A French hospital believes it can reverse soaring French obesity rates
By David Chazan
BBC News, Paris
It's a typically French approach to shedding the surplus kilos.
A leading public hospital in Paris is teaching patients being treated for obesity how to cook.
And instead of being put on a diet, they are told it's OK to sit down to a three-course meal - especially with family or friends.
But snacking and TV dinners are out.
Fat isn't something you would normally associate with the French. But the global obesity epidemic hasn't spared the country renowned for exquisite cuisine - and rates are rising.
Liberte, Egalite, Obesite!
"Enjoying food, variety in food, the culture of food are the best defences against obesity," says Dr Arnaud Basdevant, head of the nutrition department at the Pitie-Salpetriere Hospital in Paris.
Our approach isn't to put France on a diet - we try to keep the variety, the pleasure and the conviviality, with high-quality products
"When you really enjoy good quality food, it sounds strange but you tend to eat less."
Patients in Dr Basdevant's department learn to make classic French dishes. The only difference is that they're shown how to use water instead of oil or butter, but still achieve a tasty result.
Sugar and even cream are allowed in small quantities. But the emphasis is on balanced meals and nutritionists at the hospital have devised a full set of recipes to guide them.
The doctors say this system won't make anyone stick-thin, but combined with regular exercise it will help to get obese and overweight people down to a healthier weight.
Patients are taught to use water instead of oil or butter
"Our approach isn't to restrict people or to put France on a diet," Dr Basdevant says.
"On the contrary, we try to keep the variety, the pleasure and the conviviality, with high-quality products."
The health ministry says about one in six French people is now obese.
That is less than in many other countries. In the UK, for example, it is around one in four and in the US about one in three.
Dr Basdevant says one reason why obesity rates are lower here is "probably because France has held on to more structured eating habits and didn't move to fast food as early as Britain, for example".
But the French do have a taste for fast food. France is the second most profitable market after the US for McDonald's restaurants.
And with obesity increasing, President Nicolas Sarkozy is planning a major new campaign to combat the nation's expanding waistlines in the New Year.
Patients are shown that healthy food can still be tasty
The president himself is reported to have been making an effort to keep his weight down, and the example set by Mr Sarkozy and his wife Carla Bruni is said to have inspired several government ministers to start fighting the flab too.
"In France we have a prevalence of obesity in adults of around 17%," says Michel Chauliac, head of the health ministry's national nutritional health programme.
"The proportion of obese children from the age of three to 17 is about 3%, but if you also include overweight children, then it's around 16 or 17%."
But Dr Chauliac is optimistic that things will improve.
Meal swipe cards
"Obesity in adults is still growing, but the prevalence of obesity in children is now not increasing any more," he said.
The Beaupre School in Haubourdin has plenty of healthy options
Dr Chauliac says he hopes that in 10 or 20 years obesity might be less of a public health problem in France.
One of the worst affected parts of the country is the north, particularly the area around the city of Lille.
At the Beaupre School in Haubourdin, near Lille, pupils use swipe cards to choose their meals at the canteen.
There is plenty of variety - a salad and fruit bar and even a pizza and grill counter which serves chips.
But the cards won't allow pupils to choose this option more than once a week.
The school's manager, Daniel Maslanka, says pupils aren't constantly told to eat five portions of fruit and vegetables every day. Instead, they are served balanced meals that taste good.
"We offer the kids meals with lots of vegetables and fruit but we make sure they enjoy it," says Mr Maslanka.
"You have to make the effort to find out what their tastes are so you can please them. They can still eat chips and pizza - but only once a week."
Mr Maslanka says that although obesity is far above the national average in the area, there are few, if any, obese pupils at the school, which also offers a range of sports.
You can listen to David Chazan's report on BBC Radio 4's PM programme at 1700 GMT on 16 December.