Scotland is the second-fattest nation in the developed world, with only the United States having higher obesity levels, a report revealed yesterday.

Figures show for the first time the full extent of the link between obesity and serious illness in Scotland, with obese people 18 per cent more likely to receive hospital treatment than those of normal weight.

The figures, which also confirm alarmingly high levels of obesity in children, paint the most comprehensive and depressing picture to date of Scotland’s obesity “epidemic” and the extent to which this is affecting health. Obesity and its consequences cost the NHS in Scotland £171 million in 2001, the most recent year for which such figures are available.

Women are particularly likely to develop serious health problems from being obese, according to the report by the Scottish Public Health Observatory, a collaboration of public health information bodies in Scotland.

Obese women are nearly 13 times more likely to develop type 2 diabetes than women of normal weight, more than four times as likely to suffer from high blood pressure, and about three times as likely to develop cancer of the colon. They are nearly 30 per cent more likely to suffer a stroke.

Obese men are more than five times as likely to develop type 2 diabetes than those of normal weight, 2.6 times as likely to suffer from high blood pressure and about twice as likely to develop osteoarthritis. Their chances of suffering a stroke are also 30 per cent higher.

Based on 2003, the most recent year for which figures are available, nearly 500,000 cases of high blood pressure – 36 per cent of the total – and more than 50,000 cases of coronary heart disease were a direct result of obesity, according to the report. About 900 cases of cancer, mostly of the colon, were also attributed to obesity.

The report prompted concern yesterday, and threatened to overshadow plans by the Scottish Executive to help to tackle childhood obesity by removing sweets and fizzy drinks from schools.

Under new rules, at least two portions of fruit and vegetables will be served every lunchtime, oily fish will be served once every three weeks, while deep-fried food will be limited to three items a week. Sweets and fizzy drinks will be removed from schools and chips will be served only as part of a balanced meal.

Adam Ingram, the Children’s Minister of the Scottish Executive, said: “By targeting our youngest citizens we can make a lasting difference. Putting healthy options on a plate for pupils every day will develop their taste for the food that’s good for them and stop unhealthy habits from taking hold.”

However, Mary Scanlon, of the Scottish Conservatives, questioned whether enough was being done. She described the figures on obesity as horrific.

Ross Finnie, health spokesman for the Liberal Democrats in the Scottish Parliament, said: “I urge the Scottish Government to invest more in improving school meals . . . Childhood obesity rates are a ticking timebomb that the Scottish government must address as a matter of urgency.”

The report’s authors yesterday sounded a dire warning for the future of Scotland’s health. They concluded: “Obesity levels in adults and children have risen steadily over the past ten years, with marked increases in men aged 35-64 and in women aged 35-44. These figures provide little evidence that current approaches to obesity are having any impact.”

From fat to thin

Top of the table (per cent)

United States - 32.2

Scotland - 25.5

Mexico - 24.2

UK (as a whole) - 23

England - 22.5

Canada - 22.4

Greece - 21.9

Australia - 21.7

New Zealand - 20.9

Hungary - 18.8

Czech Republic - 14.8

And at the bottom Germany - 12.9

France - 9.5

Italy - 9

Norway - 8.3

Source: OECD

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