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With obesity-related illnesses like high blood pressure, type 2 diabetes and certain cancers costing the NHS over six billion a year, Miriam Margolyes sets out to find out what is being done to combat the obesity crisis and meets people who are going to extreme and sometimes controversial lengths to lose weight.

To understand the true cost of the epidemic, Miriam meets Angela, 41. Two years ago, Angela’s leg was amputated. Her weight meant she needed a knee operation, which led to a sepsis infection. Stuck at home, relying on carers to wash, dress and feed her, Angela’s weight upended her life.

It is not just the current generation that need to heed the warning – with statistics predicting the next generation will be the most obese ever, Miriam learns of the latest government initiative. Across the country, primary school children are being weighed and measured, with the obese invited to attend a 12-week course to improve diet and encourage exercise.

Miriam sits in with Emma, from the Live Lighter weight management team in Sheffield. Emma has the unenviable task of cold-calling parents to suggest their child attends the programme. It is no easy task but at least it is addressing the issue, and Miriam wishes it had been available when she was younger. Keen to know what life is like for a child who is overweight today, Miriam meets up with ten-year-old Claudia. Claudia tells Miriam she ‘knows what it’s like to be judged’. Her accounts of her weight struggles and secret eating have a familiar ring as Miriam realises she has met her mini me. Claudia’s parents worry about name-calling and feel responsible but, as Miriam tells them, the blame game is an easy one.

When Miriam was a kid, before Deliveroo and the advent of the all-you-can-eat buffet, she felt people didn’t worry so much about what they looked like – now so many seem to struggle with weight and body image. To discover why, Miriam enters an extreme world of weight loss, meeting people who have taken controversial steps to cut their weight and their bodies to a more desirable size. Jess was 23 stone – but after NHS weight loss surgery to cut her stomach in half and dramatically reduce the amount she can eat, her weight is plummeting, and she is closer to her Beyoncé-shaped dream body. In Chester, Dr Kerrigan, a leading weight-loss surgeon, explains to Miriam that with the NHS spending a million pounds an hour treating diabetes, this surgery not only helps people lose weight but could save the health service millions in the long run. Jess eats miniscule amounts of food and is on course to lose around a stone a month until she plateaus around ten stone. It is hard for Miriam to process – something clearly needs to be done and surgery may be a short cut to being healthier but is it a short cut to being happier? Miriam can’t help but wonder what psychological effect such an extreme change in eating has.

Jess’s friend Sammy had bariatric surgery two years ago. She has lost over half her body weight but it has left her with excess skin, which she is saving up to have removed. Despite dropping from 16 to eight stone, Sammy tells Miriam she has developed body dysmorphia, meaning she sometimes fails to see herself as slim. As Miriam watches Sammy pick at tiny amounts of the topping on her pizza, most of which she can’t eat or she will be sick, Miriam ponders if striving for a slimmer body should be at any cost.

Bariatric surgery doesn’t appeal to Miriam, who wonders if there is another way. She heads to meet people who have achieved sculpted bodies without surgery, through a regimen of strict diet and exercise. Aeronn has lost four stone in just 25 weeks and is now so happy with his body he feels ready to be judged. He invites Miriam to the Welsh Natural Body Building championships in Newport, where he is competing. Miriam wonders if body perfection is the dream, will everyone she meets be blissfully happy? She soon gets her answer. Bart is only 16 but despite having an impressive physique, he wants bigger arms and more muscle and tells Miriam he does bodybuilding to make him feel better about himself.

Miriam starts to wonder if our search for body perfection is just swapping one obsession for another in search of an unobtainable dream. Back home, she re-evaluates her own life. She is overweight, sure, but she is loved by her partner, had doting parents and has good friends, so, despite being 'fat at 78', maybe she has done ok on the important stuff. Worried young people will struggle to grow up happy facing pressure from social media to conform to certain body types, Miriam heads back to see Claudia, her mini me, at her birthday party to tell her what she has learnt.