuals took and kept control of their weight rather than opting for surgery, but life is not always so simple.

Although there is now much greater publicity and awareness of the need for a healthy balanced diet, with reduced fat, sugar and salt, and regular exercise, there are many pressures that obstruct the healthy alternative.

Many physically demanding jobs, for both women and men, have been superseded by sedentary occupations.

Long working hours dictate that, for too many people, evenings after work involve hours in front of the television, tucking into a ready meal, too many of which are high in salt and trans fats as well as highly profitable.

Ready meals' relative cheapness and convenience mean that they often take precedence over balanced meals involving fresh vegetables, fruit, carbohydrates and protein.

And the problem begins in early school years where children often gorge on unhealthy foods such as chocolate bars, crisps and oversweet fizzy drinks in spite of expanding efforts to encourage a greater understanding of nutrition and the need for exercise.

There is a need for a national awareness campaign so that parents understand the best nutrition for their children, but there are also financial implications.

The reality is that buying fresh produce for each meal is more expensive than snacking or eating processed foods, so healthy food, especially at nurseries and schools, ought to be subsidised.

Bringing up children to appreciate the benefits of nutrition and exercise and being able to access them will minimise future needs for weight-loss surgery.