In a recent report it has been stated that sugar is as dangerous as alcohol and tobacco and it goes on to state that Britain’s obesity crisis could be reversed within five years if food companies reduce sugar in products by 30%.  Wow! This is an incredibly surprising statement.For me, the obesity crisis has a great deal more to do with the lack of physical activity and regular exercise, not purely sugar intake. And I can’t help but recall the days when the first cotton candy machine came to my street. I grew up in a neighbourhood of about 15 kids and when this cotton candy machine came we used tons of sugar and obviously loved it. But when I was growing up I don’t remember seeing many obese children. It’s only now, over the last 25 years, that we have seen such dramatic increase in obesity. Why is that? We were eating our fair share of sugar when I was growing up – so sugar can’t be held completely accountable.I go back to my point that it is not only our diets but again the lack of physical activity that is perpetuating the obesity crisis – children being driven to school and not walking or riding their bikes, after-school physical activity programmes dwindling, kids becoming addicted to their iPads and Playstations. But I have to concede that it would be a good idea to cut at least 100 calories from each person’s daily diet – and with the high content of sugar in many of today’s processed foods I have to agree that these levels must be lowered if we’re to see improvement.Simon Capewell, a Professor of Clinical Epidemiology, states that sugar is the new tobacco and I agree with his sentiments: ‘Everywhere, sugary drinks and junk foods are now pressed on unsuspecting parents and children by a cynical industry focused on profit not health. The obesity epidemic is generating a huge burden of disease and death.’It is also stated that 1 in 4 adults in England is obese and these figures are set to go up to 60% of men, 50% of women and 25% of children by 2050. The incidence of type 2 diabetes leading to cardiovascular disease and morbidity is going to be unmanageable unless this stops. Currently, obesity and diabetes already cost the UK £5 billion every year and experts state that it could reach £50 billion in the next 36 years. This is an astronomical rise, and should have us all very worried.So, is taxing the food industry the right way to go or should we be focusing on education?  There is a general consensus that children are the primary targets of food marketing and as a very vulnerable group, heavy marketing of sweets and sugary drinks contributes to skyrocketing childhood obesity. I am of two minds here. I am a huge advocate of public health and believe that it’s vital for public health officials to educate us in the right choices.  But, I think somewhere along the line we must take responsibility for ourselves as individuals; we can’t always blame everyone else for our problems. I do feel deep down that the government has a role to play with healthy messages to deal with the ill effects of high calorie intake, but it must be a structured push from the government and ultimately the onus lies with us to take action.I am still very happy that this report didn’t come out when I was a kid, as I’ll never forget those fantastic days when we had our own cotton candy machine. This is a tricky one. This blog has no intention of causing offence to any of my colleagues, but simply to give my opinion. I have written extensively on the subject of athletes as role models, and I don’t believe that we should hold them on a pedestal or put sport stars in that elevated position. However, doctors should be role models and, in my opinion, they need to look ‘healthy.’ Doctors have a responsibility to their patients to exude an aspirational image of health.A close friend of mine was very disturbed about the amount of obese and overweight doctors and the amount of doctors who smoke. The first thing that comes to mind is ‘practice what you preach.’ Would you go to a financial advisor who was bankrupt, or to a plumber who’s sink was leaking? How are patients supposed to take advice from a doctor who doesn’t project the image of a healthy lifestyle?But then again appearances can be deceptive. People come in all shapes and sizes and we know we can’t make snap judgments about overweight physicians; they may practice good habits while many seemingly fit physicians may have very bad habits. So, do we rush to judgement? Dr Regina Benjamin, former US Surgeon General, once said that, ‘what makes a physician credible is whether they practice what they preach and the lifestyle recommendations they propose.’ I can’t help but agree with this sentiment – but judging physicians solely on their outward appearance could be detrimental.Now the NHS has spoken up on this issue. A recent article in the Telegraph states that overweight doctors and nurses have been told to slim down by the NHS Chief. There are 700,000 NHS staff classed as overweight or obese and they must shed these excessive pounds in order to set a good example to patients according to Simon Stevens, NHS England Chief Executive. My question is: how are they going to implement this? I can understand the NHS’ urgency to address this issue as it emerged recently that obesity and its related health problems, may now account for a third of the 110 billion NHS budget. But is it a feasible task?Finally, there is another side to the argument. Physicians are still people, and they can be just as imperfect as their patients. Expecting a doctor to always follow recommendations that he or she gives their patients, whilst intuitively logical to expect, is probably not realistic in real-life situations. This is a very interesting debate. I look forward to see whether Stevens’ order will actually change the aesthetics of the NHS. The emergence of obesity represents one of the most widespread threats to public health and wellbeing in the UK, with 67% of men and 57% of women either overweight or obese.The NHS is estimated to spend over £5bn a year on diseases linked to obesity such as strokes and diabetes. Within a few decades, that is predicted to climb to £15bn. Ok, so where do we go from here? Surgical solutions? This is an extremely contentious issue, and one that I feel very strongly about. The issue of diet in this country needs addressing – now!The intrinsic problem with diets is one of sustainability. Most diets demonstrate some short-term weight loss, but these loses don’t seem to be maintained over a long period of time. Therein lies the problem – overweight people turn to diets to lose weight, they achieve short-term weight loss, but then gain the weight back, if not gaining even more than they started with.Diets work because they are highly restrictive eating programs. Trust me… most diets I have seen (and I have seen a lot) are not a lot of fun. Food is to be enjoyed and is a very important part of our culture and how we interact with each other. That’s why it’s more important to teach people how to eat rather than resorting to just limiting your food. EDUCATION, EDUCATION, EDUCATION.With such a widespread obesity problem it is surely wise to investigate why people overeat. The underlying, psychological factors are a crucial factor. I truly believe that being over weight has a great deal to do with behavioural issues and as health professionals we should be providing behavioural support and psychological counselling as part of the weight control programs.These restrictive diets just can’t work as a long-term solution – they restrict you from eating foods that you actually enjoy and this may even lead to a diet-bingeing cycle. In addition, when you restrict food, your body has a mechanism where it doesn’t want to be starved; in response the body actually slows its metabolism, which of course makes it more difficult to lose weight. Diets can also be very harmful as they may lack essential nutrients and force you into bad eating behaviours leading to yo-yo dieting. And I haven’t even touched on the potential psychological problems and eating disorders that can be a by-product of intense dieting. Let’s face it, as I said earlier there’s no pleasure in a restrictive diet.Finally people should be wary of the diet industry that peddles magic weight loss potions; THEY DON’T WORK…. Remember, these products, pills and potions are marketed for one purpose – money. Do you think these companies are primarily concerned with the state of the nations health? I don’t.The bottom line is, fad diets just don’t work. The most important thing is to develop proper eating habits with a healthy variety of different foods and regular physical activity – that is the key for a healthier lifestyle and weight management.