2. Obesity the burgeoning problem “From Samoa to the Steppes, from Sunderland to Sao Paulo - every country faces a potential public health disaster if it fails to take decisive measures, not only to introduce better management but far more effective preventive measures, to halt the slide we have seen accelerating over the past 25 years” Chairman I.O.T.F 1999

3. The Rising Prevalence of Obesity in England 1980 to present YearMen%Women% 1980 6 8 1991 13 15 Currently 17 20

4. Tackling Obesity Population based or public health approach Personal or high risk approach

5. Tackling Obesity Where do we start? B.M.I > 30 kg/m 2 with a family history of type 2 diabetes and/or c.h.d in a first degree relative those with B.M.I > 27 kg/m 2 with co-morbidities which would benefit from weight loss

6. Tackling Obesity The goal - not cosmetic but metabolic health and reduction of risk This can often be achieved by a 5-10% sustained weight loss.