For those who don't know, a gastric band is the update to the old stomach-stapling routine. You have a plastic band fitted over the greater part of your stomach, or a blow-up sac and silicon loop inserted, leaving you with a small portion of stomach above and the majority below. It doesn't block the passage of food into your lower stomach, but it slows it down and you fill up faster, so the theory is, you're satiated sooner and that helps to stop you eating.

In the UK, the operation is available on the NHS for people who are clinically obese (a body mass index of 35 or above) or have other health issues such as diabetes, heart disease or high blood pressure, and whose lives may be at risk if they don't lose weight. People also have to undergo psychological counselling about their reasons for overeating - after all, this is a lot of money to come out of the public purse for people who just can't lay off cream cakes.

But many people who have the op choose to go private, at a cost of about £7,000. And I must admit that that worries me. If you don't qualify for it on the NHS, should you be having this done privately? As with any operation, there are some risks involved, including anaesthesia and leakage, which can entail a second operation to correct the first, and having this kind of intervention means you don't have to deal with the underlying issues that made you overeat in the first place.

The Fern Britton story also raises another matter. Like Anne Diamond (another TV presenter - maybe it's a fat job), Britton chose to keep her operation a secret and, on top, made a nice packet on the side out of advertising diet foods. Both women claimed to have lost weight by diet and exercise. I'm all for being private over medical issues, but in my view, what they have done is fundamentally dishonest. They could quite easily have told their agents 'No'.

My personal attitude towards diet and exercise is hard line, as it happens. Women (and we know it's women, don't we?) are so bone idle when it comes to health and fitness. I've been fat and I've been thin and I don't believe a word of this cobblers about 'having tried everything' and having been unable to lose weight. Barring a tiny minority of people, if you diet and exercise, you lose weight - it's as simple as that. As my old driving instructor said one day as we stopped to let an enormous woman inch her way across the road: "They can't ALL have gland trouble..."

"I'm of the opinion that no-one should need that drastic an intervention," says Dr Dr Funke Baffour, who specialises in the psychology of weight management, on the issue of gastric banding. "I have had patients who are thinking about it, tell me they have done everything they can to lose weight, but, after discussing it, they haven't."

In an article by Anne Diamond, I was struck by these words: "Now I can do what I never thought I'd be able to - eat half a pizza and happily watch the waiter take the rest away." Now what, exactly, is so very difficult about that? For that matter, what is so difficult about saying no to pizza altogether? I eat maybe four a year, dear reader. And no, I don't find it easy. I LOVE pizza. I love bread and biscuits and cakes and chocolate. That's why there aren't any in the house.

Yeah, yeah, I know we all have 'issues'. Who doesn't? Who doesn't wish their parents had been kind instead of control freaks? Who wouldn't rather have a great job with more money? But doh - who wouldn't rather lie in bed than go jogging? Who wouldn't like to eat chocolate every day? Issues with food - and comfort eating - have to be dealt with the same way you deal with issues with drugs and alcohol and sex. See a shrink, not a surgeon.

Lifestyle, I feel, remains the main factor and it's no surprise that fat parents raise fat kids. I grew up in a lardy Celtic family with a thick line of obesity running through it - my paternal grandmother and aunt, my mother and my sister were all clinically obese and we ate chips with everything, along with huge mounds of bread and butter. But you don't have to accept your fat destiny any more than become an alky just because your parents were. In her 20s my sister lost over seven stone with diet and exercise - that's 98 pounds - and she struggles with her weight every single day. Her overweight son in his turn has now lost about five stone (70 pounds). This has entailed huge changes in their lifestyle, and iron-willed discipline.

This may not be the easy option, but it is by far the longest-lasting. In my view, gastric banding shouldn't be a lifestyle choice - it's just another example of whining adults wanting someone else to step in and sort out their problems for them.

Today I started walking again - for the first time in a month. The wake-up call was putting my back out a week ago. OK, I admit it's my own fault. My sister visited at the end of September and I did nothing but clean, tidy and decorate for a fortnight before she got here, then drive her around for a week. The dog was going nuts, wondering where his morning run had disappeared to, but impressing my sister was obviously more important. I even stopped my morning yoga in favour of slapping paint on the salon walls.

The trouble is, I'm not a teenager any more, am I? At 44 you can't just stop exercising for three weeks and then carry on like nothing's happened, especially when you have a dodgy back. So last Friday, I should have known better than to pick up a 10-litre can of paint and carry it upstairs - even with a daily four-mile walk and my yoga exercises, this would be daft for me without a back brace, but having not exercised at all it was very stupid indeed. Luckily I got away with strapping myself up for three days and taking it easy.

Today's been my first walk since then. I live in the countryside and it's a beautiful autumn day, with mist and yellowing maize, and the cherry trees turning red. Walking is a complete and private pleasure. At heart, I think I do it not just to stay fit, or to keep the dog out of mischief, but to connect with nature, mull over thoughts and feelings, and to calm myself down. I also like being alone for a while, with only my untalkative mutt for company. The idea of exercising on a treadmill or lifting weights is anathema to me, but it's horses for courses I guess - some people like their gym membership, or to exercise in a class. I'm more of a loner. The important thing is to find what exercise you like, and to stick to it.

