'Tsunami' of obesity-related disease warning for NI
Northern Ireland faces a "tsunami" of obesity-related diseases with which the health service will struggle to cope.
That is the stark warning from Dr Mike Ryan, who runs a weight management clinic in the Northern Health Trust.
In the past year over 2,000 referrals have been made to his clinic. A two-year-old is currently being treated.
"It's best described as a tsunami of obesity-related morbidities that's coming down the track in just five to 10 years, " Dr Ryan said.
"For example, stroke, heart attacks even respiratory conditions. It is just not about prevention, but intervention and unless significant resources are put in now, the NHS will not be able to treat these patients effectively. "
Experts say the review into Health and Social Care due to be published this month must tackle the prevention of obesity in the same way as decades of effort - and money - have gone into tackling smoking.
While the biggest cost is ultimately lives, dealing with obesity-related conditions is soaking up around 20% of the entire health care budget. Unless urgent action is taken, that figure is set to rise.
Dr Ryan said obesity underpins a large proportion of patients who are ill.
"In fact 75% of our patients have a weight-related illness contributing to their disease," he said.
"For instance those with respiratory disease, cardiac issues and stroke. Alarmingly our youngest patient is two - the eldest is around 70."
In Northern Ireland, about 24% of adults are obese. The figure for children is 8%.
In essence that means they have so much excess body fat that it is having an adverse effect on their health.
Dr Ryan described the number of people coming through the doors of his clinic as "shocking". The clinic is officially called the "managed obesity network."
The approach is novel. Unlike conventional weight loss programmes, the Northern Health Trust's programme involves a networking, or joining up, of services in the hospital and in the community
For instance, a cardiac patient may be referred to the diabetes department who may have to call in the advice of a respiratory therapist, but all will be linked back to the weight loss clinic.
One patient who has made that journey is 64-year-old Phil Carruthers. After suffering a heart attack, doctors felt his excess weight of two stone could trigger other life threatening diseases.
"Having survived the heart attack, I accepted that it was me who had to lose the weight. I wasn't obese just a little overweight," he said.
"Being on the programme means they are monitoring me for stroke and for cardiovascular problems.
"So by being on the programme, I'm being helped not to put on extra weight and hopefully avoiding a range of potentially killer diseases which could cost me my life, but also cost the health service a lot of money. "
Dr Ryan said the programme also examines a patient's relationship with food. He said that when a person resorts to overeating it could be a signal that all is not right in their life.
"Those triggers might be grief, anxiety - instead of turning to food we can suggest different coping strategies," he said.
The chief executive of the Chest, Heart and Stroke Association, Andrew Dougal, agrees that preventing obesity should be a priority.
But he is frustrated that the health service has failed to get a firm grip on the problem.
"People so far have been dithering. The whole thing has been terribly frustrating," he said.
"We've known since 2003 that there was a time bomb out there in terms of childhood obesity and really little has been achieved since then. Delay after delay is not doing our children any good. "
Demand for surgery to tackle obesity is still high. Privately, people in Northern Ireland have spent almost £1m having gastric bands fitted. The Hospital Group - a private clinic in Belfast - has carried out 148 gastric procedures in the past two years.
While surgery is available on the NHS - it only commissions extreme cases.
Instead the Health and Social Care Board considers that health, education and primary care based programmes based on exercise and healthy eating are the most risk free and cost effective mechanisms for tackling or preventing obesity.
This means that patients who are obese have an option of self-treatment which can start immediately.
The review into health care is attempting to identify areas which can tackle how to prevent people becoming obese in the first place. A fitter, healthier, slimmer nation makes for a more efficient health service.
The BBC understands that one of the main themes of the review is to target more resources at the young. This will come in the shape of Sure Start programmes and healthy eating initiatives in primary schools.
Clearly obesity is such a huge issue that the government must begin thinking bigger - and fund accordingly.
- With a major review of Northern Ireland's health service due to be published later this month, BBC Health Correspondent Marie Louise Connolly will be looking at the big issues it will tackle each night this week on BBC Newsline at 18:30 GMT on BBC One.