Current provision of NHS services to tackle obesity is uneven and combatting the condition is likely to remain a major challenge for the service in the future.

A new report by independent healthcare consultant Dr Foster found that although PCOs are putting measures in place to fight obesity, some areas still refuse to fund drug and surgical treatments for obesity, ignoring NICE guidelines.

The Dr Foster study was supported by an unrestricted educational grant from Abbott, manufacturer of obesity treatment Reductil, which competes with the only other NICE-approved obesity treatment, Roche's Xenical.

The survey of primary care obesity management strategies found that about 30% of PCOs did not have access to dieticians, and more than half had no strategy in place to audit GP practices and monitor the implementation of NICE guidelines on obesity treatments.

Dr Foster did have some positive news for PCOs. Central government policy initiatives on healthy behaviour and accessibility, such as the '5-a-day' campaign in England and the 'exercise on prescription' have been almost universally taken up.

Dr Ian Gibson, MP, Chair, House of Commons Science and Technology Select Committee, said: "Although significant progress is being made by the NHS, there is unacceptable inequality in services between PCOs in the UK. Policy needs to be driven nationally by government and locally by PCOs."

Current obesity policy focuses on the condition as a risk factor for other chronic diseases, such as heart disease, diabetes and cancer, rather than as an illness in its own right.

Dr Ian Campbell, Chairman of independent medical organisation, National Obesity Forum, expressed concern at viewing the condition in this way.

"It is important that obese patients who are worried about their weight should feel able to go and seek their doctor for advice," he said.

Although approximately 20% of the UK population is obese, only 1% of those patients are prescribed obesity medication and Dr Foster's report found that around 3% of PCOs do not provide any funding for obesity drugs.

Prescription weight loss treatments have struggled to reach their full potential, mainly because of the hesitancy of regulatory authorities to approve them for reimbursement. Sales of Roche Xenical fell by 16% last year, a drop the company said was in line with the general decline of the anti-obesity market.

Obesity affects 20% of the adult population in the UK, directly costing the NHS £480 million annually. Indirectly, obesity is estimated to cost the UK economy at least £2.5 billion a year, in costs to the NHS and to industry through sick leave.