So even though my inguinal ligaments were screaming after about 30 minutes and my normal walk took 15 minutes longer than usual, I now feel fantastic. I also know that today I'm in better shape than yesterday, and tomorrow I'll be in better shape than today. It's all worth it.

1 Stay out of the sun. Yeah, yeah, we all know this one, and for many women the damage was already done back in the 70s and 80s before the news got out. But there is nothing to stop you protecting your skin from now on. Winter and summer alike, every day you should wear a moisturiser with at least a factor 15 sunblock in it (30 is better) and at the slightest hint of sunshine, up this to a factor 60.

2 Drink. And drink water. When your body's thirsty it's not asking for tea, or diet Coke, or a smoothie - it wants water. Give it what it wants. If that wasn't bad enough, it's now known that thirst is a poor indicator for hydration, so you shouldn't wait till you're thirsty before you drink. You should be drinking a good two litres of water per day. If, like me, you find drinking large quantities of liquid quite difficult, try downing a pint of warm water on rising, on going to bed and a couple of times during the day, such as when you're preparing a meal - raising the temperature of the water makes it easier to glug it down. By the way, for every alcoholic drink, or tea or coffee you take during the day, you need to add another one third of a pint of water to your intake because alcohol, tea and coffee are diuretic and are therefore robbing your body of fluid.

3 Don't smoke. Besides the numerous other nasties that smoking merrily gives you, such as heart disease, cancer and death, it also ages your skin. It does this in three ways - firstly, the repeated pursing of your lips as you take a drag adds up to hundreds of thousands of lip-pursings that, in time, result in deep vertical lines around the lips which are almost impossible to get rid of. Secondly, smoking destroys collagen and elastin, which are what keep your skin plump and youthful. Thirdly, smoking causes narrowing of the blood vessels in the outermost layers of your skin, which impairs blood flow. This depletes your skin of oxygen and important nutrients, such as vitamin A.

4 Keep hydrated. That means externally, with water sprays, humidifiers, water reservoirs on your radiators etc. If the humidity level in your home drops below 50 per cent, it begins to have a detrimental effect on your skin - not to mention your health generally, particularly the mucous membranes in your nose, throat and lungs. As a clue, if your hair becomes static in winter when you brush it, your house is too dry. Even standing a shallow bowl of water on the sideboard will help - but make sure you change the water daily to prevent bacteria building up.

5 Don't use soap on your face and neck. I would have thought we'd all know this by now. It's generally better for your skin to cleanse with creams and oils, then apply creams and oils, unless your skin is very greasy. If you like the feeling of water on your face, try washing with emulsifying ointment. Available from any pharmacy counter (you'll have to ask, because it's so cheap it isn't given display space) , this comes in big tubs and is hypoallergenic, non-drying and contains no colour. Other non-soap bars include Neutrogena Dry Skin Soap (which isn't really soap at all) and aqueous cream bars, which are simply a solid version of aqueous cream BP, a kind of moisturiser.

6 Maintain good skin hygiene. In other words, don't keep touching your face all day. Wash your hands before you do your makeup. Keep your phone handset clean with a mediwipe each day. Don't rest your chin in your hands. Don't pick at your spots - dot a drop of tea-tree or geranium oil on spots, using a cotton bud and allow to air dry before applying moisturiser.

7 Don't drag at your skin. The skin on your face is much more delicate than the skin on your hands and body, and it's particularly delicate on your eyelids. When applying or removing makeup, don't be rough - use good-quality cottonwool pads and enough product so that you're not pulling and tugging at yourself. Pat on moisturisers and blend lightly with clean fingertips - don't rub until your skin changes colour.

8 Exercise. Exercise oxygenates your skin, which improves collagen production. Any exercise that raises your body temperature and reddens your skin is helpful, but the best for your face are specific facial exercises - I'll write about these tomorrow.

9 Don't have long, hot baths. If you stay in long enough to prune, that's a sign that your skin is losing moisture. 15-20 minutes is about the maximum time you should spend in the bath and if you can, shower instead.

10 Use bath oil. Preferably an organic-based oil such as sunflower, rather than an inorganic oil such as baby oil. A good squirt of this into the water and broken up with the head of the shower hose will coat your skin nicely, preventing too much water loss. It also saves time, as you don't have to moisturise afterwards. Add a little lavender or geranium essential oil to it for a pleasant scent. If you shower rather than bathe, mix your oil with equal quantities of sea salt and use it as a body scrub - make sure to use a non-slip mat, though, as it will turn your shower into an oil slick. Generally speaking, only your armpits, crotch and feet actually need soap - these are the areas where you have apocrine glands which produce pungent sweat, as opposed to the eccrine glands that produce odourless sweat all over the rest of your body. The rest of your body doesn't need to be soaped on a daily basis.