Sadly, while Malta punches well above its weight in a number of areas, the Maltese are also well above their (ideal) weight as a population.

Maltese children are among the most overweight in the world, ranked second in the obesity stakes, with nearly one in four obese or overweight. This is not about children having puppy fat, it is about Maltese children being exposed to early death from diabetes, infections and from suffering from psychological traumas associated with being obese. It is about exposing children to having a lifelong chronic and debilitating illness.

Obesity is the most important public health issue that Malta faces. Without any action being taken, in two decades’ time the country is committing itself to spending most of its national budget and certainly much of its health budget on the complications of obesity: diabetes, heart disease, cancer, infections and mental health problems.

Obesity is, of course, not just a unique problem for Malta. I am a general practitioner in London, in a large inner city practice and spend my day trying to help patients with obesity. I see babies as young as 12 months old who are already overweight.

I see children in first grade who are obese and their parents who are unable or unwilling to understand that being fat does not equate to being healthy.

I see young adults who have obesity-related illnesses. Recently, a 21-year-old with a BMI of 40 asked why her knees were painful and “what would I do to help…” When trying to gently ask what could she do... to help herself, she seemed unable to link her weight to her pain.

I see 35-year-old men with newly-diagnosed diabetes, pointing out that if they modified their diet they could reverse the high sugar, but to no avail. Diabetes, the main complication of obesity, is a major problem across the world and these non-communicable diseases will soon be Malta’s biggest problem. In the UK, we spend 11 per cent of all of our national healthcare money on diabetes.

Obesity is the most important public health issue that Malta faces

I have been watching the growing weight of the Maltese from afar and am worried but also perplexed by the rising tide of obesity, especially among children. Why should a country surrounded by sun, sea and sand, with so much opportunity for walking and ready access to fruit, vegetables, olive oil and fish have such a problem?

As Anton Grech has said, obesity is the easiest diagnosis to make but the hardest to treat, or understand.

Obesity is a new problem and changes in diet is the main culprit.

A report in 1839 for the British government about the health of troops in Malta had said that “the Maltese use very little animal food, bread, with the vegetables of the country, and, occasionally, a little fish, forming their principal sustenance”. Yet, 150 years later (1986), the World Health Organisation said that “the average Maltese diet is not a healthy one. It is especially rich in fats and sugar and low in fibre”.

The findings of a survey in 2011 on the diet of the Maltese illustrates how far this Mediterranean island has moved from having a Mediterranean diet.

The average Maltese person is more likely to have biscuits, chocolates and sweets for breakfast and pasta followed by chicken and beef for dinner. Vegetables and fruit are rarely eaten.

Malta’s greatest challenge comes from the usual sources: addiction to sugar, fast food and little time to prepare the right foods or time for regular exercise – the latter point made worse by Malta’s reliance on cars.

The car population in Malta has now grown to over half the size of its human population – in 2010 there were nearly 580 cars per 1,000 Maltese people – the eighth highest passenger cars per population in the world.

So what can you do to change this obesity epidemic?

Malta is about to pass an ambitious Bill, led by MP Robert Cutajar. The proposal is a comprehensive law based on prevention and will include restrictions on what foods can be sold in schools, ensuring exercise is built into the curriculum, encouraging councils to provide more spaces for exercise and addressing the growing burden of obesity among the elderly.

Hopefully, this will stem the tide of the obesity tsunami.

Clare Gerada is a London-based GP and was chairwoman of the Council of the Royal College of General Practitioners.