You don't get offered a cup of coffee and a piece of chocolate cake when you visit Jennifer Attride-Stirling's office — you have to make do with a drink of water.

And when you let it slip that you took the elevator up to the first floor instead of using the stairs, you're soon left with no doubts about what your problem is: you're lazy. It's not that Dr. Attride-Stirling is a bad host — it's just that as the poster child of Bermuda's anti-obesity drive, the Island's Health Promotion Coordinator never wastes a chance to get across the message that mindsets have got to change.

Throughout the past few weeks, as the Island has responded to alarming figures suggesting it's the fourth fattest country in the world, she's been at the forefront of the mission to convince the obese population to eat better and exercise more.

The awareness campaign, which has included countless press calls and discussions with influential partners like supermarkets and schools, was launched with a bang two months ago when a survey revealed one in three five to ten-year-olds is obese.

Since then, Dr. Attride-Stirling's determination to change attitudes has carried over into everything she does. It's become a running joke with her family, while friends and colleagues have resorted to hiding their chips when she walks into the room. But if the Health Promotion Coordinator isn't going to tell people where they're going wrong with their diets, you might ask who is.

"It's close to my heart, but to be honest I tend to be passionate about anything we advocate," she told The Royal Gazette. "The obesity work is part of Well Bermuda, our National Health Promotion Strategy. But Well Bermuda is about a whole range of things and I can speak passionately about every single one of them. Obesity is the first issue because we have to tackle it urgently.

"Of course it wasn't easy for me to become a bit of a poster child for obesity. It's an uncomfortable position for me. It's not the sort of role I'm happy with — the person who responds to every x, y and z. It's not in my character. But it's very difficult to get away from it.

"I can walk into a meeting sometimes and people start to hide their chips. I can get on the soap box in the office and in meetings, especially in the Ministry. With my immediate family, at the moment, it tends to be a running joke about what we are eating and what we are doing and whether it's the right thing. I'm lucky that I tend to have a pretty close and healthy family."

Those soap box lectures can make a difference, she explained, pointing to how she recently helped organise a family fun day for the Ministry of Health.

She said: "We were discussing the menu and one of the committee members says, 'What's wrong with hamburgers? You're trying to tell me that a hamburger's not healthy?' The rest of us were floored. Where have you been? Have you had your head in the ground? You work in the Ministry of Health!

"In the end, thanks to our nutritionists, we had an exceptionally healthy menu. You can actually have a very nice meal that's healthy. You don't have to have hot dogs and hamburgers to enjoy a day out.

"The thing about a hamburger is that there's nothing wrong technically with it in moderation. The challenge is that if you are overweight, you are clearly not consuming them in moderation. The 64 percent of adults in Bermuda who are overweight are not consuming these foods in moderation and are not engaging in enough physical activity to burn off the excess calories."

The Bermuda Health Survey results may have been shocking to the public, but they were no real surprise to health experts.

Dr. Attride-Stirling, a Mexican whose father is Bermudian, discovered things were seriously wrong shortly after her appointment as Health Promotion Coordinator in March 2004.

"A 1999 survey showed a high proportion of obesity," she said. "Nobody who was tracking this issue was surprised about the Bermuda Health Survey. We had a strong suspicion it was going to go in that direction. Perhaps the public was surprised.

"We, like so many countries, have developed a culture where being big is acceptable. We use euphemisms like 'big', 'big boned' and 'full figured'.

"Fat is considered a very rude word — and it is; if someone came and told me I'm fat, I would be upset — but we see being fat as acceptable and in some sections of the population even desirable. To see us turn around and say this is a problem surprises a lot of people."

She is adamant that the finger of blame should not be pointed at anyone — not even supermarkets which tempt shoppers with sugary snacks next to the check-out counter.

"When we have approached supermarkets to support us in different activities, their response has always been very positive," she said.

"The onus of responsibility is on us to get them to do more, like getting candy out of the checkouts. Like any other vendor or commercial establishment, their priority is to sell products. There are other things that can be placed at checkouts instead of candy, but it has to be done voluntarily, through a social sense of responsibility.

"We certainly don't want to make vendors out to be bad guys. It's our responsibility to get them to give not just what the public want, but what the public need."

And despite what the international press has reported in recent weeks, it's not all Kellogg's Coco Pops' fault either.

A few weeks ago, Dr. Attride-Stirling's flyaway comment about the dangers of starting the day with a "massive bowl of Coco Pops" found its way into the foreign media, with UK and US newspapers reporting that Bermuda was blaming its obesity problems on the chocolatey snack.

The fact 'Coco Puffs' and not 'Coco Pops' are sold in Bermuda didn't really come into it.

Dr. Attride-Stirling says she didn't even know a breakfast cereal of that name existed.

"That was funny. Coco Pops was a term that popped into my head. I'd been looking at a cartoon strip with a made-up cereal called Chocolate Frosted Sugar Bombs," she said.

"But I was being interviewed at the airport, and I was about to get on the plane, and Chocolate Frosted Sugar Bombs was such a mouthful, so I just said Coco Pops, thinking there was no such cereal.

"Then I find out Coco Pops is a Kellogg's breakfast cereal and it's all over the international press that Bermuda is eating too many of them. I had a lot of people come to me talking about Coco Pops. I was like 'Oh my God'. One tries to say so many clever things and nobody listens, and you say one stupid thing and everyone notices.

"But the message is about portion size. It's not about demonising any food or brand."

She's hopeful that message is now starting to sink in and that Bermuda can soon start to reverse the obesity trend.

But with other issues to tackle, such as quality of life, heart health and cancer prevention to name just three, her life isn't going to get any easier.

"People will often make the mistake that public health is health services for the poor, which is not correct. Public health is about ensuring that the public is able to enjoy a good quality of life, and a good quality of health," she said.

"The big challenge that I face now is the same one as so many other people — there's more to do and more work demanded from us than we could possibly meet. The more we find out, the more we know what needs to be done. It's absolutely clear we need to do so much more. Finding the resources to do that is extremely challenging. That's the biggest challenge right now."