Desperate slimmers flock to clinics

Increasing numbers of people are turning to private slimming clubs as a way of shedding the pounds, disillusioned with radical carb-free diets and expensive gym memberships.

It is estimated that more than 100,000 people this year will have joined clubs where they have to check in once a week for medical advice, help and support as a last-ditch attempt to lose weight.

Some clubs use controversial appetite suppressants alongside the usual dietary advice. Others provide clients with all the food they will need for a week as a way of helping them avoid the temptations laid out in supermarkets.

Britain faces an obesity epidemic and John Reid, the Health Secretary, is to make recommendations in a White Paper on public health to tackle it. Private clinics hope to be included in the equation, so that GPs could prescribe a course in a registered clinic on the NHS as a cost-effective and efficient way of helping those seriously overweight.

The White Paper will also address the problem in children, among whom obesity rates have trebled in the past two decades. The proposals will spell out that young children at risk of being overweight must be identified by health professionals so that their families can be given advice on how to keep them fit and healthy.

Health visitors will be asked to help identify the toddlers who appear to be putting on too much weight for their age, and this will then be monitored. Later, it will fall to school nurses to pick out the children facing serious health problems because of their size, and liaise with their families. There will also be a telephone helpline to give parents advice on how to give their kids a more active lifestyle.

Obesity is estimated to cost the UK up to £7.4 billion a year and will soon supersede tobacco as the single greatest cause of premature death. It is related to serious conditions such as type 2 diabetes, hypertension, coronary heart disease, strokes and some cancers.

By the time a girl reaches adulthood, her risk of a heart attack if she is obese is three times greater than that of a slimmer woman. Adults who are seriously overweight have a threefold increase in the risk of cancer of the colon.

Private companies claim that they should be central to the government's attempts to tackle the crisis. Although there are few published statistics to show their effect on long-term weight loss, the companies claim to be highly successful at helping people who have tried countless diets and failed to lose the pounds. Many patients say the weight stays off if they change their lifestyles to become fitter.

Some of the groups such as WeightWatchers and Slimming World have offered to give three-monthly courses at a reduced rate on the NHS. However, to qualify for free help the patients would probably have to be seriously overweight at the start.

There are concerns that doctors may send patients to classes that have a lower success rate than others. Specialists want to see more controls in the sector so that clubs have to produce long-term evidence that patients who lose a lot of weight are supported afterwards, instead of being left to carry on with no help.

There are also concerns about whether private clubs should prescribe drugs for patients. National Slimming Centres, which has 35 branches across the UK, uses the appetite suppressant phentermine, a drug which can only be given to clinically obese patients whose body mass index is greater than 30, and is prescribed by GPs who work privately for the centres. The clinics have 250,000 patient visits a year, with the average patient visiting five times a year. The centres' founder, Robert Houtman, said the drug had been given a bad press undeservedly and that it helped thousands every year to reach a healthier weight.

'I'm only interested in what works,' he said. 'It's very hard for many clients to find the willpower that they need to lose that weight, and this medication is really effective. They still eat healthily, they can take in 850 calories a day, and their weight goes down, which is a huge health benefit for them.'

Houtman believes the NHS does not have the capacity or expertise to help the patients he sees each day. 'GPs would like to do more, but don't have the time to spend with patients. It would be lovely if the NHS could send patients to us, but that's as likely as me becoming Prime Minister.'

Patients have to be carefully monitored during the course of drug therapy. The two drugs most commonly prescribed by GPs are sibutramine, whose brand name is Reductil, and orlistat (Xenical) which work in different ways but have good weight loss records.

In the past two years, 10 Healthier Weight Centres, run by Dr David Ashton, have sprung up around England. These centres, which focus on changing the lifestyle of overweight clients, pro vide a weekly bag of groceries for each person so they can avoid the temptation of supermarket food.

Ashton said: 'I set up these centres because I didn't think that obese people, who can be very vulnerable, were really getting the help they needed. It is very, very difficult to lose a lot of weight, and you need to give them an enormous amount of support, but also a lot of education about how to become active and eat nutritious food. There is no quick fix.'