IN THE Yorkshire region alone there are 50,000 people with a body mass index of more than 50.

Given that a healthy BMI is between 20 and 25 – slightly less for those with Asian ancestry – this is not just a frightening statistic it’s also an expensive one in terms of both the personal cost of obesity and the financial cost to the National Health Service.

The NHS body mass index scale regards people with a BMI of over 25 as “overweight” and BMI of over 30 as “obese”.

Being overweight can lead to a whole raft of health problems from aching joints and breathlessness to cancer, diabetes and heart disease.

Despite the fact that health campaigners consistently highlight these facts and most people must now know they need to eat more carefully and take more exercise, the problem seems to be getting worse.

It’s estimated that a quarter of all UK adults are now obese, a statistic that reflects the wide availability of cheap, high calorie foods and increasingly sedentary lifestyles.

According to Dr Chinnadorai Rajeswaran, an NHS diabetes consultant in Kirklees and Calderdale who has a special interest in obesity, our nation’s growing weight crisis is “the collateral damage from materialism, separation, divorce and emotional problems”.

And he warns: “You can’t just blame someone or their genes.”

He believes it’s critical that obesity is seen as a psychological as well as physical condition.

The obesity epidemic – Britain now has the second highest levels in the world next to the USA – is fuelling a dramatic rise in the number of diabetes patients – and 70% of them are overweight.

Last year there were 1,400 new diabetes patients in our area – 200 more than the previous year – and almost all of them were diagnosed with associated complications from minor concerns such as high cholesterol through to kidney damage and eye disease.

For the heaviest patients with related health problems, weight loss (bariatric) surgery is a recommended option. Dr Rajeswaran believes it may be the only option once someone has reached a certain BMI.

“There really is no other way they are going to lose weight,” he says.

But even major surgery is not always enough to break the hold that food has over some patients. As many as half of those who have surgery put weight on again in the future.

“A lot of people have a psychological dependence on food,” Dr Rajeswaran added. “As a child they start to link certain foods with comfort or security. I have patients who began over-eating because they were abused.

“We spend quite a lot of time with our patients over a 12-week programme. They have an appointment with a psychologist before and after surgery, which is better than in some parts of the country, but my worry is that they don’t get long-term support and obesity is a chronic illness.”

Because of this concern Dr Rajeswaran has launched a unique evidence-based website which is free to patients in this area.

Called www.simplyweight.co.uk it offers advice and information on weight management, including details of what happens during and after bariatric surgery. There is also a patients’ forum.

“We are hoping it will save money for the NHS because patients will be better informed when they come to us,” he said.

The website will also collate information and he’s hoping to show that bariatric surgery can, in the long term, reduce the cost of medication as well as save lives.

At the moment each hospital nationally performs 100 weight loss operations a year, but there are calls for this to be increased to meet the growing demand.

Psychologist Sarah Jane Daly from Huddersfield University says there is a known link between traumatic childhood experiences and obesity.

“But there is also some debate about whether it’s an addiction issue, an impulse control disorder,” she said.

“There are so many different reasons why someone over-eats. I’m not saying that every overweight person has been abused.

“Some people put on weight to avoid sexual activity with a partner or so they can’t engage in certain activities.

“They may eat because their partner has died or a close relationship has broken down. If you are brought up in a household where everyone eats a lot then it’s normal for you. These people have underlying issues.”

She agrees that it’s too simplistic to say overweight people are greedy and have no willpower.

“It’s fine to eat things that maybe you shouldn’t eat every now and again – that’s normal,” she explained. “But if it’s a compulsion then you need to seek help.

“If food is starting to dominate your existence and is interfering with your life or people are starting to comment on your weight or none of your clothes fit properly any more then you have a problem.”

Fitness consultant Chris Ball, who runs The Fitness Suite, in Elland, sees a seasonal influx of people wanting to lose weight after Christmas.

But he explains to them all that improving health, fitness and weight management is not a quick fix and it’s better to start with small goals and make small changes.

“Our approach is to find out what motivates someone and then we give them the information they need,” he said “We find it works if we explain to people why they should do each type of exercise or why they should or shouldn’t eat certain things.

“People are not stupid – they know which foods are good and bad, but they may not know why.

“It’s that clarity of knowledge that drives what we do.”

Chris agrees that many people have an emotional relationship with food and get stuck in a rut with poor eating habits.

“I think the best thing someone can do is to make an appointment with a personal trainer,” he said. “A lot of people have this preconception that it’s expensive, but you can use them as a consultant, visit them once and talk things through – find out what your body type is and what sort of exercise is best for you. Everyone is different.”

Increasing daily activity is a key to weight loss and ideally we should all have a weekly schedule of mixed fat-burning aerobic and muscle-building weight resistance exercise – three hours a week in total.

But fitness professionals know that for many people exercise has to be fun, which is why dance-based Zumba became so popular last year.

Chris said: “It brought the fun back into exercise, but it’s gone off the boil now.

“I think 2013 will be the year group personal training will take off. It’s more affordable than having a personal trainer to yourself and it means you can get all the benefits at a lower cost and exercise alongside your friends or family.”

However, if going to the gym or an exercise class is a step too far, then his advice is to start with a brisk walk around the block and back in the fresh air.

The Obesity Specialist: Eat three decent meals a day and don’t snack. “A study has shown that those who have proper meals tended not to put weight on,” says Dr Chinnadorai Rajeswaran. “But those who snack all the time did. Snacking stimulates insulin production which increases metabolism and makes people want to eat more.” Don’t skip breakfast.

The Psychologist: Explore the reasons for overeating. “The underpinning reason why someone eats might never have been spoken about or addressed,” says university psychologist Sarah Jane Daly. “It’s important to seek help and talk it through. It can also be helpful to redirect your energies into something more positive like walking, running or swimming.”

The Fitness Consultant: Make small, sustainable changes to your lifestyle like taking a regular brisk walk to the shops instead of using the car. Don’t embark on a drastic diet and challenging exercise programme that will bite the dust in February. “Don’t make losing weight your sole focus,” says Chris Ball from The Fitness Suite in Elland. “If someone focuses on doing 10 minutes of cardio a day, integrating it into their daily life, then you’re improving fitness and weight loss is the by-product.”