When images of 45-stone teenager Georgia Davis hit the headlines recently, the world gasped in shock. Not only did the British 19-year-old need to be rescued from her room by a team of 40 people in an eight-hour ordeal, Davis also had to be rushed to hospital in order to be treated for organ failure.
Alas, experts warn that within years these astonishing images will become less the exception and more the rule. And in Ireland, warnings abound that we could be the first generation who will bury our children first.
We are generally aware of the worldwide sweep of the obesity epidemic and, closer to home, the statistics make for grim reading.
Up to 327,000 children (20pc of the population under 18) are either obese or overweight, and experts have warned that Ireland is heading for a US-style epidemic where 33pc of children have weight problems. Even more worrying, one in four three-year-olds are overweight or obese.
And, according to endocrinologist Donal O'Shea, who runs obesity clinics in St Vincent Hospital and Loughlinstown Hospital, "most adult obesity begins in childhood, and overweight child is 80pc likely to be an obese adult". And thus the vicious cycle begins.
Of course, it hasn't always been this way ... so how did we get here? Given that weight gain happens when the calorie intake (food) exceeds the calorie output (activity), a number of variables have contributed to the rise in childhood obesity in Ireland. One of the biggest culprits is the exponential rise in fizzy or energy drink consumption. A generation ago, coke and lemonade was wheeled out for special occasions, but not anymore.
"Up to 80pc of five- to 12-year-olds intake sugary drinks on a weekly basis," says Dan McCartney, a nutritionist who works at the Irish Nutrition & Dietetic Institute. "Four to 6pc of their overall energy is attributed to these drinks, which is quite staggering."
Energy drinks are a particularly stealthy culprit, as they are targeted largely at elite athletes and sporty types and manage to seduce people with their isotonic or 'electrolyte' content.
"Young men see Paul O'Connell drinking an energy drink and assume, 'that's good for me'," says Donal. "They don't have the full picture."
In fact, advertising has caused a huge shift towards the emphasis on sugary foods. 'Pester power', whereby a child harasses parents for products they see advertised on TV, is the axis on which the food industry economy spins.
"The food industry spends 85pc of their budget on the 'top shelf', nutritionally empty foods on the food pyramid," notes Donal.
"And the advertising is targeted at children. Advertising works; they wouldn't spend the money if it didn't."
Another unlikely force is at play, however; parents' hectic work schedules.
"A high proportion of parents who work in the week have their children in the morning when they're tired and cranky, and in the evening when they are tired and cranky," observes child psychologist Colman Noctor.
"They don't want their only contact with their child to be about withholding, and so resilience about nutrition goes out the window. Food is an integral part of treating children. Now, children get soda five times a day.
"There are high levels of irritability and mood swings involved in a high sugar diet, and parents want to offer their children something that appeases that."
Further compounding the problem, and thanks in part to the advent of the Xbox, multi-room TV and mobile phones, kids' physical activity has dropped dramatically, too.
"Eighty per cent of schoolgirls fall below the basic recommended level of physical activity," reveals Donal. "A recent survey showed that Irish schoolgirls are five times more likely to get a lift to school than to cycle. And when it comes to activity, school isn't the main problem, in fact research shows that activity levels fall off at the weekend."
Adds Noctor: "Beforehand, kids were out running in fields but parents are aware that the jurisdiction is more limited. Because of insurance issues, there is no running allowed in school playgrounds. Socially, too, we are less free, and this has an affect on a child's psyche. The freedom to run and play sport helps with a child's mood and esteem. They are more solitary compared to years ago."
Given that exercise encourages endorphin and serotonin production (feel-good chemicals) in the brain, a distinct lack of exercise can cause depression. Add the crash after lurching from one sugar high to the next, and Irish children are in real danger of falling victim to a cycle they can't escape. Experts have established links between childhood obesity and depression... but which came first?
"We would have dealt with restricting disorders like anorexia, but with obesity we are becoming more aware of the psychological dimension," says Noctor. "When you were good as a child, you were given chocolate buttons, and if you misbehaved, you didn't get desserts. So these messages run deep early on and we develop comfort eating patterns to cope when we are sad. There are psychological links between the two -- we do it to feel better.
"When it comes to child obesity treatment, the weight issue is often not the primary thing that gets treated," he adds. "Often, low moods or low self-esteem are the primary cause for treatment. If a child is sad, and you see them as treating themselves. If a child is bullied about their weight, they don't get the self-esteem boost that other children get, and this causes them to eat more."
And, for many youngsters, low self-esteem can originate in a number of places; not just their appearance, but whether they are good enough academically, or fit in with their peer... or whether they measure up to the media ideal.
"Media messages are in the ether, you can't help but pick up the messages that role models for young females are low," admits Colman. "There aren't many that aren't thin, attractive and rich, and it's a narrow range of qualities.
"We're a weight-conscious world," he continues. "In Fourth or Fifth class, kids are becoming diet conscious, but unfortunately they don't have information on what is good or what is bad. So they will skip a main meal and load up on toast, little knowing that the main meal is probably a healthier bet."
Oftentimes, cognitive behavioural therapy is used to treat obese children in a professional environment. This way, emotional origins for difficulty are pinpointed and self-esteem can be worked on.
However, steps towards overcoming obesity can be taken outside the psychologist's clinic.
"We need to help kids feel a sense of accomplishment about something," advises Colman. "There's a feeling that you're supposed to be skinny and popular, and if you're not, you become worthless. Be creative and let them know that there are other qualities to life. I love to hear of sports events that aren't based on ability. In our society, the plaudits go to the athletically able as opposed to the athletically eager all too often."
In a wider sense, too, sea changes are afoot.
In 2005, the Report of the National Taskforce on Obesity recommended banning vending machines in primary schools, launching an education and training programme for health professionals, introducing guidelines for food labelling, examining fiscal policy and its impact on obesity, and introducing guidelines for the detection and treatment of obesity. Progress is certainly being made to raise awareness of the topic, but plenty more needs to be done.
Ursula O'Dwyer, a national health promotion policy adviser at the Department Of Health, outlines a number of initiatives currently under way. Physical activity is also high on the Government's priority list, and so the HSE have recently launched the 'Get Ireland Active' website.
The Government is also planning to weigh children up to the age of 16, too, and advise parents if their weight is ahead of their height.
Just this week, Health Minister James Reilly unveiled new healthy eating guidelines.
From ensuring that vending machines in schools have only low calorie/sugar/fat foods in them to appealing to the Broadcasting Authority of Ireland to limit children's exposure of adverts of fatty foods with a 9pm watershed, the Government's Special Action Obesity Group has its work cut out for it.
Estimate figures put Government spending in the area of obesity awareness in Ireland at around €10m.
"More money is being put into the Department Of Health year on year, she reveals. "If things don't change, the State won't be able to afford to treat these children, who will probably need treatment for the rest of their lives, if things continue as they are."
No matter how effective these Government initiatives, the buck ultimately stops with the individuals (or perhaps more specifically, the parents).
The key is to lead by example, simply by incorporating activity into family time at the weekends and implementing a treat system that doesn't rely on sugary treats.
Donal issues a simple but stark warning: "The Government can do lots of different things, but if the individual doesn't get the message it all unfortunately counts for nothing."