Paediatric dietician Heidi Guy has a unique insight into the pressures facing British kids.
By Helen Briggs
BBC News Online
In the two years she has been running a child obesity clinic at St Richard's Hospital in Chichester, West Sussex, she has heard some alarming things.
Some of her young patients admit to eating dozens of bags of crisps and chocolate bars in a weekend.
Children are bullied in the playground over the brands of food in their lunchbox and there is over-whelming peer pressure to look good and fit in.
"I would say just about all of them have been bullied or teased because of their weight," she says.
"We go through boxes and boxes of tissues and a lot of them are very tearful about everything."
Britain is said to be on the brink of an obesity epidemic. According to figures from the Department of Health, more than 8.5% of 6 year olds and 15% of 15 year olds in England are classified as obese.
Yet despite these stark statistics there are only a handful of specialised clinics that offer help.
The NHS Child Obesity Clinic at St Richard's Hospital, which was set up in February 2001, is one of the pioneers.
Facts on obesity
The % of obese adults in England has almost trebled since the beginning of the 1980s
21% of men and 23.5% of women are obese
The proportion of overweight children increased by 7% between 1996 and 2001
It tackles the problem on two fronts. Children referred to the unit are asked to complete a food diary to identify areas of weakness. They are then given sensible dietary advice on portion sizes and healthy eating.
Staff at nearby University College, Chichester, run an after school activity club that promotes exercise in a supportive, non-competitive environment.
"Their confidence and their ability and their self-esteem are so dramatically improved because they're in a club with other children who are also significantly overweight," says Heidi Guy. "So they're not competing against the slim kids."
Professor David Candy, a paediatric gastroenterologist at the hospital, is one of the founders of the New Leaf (Lifestyle, Eating, Activity and Fitness) programme at St Richard's.
In his smart suit and cartoon tie - standard wear for paediatricians - he is a popular face in the children's outpatient centre.
Professor Candy says when children join the programme their fitness is assessed by walking a mile on a treadmill at their own pace. Some of them are totally exhausted by the end of it.
He says the key thing is to encourage children to exercise in an environment where there are no winners and no losers.
"At school, there's the embarrassment of the changing rooms - and nobody wants them on their team because they have to move around a lot of extra weight.
"Here none of that happens and they're all here for the same purpose and there's no teasing."
Children as young as three and even babies have attended the clinic at St Richard's but the average child is aged eight or nine and there tend to be more girls than boys.
"I like the club it's really fun," says Jessica, aged 11, who has been attending the clinic for six months. "I feel like I have lost some weight and I feel happier with myself now."
Laura, aged 17, has been coming to the clinic for nearly a year and says she has lost quite a bit of weight.
PE teacher Joanne Bruce supervises sports
"The people who run it are very very positive about it and they don't look at it as a temporary thing they look at it as a life long thing."
Lorraine's son Paul attends the clinic. She says it has built his confidence and he has become less withdrawn.
"At home, he used to always stay indoors - people came and called for him but he wouldn't go out.
"Now, nine times out of ten, he will go out, he'll play football, he'll jump on his bike and do things, which is good, that's all really been since he started here."
PE teacher Joanne Bruce runs the activity club at University College Chichester. She says many of the children had given up sports because they were so self-conscious about their weight.
"I think their weight does affect their confidence and they don't feel that they can perform as well as most of their peers and that's when they start dropping out of participating in their activities.
"A few of them, from being here and seeing that actually they can do these activities, have taken up sports at school and taken outside clubs."
The children have access to world-class facilities at University College, including a gleaming indoor sports hall and numerous football pitches and grounds.
Inside the sports hall, as his patients play a hearty basketball game, Professor Candy gives his prescription for tackling child obesity in the UK.
Heidi Guy and David Candy have been running the clinic since 2001
"I think the answer is more exercise, in simple terms. Smaller portions of food - sandwiched between exercise."
He says the NHS is starting to take the idea on board for adults at least with schemes such as GPs being able to prescribe exercise to adults. But he says the most important time to intervene is during childhood.
"By the time you get to 17, you're pretty set in your ways and you probably can't teach many new things, which is one of the reasons I came into paediatrics," says Candy.
"There's still hope for you when you're a child and so this is the age group that I think should be targeted to set up a life-long practice and habit of getting up and walking."