Trimming the fat

Observations on the obesity crisis

As a fatty, I have a vested interest in scaring myself by logging on to the NHS Direct website to read the growing list of ailments that obese people like me will develop. At one point, I became so scared that I rejoined my local gym in west London. There you can find the perfectly formed, the chubbettes, the plumpettes and then me, the sole "fat one". I think it is time that health officials took pre-emptive action about the growing obesity crisis. Apart from anything else, I do not wish to be the only fat person in the health village.

If you put the word "smoking" into the NHS Direct search engine everything is on offer: a freephone quitline manned from 7am to 11pm, free one-to-one sessions, group sessions you can start two weeks before giving up. If you are very overweight, the NHS site may enable you to find out what may befall you if you eat too many Mars Bars, but there's no free help. Even if you are unemployed and on benefits you will have to pay up to £3 (the subsidised price once you have bought a leisure card) each time you go to the gym. Another discount route is by making a good case to your GP, pointing out that you are circumferentially challenged. She can write an exercise prescription and fax it to a participating gym, which you can then visit for £2.70.

If you need someone to motivate you to stay on the trim and narrow, there is the local diet club, but unlike the freephone quitlines for smokers, there is no equivalent Trimline provided by the NHS. At most diet clubs, lower-income fatties can pay a reduced rate of roughly £4 a week - and then be urged to buy the food scales, calorie-counter books and everything else on sale.

For an overweight person on a low income or on benefits, advice about cutting back on fats or taking more exercise is not enough. External motivation is also important. There is nothing like seeing a gym with clients running on treadmills close to large windows - even if they look on to an estate where no one can afford the membership. For even local authority "cut-price" gyms are now run to attract the metropolitan professional, with fees to match the MTV monitors and £3 power drinks. I can only "take advantage" of my leisure card subsidised price if I visit between 9am and 11am. Someone on a salary of £15,000 - standard for a customer service position - would still be expected to find about £10 a week for gym classes and another £5 for the diet club.

The savings from not having to treat illnesses from heart disease to diabetes would outweigh the costs of free gym membership for a year, the time it takes a motivated gym-goer to lose five stone. The NHS Direct website describes obesity as one of the most serious medical problems in the western world. It will become even more serious if the same purse that produced the funds to prevent many smoking-related diseases is not opened to help the overweight on low incomes as well.