I have been watching with interest the TV series The Big Ward, screening on TV2. It follows patients having bariatric weight-loss surgery at the Manukau Super Clinic over a year, pre- and post-surgery.

It's a fascinating and often disquieting watch. Initially, it brings home the scale, pardon the pun, of our obesity problem. It's one thing to hear the statistics: one in three is obese; one in 10 children are, and so on, it's another to see the reality.

The people on The Big Ward are morbidly obese. Young people with short life expectancies tipping the scales at well over the 100kg mark, looking for a life-saving solution.

They have got there, usually, from a lifetime of poor food and inactivity. Often they simply don't have any knowledge of what healthy eating is.


One woman was amazed to discover the existence of such vegetables as red cabbage. Another young man's regular habit was a daily takeaway breakfast of fish and chips and fizzy drinks.

It's easy to judge - to blame the parents or laziness or lack of willpower. But obesity is the result of a complex patchwork of causes, and lack of education and deprivation are high on the list.

It is also intriguing to see how much the psychology of eating comes into play. For many of the people depicted, food is a comfort. It's a friend when nothing else in life is going well. Food gives a momentary relief and pleasure.

That's something, unfortunately, that weight-loss surgery won't fix.

The surgery drastically reduces the size of the stomach so patients can only eat tiny amounts of food. It is not done lightly. It means permanently changing the way they eat.

People can be judgmental about those opting for weight-loss surgery, thinking it's an "easy" option. But nothing is easy about only being able to eat half a cup of food at a meal. Patients have to carefully manage their diets to get enough nutrients from those tiny portions. It's easy for their diets to become unbalanced and they can even become malnourished.

And surgery is not a magical weight-loss cure. Although everyone who has the surgery will lose weight, there's still the possibility of failing to keep the weight off.

One study of patients found nearly 20 per cent failed to lose at least 50 per cent of their excess weight by the one and two-year follow-ups. Even small amounts of the wrong foods can still undo the benefits.

For those not wanting to take the drastic step of surgery, there are still benefits to losing even a little weight.

A recent study by US researchers found losing just 5 per cent of your body weight is beneficial - enough to lower risk factors for type 2 diabetes and heart disease. Downsizing - even a little - is worth it.

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