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Some cases can be linked to genetics, Giada, 20 eats very little but is still overweight, as is her father and brother. More often though, sufferers are caught in a vicious cycle of dieting, over-eating, depression and despair. Maria Rosaria, 21, has struggled with her weight since she was just 12. She lost her mother when she was very young and suffers from loneliness and poor self esteem. Silvia, 32, has spent years trying to overcome her obesity. She had a gastric band fitted which caused her constant pain, and spent time at a health farm where she followed an extreme diet. Back home she couldn’t keep it up and turned to appetite suppressants. Her skin started to peel off and her mouth bled. Beating obesity is a life-long process. There are no quick-fix cures. The goal for programme’s participants is to slim down and to stabilise for a year before losing the final 10 or 15% of their excess weight. Once they have achieved this they can start losing the last few kilos, but, they must accept that even when the weight is lost, they will never be entirely free of the disease. There is every risk that it could come back to haunt them.