In Britain, between 1980 and 1998, the number of people classified as obese tripled to 21per cent of women and 17 per cent of men. It is estimated that this costs the economy, as a whole, �2 billion and the NHS �0.5 billion in treatment. However the response of the NHS is patchy, with no national guidelines and only 28% of health authorities taking action to address the problem. There is little activity related to the management of obesity outside of general practice but only a small proportion of GPs follow a protocol. This report recommends that there should be strategies to reduce obesity and that the Department of Health should build on the plan in the National Service Framework on coronary heart disease and work with partners and professional bodies to clarify responsibilities. It should also work with the National Institute of Clinical excellence to disseminate information. The Department of Health should also lead a cross government strategy to promote the benefits of physical activity and there should be local targets to encourage cycling and walking. It should also work with the food industry to improve the balance of diet. Much of this work needs to be aimed at school children to promote a healthy lifestyle throughout life and guidance to schools on commercial sponsorship should be strengthened so that there is no conflict with messages on healthy eating.