A gastric band or bypass should only be done when all other avenues have been explored and I don't believe they have been in anyone as young as 14. It's vital to address the cause. In a lot of cases, parents need treating as well as the child. Many misguidedly overfeed children, expressing their love through food. Many let kids overeat because they overeat themselves, or won't say no to their child.

A child can't become overweight unless they're allowed to eat too much - and we see this happening from as young as two. Research shows that obese children have furred-up arteries from the age of eight, setting them up for a stroke, heart problems, diabetes and premature death. Parents need information, support and encouragement to feed their children properly.

I'd like to see more fat camps where kids are put on a supervised healthy eating and exercise regime. It's unfair to allow a child to reach 18st. They can't do normal activities and will almost certainly be bullied. Re-educating eating habits would be a kinder and lower-risk long-term solution.

Medical treatment is best kept for adults as a last resort. But it only gives a kickstart, it won't do the work for you. Here are the options:

Four medical ways to tackle weight trouble

Xenical (orlistat)

● What is it? Alli (see left) - but it's twice the dose and will prevent your body from absorbing a third of the fat you eat.

● Who's it suitable for? You need a BMI of at least 30, or 28 if you have a weight-related condition like type 2 diabetes or high blood pressure.

● Will it work? Yes - but, as with Alli, only if you change your diet.

● Any risks? It's been considered very safe until now but see Alli for details of an ongoing investigation.

Gastric bypass

● What is it? A small stomach pouch is created so food bypasses part of your small intestine, making your digestive system shorter. This means you can only eat small meals and your body absorbs less food. It's more invasive than a gastric band op so you'll have more scarring and will be in hospital for two to four days, followed by about four weeks of recovery.

● Who's it suitable for? You need a BMI of at least 40.

● Will it work? Most patients lose two-thirds of their excess weight, roughly within the first 18 months. US research suggests weight loss and improvement in weight-related conditions like type 2 diabetes are greater with a bypass than a band. However, a bypass is a riskier procedure.

● Any risks? If you eat foods too high in sugar or fat after the op you'll get "dumping syndrome" - an unpleasant combination of nausea, abdominal cramps, sweating and diarrhoea. Because your body absorbs less food, you need to eat a nutritious diet and take supplements to prevent vitamin deficiencies.

Other possible complications include leakage from the intestine or bowel, obstruction of the bowel, internal bleeding, blood clots and infection. A 2005 study showed that just over one in 1,000 people die during or soon after a bypass.

Gastric band

● What is it? Through keyhole surgery, a silicone band is placed around the upper part of the stomach and can be adjusted by injecting or removing salt water through a port implanted just under the skin. The more it's filled, the more it reduces stomach capacity and slows the passage of food so you feel full for longer. You'll probably be out of hospital after 24 hours and back at work in a week. It's reversible and considered safer than a bypass.

Initially, you need to eat a liquid diet to get your stomach used to smaller portions. Food needs more chewing and food range is very restricted at first, widening gradually.

● Who's it suitable for? You need to have a BMI of at least 40, or 35 if you have a serious weight-related condition. You need to show you've previously tried to lose weight and that you're committed to frequent follow-ups and to changing your diet and lifestyle.

● Will it work? It depends how well you follow the diet and lifestyle advice.

● Any risks? They're low but include vomiting if you overeat, the band slipping or stretching so you can overeat, a tear in the stomach wall, or blockage, leakage
or erosion of the band. With any op,
there's a risk of infection or a bad reaction to anaesthetic.

Alli

● What is it? An over-the-counter pill that prevents your body from absorbing a quarter of the fat you eat. It's a half-dose (60mg) version of orlistat, a prescription drug that's been available for about 10 years. It costs around £50 a month.

● Who's it suitable for? You need to be over 18 with a BMI of 28 or above (see left, Check your BMI). It's not suitable for people on certain medications or with some conditions. Your pharmacist can assess your suitability, give you diet and lifestyle advice, and monitor your progress.

● Will it work? Clinical trials suggest it could help you lose 50% more weight than you would by diet and exercise alone but only with a reduced-calorie, reduced-fat diet.

It won't get rid of fat already stored in your body and, if you don't eat less fat, you can expect some diarrhoea, wind and bloating. You're not advised to stay on it for longer than six months and some people regain some weight after they stop.

● Any risks? Last year a few reports of liver damage led to an ongoing US Food and Drug Administration investigation but no connection has yet been shown. Patients are advised to keep taking it unless they get unexpected symptoms.

Check your BMI

Your BMI (body mass index) roughly determines how healthy your weight is in relation to your height. To find yours, divide your weight in kilos by your height in metres multiplied by itself.

Under 18.5: Underweight

18.5 to 24.9: Healthy

25 to 29.9: Overweight

30 to 39.9: Obese

40+ : Severely obese

Source: Daily Mirror