Obesity is a word once reserved for the grossly overweight. It is a pity it has been co-opted by a campaign to shock the high proportion of New Zealanders who are merely heavier than is healthy. Like most words used in this way, it has probably lost its sting. But a reality show starting on TV2 this week will follow the weight-loss efforts of people who fit the unfortunate term.

They are in "The Big Ward", as the programme is called, a clinic in South Auckland which prepares people for bariatric surgery, "stomach stapling". To qualify, they need to show they can lose some weight first. Why this is necessary, and the surgery should still be necessary for those who can lose weight naturally, are just two the questions that might be answered if this programme is better than most in the "reality" style.

We don't need mawkish sentimentality as it follows the struggles of the patients and their families to qualify for the procedure that will be life-extending, even life-saving, for the morbidly obese. It will be dramatic enough after the surgery is performed and the transformation is remarkable. Anyone who has had bariatric surgery, or known someone who has had it, can attest to that.

Tears of happiness and new hope can be guaranteed but we ought to learn more than that. We should see what it means to live with a stomach so much reduced. It has been described as living with a stomach that feels permanently full. That must raise its own nutritional problems.

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Done well, reality television can open our eyes to important health issues that are usually debated in abstract theory. One side of the obesity issue blames manufacturers of food with high fat or sugar content and its advertising, convenience and low cost. The other side blames human weakness, greed and inactivity, arguing the solution is simple: eat less, exercise more.

That is probably what the obese will have to do to qualify for bariatric surgery. It is not as easy as it sounds, as too many Kiwis know. We are the third-fattest people in the developed world, after the United States and Mexico. We should not be. Our climate, recreational opportunities and agriculture are ideal for producing a fit, healthy population.

If these are not enough to make us eat sensibly and exercise daily, it is doubtful that selective taxes, advertising bans and free fruit in schools can do much about it. But watching this programme and following the efforts of those who really have to lose weight could be salutary. Sustained dieting is hard work. The specialists may have much useful advice if it can be heard amid the hugs, tears and tantrums that characterise reality TV.