A CLINIC in Swindon is fighting a losing battle on the frontline of Britain's obesity crisis.

Swindon Primary Care Trust (PCT) says the town appears to be about average in terms of its figures.

However, for dieticians at the intensive weight management clinic based at the Great Western Hospital, the situation is definitely worsening.

Since 2006, Swindon & Marlborough NHS Trust's Dietetic Department have seen a 25 per cent increase in new referrals for obesity management with the greatest increase being in the body mass index (BMI) range above 35.

Community dietician Deborah Collins helps to run the clinic at the hospital, which deals with the most serious obesity cases.

"It has shifted," said Deborah who has started to see more and more patients who may weigh 30 stone or more.

"What's the cause? I don't know - the theory is it's to do with lifestyle."

The service is quite costly, but according to the dieticians it is almost the last ditch attempt to get people to lose weight and keep the weight off.

With current funding, the once a month clinic sees two new patients, two three-month stage patients and two patients at six months.

They will sign an unofficial contract, but sometimes in the end people feel surgery is their only option.

A common theme among obese people is low self-esteem, which leads them to comfort-eat.

"It's trying to break that cycle," said Deborah.

Furthermore, Deborah says that once someone is overweight, general activity becomes harder and harder so people struggle to keep physically fit and may even end up in a wheelchair, making the situation worse.

Outside influences such as friends and family also play a part.

"We're of that sort of mindset where food is love - a lot of people will give food as a reward," said Deborah.

According to the dieticians, patients' treatment at the hands of people on the street on a day-to-day basis contributes to the problem.

"The general population are not nice to large people - they heckle them," said Deborah.

"They think they're different and stupid just because they're overweight."

Sometimes a person's environment may affect their ability to eat healthily, such as not being able to get to a supermarket where fresh food is cheaper.

Another problem they say is that they find children are not taught to cook at school any more.

Deborah shares her responsibility for weight loss with consultant of endocrinology Saheed Ahmed, and Lesley Hitchman, a clinical psychologist.

Deborah said: "We work hand in hand because a lot of it is behaviour changes to make them lose weight. Willpower is a bit of a simple explanation.

"If somebody is ready to change they will."

She said even if somebody turns to surgery the clinic provides support because without this it will likely fail.

For example, the clinic often finds that people who have a gastric band fitted to limit food intake, don't always come back to get it tightened, therefore it fails to work effectively.

Deborah has also known people to cheat the band by melting foods like chocolate to make them go down.

Sadly the dieticians say that their service often fails to yield results.



A sedentary lifestyle
A LOCAL heathcare representative claims our multiple choice lifestyle is largely responsible for today's nutrition problems.

Fiona Dickens, obesity lead for the Swindon Primary Care Trust believes, compared to 60 years ago, we have a far greater variety of products.

However, despite more fresh fruit and vegetables available, safer water and better housing she does not believe that these advantages makes us automatically healthier than then.

Fiona, pictured, points out that when the NHS started there was still food rationing.

"People were not overweight, but their intake was lower - there were more home grown vegetables, but less fruit," she said.

Fiona says that today there is a wider range of snacks, biscuits and ready-made meals available and many more labour-saving devices.

"People choose to be physically active now," she explained.

"People were much more physically active then so didn't have to think about the concept of exercise, whereas now we're so sedentary."

Our natural instinct as human beings, according to Fiona, is to eat what is available and goes against the idea of dieting.

"Naturally people are programmed to conserve energy," she said.

Fiona says the problem has almost crept up on society and was not considered a problem 10 or 15 years ago.

She also said that it is only recently that people have recognised the important role prevention has in keeping people healthier and reducing the strain on the NHS.

However, she says there are lots and lots of activities available in Swindon if people want to get fit and support for those that want to be more active.