Gastric banding - just cheating, in my opinion

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.