There's no easy cure for childhood obesity

However, after numerous consultations and a raft of psychological and social assessments, two morbidly obese boys were fitted with gastric bands.

When the story broke yesterday under the headline "18st boys get fat ops on NHS", the hospital, which is at the forefront of weight-loss surgery was forced to defend its position.

The two boys, a spokesman said, were extreme cases – both were double the weight of a normal healthy 14-year-old – and the 7,000 keyhole surgery operations, which took place in 2006 and 2009, were a last but vital resort. Their weight had gradually ballooned and as teenagers the were both living under the threat of heart disease, diabetes and a string of other debilitating disorders.

Patient confidentiality meant no further details of the boys or their progress since surgery was released, but with the rules relaxed in 2006 to allow under- 18s to have bariatric surgery when all other options have been explored, many fear the cases could be the tip of a growing iceberg.

While the results of gastric band and bypass operations can be impressive, they are by no means a cure-all for the morbidly obese and some experts have begun to wonder just how these children were allowed to pile on so many pounds.

"It's a horrendous indictment on society that we should ever allow these children to get this fat," says Tam Fry, of the National Obesity Forum.

"Why didn't social services, why didn't doctors, why didn't nurses trigger alarm bells years go?, because this kind of thing does not happen overnight."

In the past-two years, the number of adults undergoing weight-loss surgery on the NHS has doubled. Youngsters make up a fraction of the cases, but with stomach-stapling, gastric bands and bypasses all carrying a risk of infection and a need for carefully controlled aftercare, the initial procedure is only the start of a long and often difficult road.

However, while many may worry about the use of surgery on children so young, there are no easy solutions to the growing problem of obesity and each new set of statistics seems to paint an ever bleaker picture.

While just over one in five children in England start their school life either overweight or obese, by the time they leave for secondary school that figure has risen to one in three. A significant number come from families where junk food is a staple diet and where exercise is non-existent, but behind the headline-grabbing figures there are a hundred and one reasons why today's youngsters are bigger than any previous generation.

A more sedentary lifestyle plays a part, as does a lack of fruit and vegetables, but in some cases comfort eating is a symptom of much deeper-rooted problems.

Katie Ward, from Garforth, Leeds, was at primary school when her family first began to notice that she was getting bigger. Her brother had always been on the large size and initially they thought Katie was simply taking after her older sibling.

As each year passed, the problem seemed to get worse, but when her parents, Sarah and Colin, initially consulted paediatricians, they were reassured here was nothing to worry about. The official diagnosis was puppy fat, and the family were told it was something Katie would eventually grow out of.

But Katie didn't grow out of it and as her parents struggled to put their finger on what was wrong, Katie confessed to being a secret over-eater. Bullied at school from a young age, food had become a cushion from the outside world.

Sarah admits that when her daughter finally admitted the cause of her weight problem, both she and her husband were overwhelmed by guilt.

However, they were also determined to help their daughter get her weight back under control and Katie was soon spending Saturday mornings in sessions run by Carnegie Weight Management.

A residential course at the Leeds-based organisation followed and, regaining her love of sport, Katie, now 13, has already shed more than a stone and is hopeful of losing even more weight.

"Colin and I were lucky, we could eat anything we wanted and never had to worry about putting on weight," says Sarah.

"When Katie was born she was actually underweight and as a toddler she was still very small, but something changed when she was about six or seven.

"Suddenly she was bigger than other girls in her class and that's when the teasing started. When things became difficult at school, Katie's eating spiralled out of control and she found it really difficult to admit what was happening.

"Fortunately I think we have turned the corner. We never wanted her to crash diet, but the weight is gradually coming off and as a family I think we have all become aware much more about what we eat."

Faced with photographs of morbidly obese children, the knee-jerk reaction is to blame the parents. Some are certainly guilty of indulging bad habits, but the parents are as much a product of the fast-food society as their children.

"It's too easy to lay everything at the door of parents or say obese youngsters should eat less and exercise more," says Paul Gately, who set up the Leeds-based Carnegie Weight Management in 1999.

"The reality is that 14-year-olds are very independent and environmental influences are often more important than their family background.

"What's not debatable is the serious consequences of obesity. Research out recently suggested morbidly obese youngsters will shorten their lifespan not by 10 years, but between 20 and 30 years.

"To combat the issue, the NHS would need to spend in the region of 2.4bn. It might sound like a lot, but it would save 105bn in future healthcare costs."

Since launching 10 years ago, more than 1,000 children, between eight and 17, have passed through the doors of Carnegie's weight loss camps

and club programmes and have collectively shed 730 stones. However, despite thousands of children needing help, the organisation always has places

to fill.

"In the early days we had a huge amount of negative attention, but since then people have become much more aware of the issues," adds Prof Gately.

"Given that there are 4.5 million overweight or obese youngsters in this country, you'd think our courses would be oversubscribed, but they're not. The problem is that each PCT has a different way of dealing with childhood obesity and there isn't one overall approach.

"Surgery is something that may be considered in the most severe cases. I am not aware the risks for children are any greater than they would be for adults, but in many cases alternative approaches can have really impressive results.

"Losing weight is like riding a bike; if you fall off you've just got to learn to get back on and work at it. Whatever route you choose to lose weight, it requires a lot of hard work. There is no miracle cure."