So you've been working out hard and eating fairly well, but you want to improve or increase the rate of weight loss. The 52-week programme achieved even greater reductions in illnesses than the 12-week programme and resulted in more QALYs. The costs of the 52-week intervention were not outweighed by the cost-savings on NHS treatment of weight-related illnesses, but the cost per QALY gained was only £2,394 compared to the brief intervention, and only £3,804 compared to the 12-week programme. NICE usually consider treatments to be worth funding if the cost per QALY gained is less than about £20,000.

Guilt-free, the drumbeat of the 1990s. Any undesirable ingredient was cause for guilt. There were even guilt-free, fat-free Lay's potato chips, a virtual impossibility since even I knew that the food pyramid's golden fats and oils were a key component of potato chips' very making. The secret was Olestra, a synthetic fat substitute that the body can't absorb My guts were always in knots from this sort of thing, after the entire boxes of Snackwell's and the bitter, cardboard-textured bags of fat-free Lay's I regularly inhaled after school. I was simultaneously always hungry and somehow gaining weight.
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