With one in 30 of the UK population now classed as morbidly obese, the NHS is spending increasing amounts on weight-loss stomach surgery.
Figures released by the NHS Information Centre last week showed there had been a 30-fold increase in bariatric surgeries in a decade - up from 261 in 2000-01 to 8,087 in 2010-11.
While some NHS trusts continue to fund such surgeries for people with life-threatening obesity, others prefer to take a different approach.
In Leeds, teenager Emma Jane Money has recently undergone a gastric bypass operation.
She lost more than two stone in weight in the two weeks after the NHS paid for her to have the surgery at the private Thornbury hospital in Sheffield.
'Potentially dangerous' The 16-year-old, who weighed more than 21st (133kg) before the operation, said she had tried to diet and exercise more but had been unable to lose weight on her own.
She told the BBC's Inside Out programme: "With constant images of ribcages and bones and bony elbows and things like that it is hard and people do get this idea in their head that this is what every person is meant to be.
"It's really hard when someone then looks at me and thinks 'they're not right, that's not normal'."
Emma said she was "excited" about losing weight.
"I will get to wear all the new fashion trends with my friends. I will get to go anywhere and I don't have to worry about people saying things or judging me."
About 1% of patients die after weight-loss operations but consultant surgeon Roger Ackroyd, who operated on Emma, said the benefits of the surgery far outweighed the risks.
"It's extreme, it's potentially dangerous but it really does work," he said.
"People come to me and say... you are spending hard-earned taxpayers' money treating people who basically all they need to do is eat less and exercise more. That's a very valid argument.
"The only thing I would say is these people such as Emma would in time go on to need a hip replacement, knee replacement, she'll go on diabetic medication, she'll go on blood pressure medication and cancer is much more common in overweight people.
"If we can invest in this type of surgery now then it saves the NHS money in the long term."
In the East Riding of Yorkshire, people with a body mass index of more than 45 are being referred to a programme where they are given a personal trainer and nutrition advice.
Mandy Bennett, from Driffield, is one of nearly 50 patients signed up to the Live Well scheme and has lost three stone.
She said: "I have been maintaining my weight for three or four months now which is a big part of it. Learning to maintain your weight is as big an issue as losing the weight."
She said that without the help of her personal trainer she would "still be sat in front of the TV eating the wrong things, getting bigger, getting more unhealthy and probably not anywhere near as happy as I am".
Dr Tim Allison, NHS East Riding of Yorkshire's director of public health, said: "We have seen the number of surgical operations drastically go down by about 80%.
"The levels of bariatric surgery had been increasing quite considerably and we didn't have the services in place to give people the opportunity to have that dedicated six to nine months of intensive diet and physical activity.
"We felt it would be far better if we could put that in place rather than simply have people go forward to surgery.
"People shouldn't be desperate to have bariatric surgery, they should be desperate to change their life around and to work to lose weight."
