Could it sound any easier? Just pop into hospital for a stomach-shrinking operation and watch the pounds fall away.
Last week, TV presenter Vanessa Feltz was the latest celebrity to come out about having the operation, announcing she'd had a gastric band after her weight ballooned to 16st 4lb. 'I want to lose about 4st or 5st,' she said.
Such operations have spiralled to record numbers this year, but behind the celebrity glitz and apparent convenience, serious concerns are emerging about their overuse, their soaring failure rate and the deaths and lifelong complications that can result.
Weight-loss surgery, called bariatric surgery, involves either having a silicone band fitted around your stomach, or staples inserted to make it smaller. (Less common is a gastric bypass, where the gut is 're-plumbed' to make the stomach smaller and the digestive tract shorter.)
All forms of bariatric surgery aim to make patients want much less at meal times. The surgery was introduced in the early Nineties and has helped thousands of obese people, particularly those with life-threatening complications such as diabetes or high blood pressure.
But as experts gather this week for an international conference on obesity, there is worrying evidence that weight-loss surgery is failing, sometimes with disastrous consequences.
The key finding is that a significant number of operations don't work. About 20 per cent of gastric bypass patients regain much of their weight within a few years of surgery, report researchers from the University of California, San Diego.
This is due to stretching of the surgically 'shrunken' stomach. But it's gastric band operations that are particularly affected by problems.
A study by Dutch doctors has found the success rate for gastric banding might be so low it calls into question whether the operation is worth doing.
Five years after surgery, a third failed to lose significant weight; after ten years, two-thirds were around their original size. As a result of complications, a third of patients needed the operation re- done after five years, while half needed this at ten years.
'You must realise this is not the final answer most of the time,' lead researcher Dr Edo Aarts told the American Society for Metabolic and Bariatric Surgery conference last month.
Other new research points to long- term health problems including bone- thinning, fractures, anaemia, kidney stones and psychological problems even suicide.
As a nation, we are spending ever more on bariatric surgery. Last year, the NHS bill came to about £20 million. Guidelines say surgery should be done as a last resort, but 4,300 operations were carried out by the health service in 2009 - a 55 per cent rise over the previous year.
There were another 5,000 operations performed privately. The past few years have seen a series of deaths as a result of bariatric surgery.
Last July, Kerry Greaves, 30, from York, suffered complications from a gastric bypass performed by the NHS.
She died a month later, despite doctors operating 14 times to try to save her. Her stomach was leaking bile and she died from organ failure.
Greaves, who was 18st, had wanted surgical help to slim because she feared her daughter would be bullied 'for having a fat mum'.
Greaves's mother Anne warned: 'My advice to anybody thinking of having this operation would be: "Have more pride in yourself and don't do it." '
Last August, Anne Truesdale, 42, died from blood poisoning after surgery in a private hospital. With a BMI of 70, she'd undergone an NHS-funded stomach-stapling operation when a leak resulted in a number of complications over nine months that led to her death.
Other deaths include that of Susan Wrighton, 59, after a surgeon failed to spot internal bleeding following a stomach-stapling operation at a private hospital in Macclesfield.
It took three returns to theatre before doctors realised the mother-of-two was bleeding from the surgery site.
There's also been a massive rise in private patients suing their surgeons for poor results, according to the doctors' insurers, the Medical Defence Union.
Cases of post-operative infection and gastric bands slipping or leaking are increasingly common. But in many cases, the op simply fails.
Lisa Cookson's story is typical. The 33-year-old nurse from Preston, Lancashire, had a gastric band 16 months ago, but is the same weight. Lisa has long suffered weight problems - at 5ft 11in, she weighed 17st 6lb. Her GP prescribed her the anti-obesity drug Orlistat to block fat absorption.
'But the drug made me ill,' she says. Lisa also tried exercising more. With a BMI of 34, she was clinically obese, but did not meet her primary care trust's criteria for treatment because she didn't have related illnesses such as diabetes.
So she decided to pay £8,000 for an operation at a private hospital in Lancashire. The mother of two girls, aged 11 and three, says: 'The reason I had it done was because I never get a feeling of fullness. The surgeon promised me on the day of the operation that I would feel full on smaller portions. But I never did.'
In the procedure, an inflatable silicone band is placed around the top portion of the stomach; it is adjustable, so the circumference can be altered to control how much the patient can eat.
Lisa's surgeon made several attempts to adjust the band, but none worked.
Lisa says: 'It was a waste of £8,000. The doctors have just said that sometimes the operation does not work. If I had been told more about the risk of failure, I might have saved myself the money and misery.'
Bariatric surgery can have a devastating effect on the patient's long-term health. Researchers at the Mayo Clinic in Minnesota report that people who undergo bariatric surgery have twice the average risk of breaking bones later.
One theory is that the patients' reduced ability to absorb nutrients leads to bone-thinning. Iron absorption is also affected, leaving patients at much higher risk of anaemia.
Gastric bypass patients are also at significantly greater risk of developing painful kidney stones thanks to changes in their urine, researchers report.
But perhaps the most common post-operative problems come from the psychological and lifestyle shifts patients must make after their operations.
Bariatric surgery is no magic wand and one in five operations fails due to a patient's psychological problems.
Under NICE guidelines, patients with psychological problems should not be considered for stomach surgery. But this can be ignored, says John Morgan, a consultant psychiatrist at the Yorkshire Centre for Eating Disorders.
'A quarter to a fifth of patients have bad outcomes, particularly if they have a history of binge-eating, bulimia, depression, or even anorexia. If you're eating because of a need in your brain rather than a need for stomach satiety signals, then having your stomach reduced is not going to solve that,' he says.
Psychologists have discovered that while many surgery patients cut their eating, they transfer their addiction, becoming alcoholics, binge-shoppers or sex addicts.
Samantha Scholtz, who gives NHS patients pre-surgical psychiatric assessments at the Imperial Weight Centre, Charing Cross, says that post-surgical support is also a problem.
'For the first few weeks after the operation, people are emotional, thanks to the effects of the surgery, not being able to eat and losing weight. These all cause depression and anxiety,' she says.
Alternatives are sorely needed. An estimated one million Britons pass the NHS threshold for treatment - a BMI of 40 or more (or 35 to 40 if the patient has type 2 diabetes or high blood pressure) - which would cost an astonishing £9.1 billion, says Professor Tony Leeds, a bariatric physician at the Whittington Hospital in North London.
'GPs have little to offer apart from the extremes of surgery and advice to go away and eat apples and lettuce,' he says.
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