Image copyright SPL Image caption The number of obese and overweight people has been rising in recent decades

Being overweight is increasingly seen as the norm, England's chief medical officer says.

In her annual report on the state of health, Dame Sally Davies said this was concerning, pointing out many people did not recognise they had a problem.

Parents of overweight children were also failing to spot the signs too, she said.

Dame Sally blamed the way weight was being portrayed by the media and clothes industry.

BMI Image copyright Science Photo Library Body mass index (BMI) is used to calculate whether a person is underweight, a healthy weight, overweight or obese for their height.

It is calculated by measuring weight (in kilograms) and dividing it by height (in metres) squared to give a BMI score

A BMI of 25 to 29.9 is considered overweight and one of 30 or above is considered obese. Calculate your BMI

"I have long been concerned that being underweight is often portrayed as the ideal weight, particularly in the fashion industry.

"Yet I am increasingly concerned that society may be normalising being overweight.

"Larger mannequins are being introduced into clothes shops and "size inflation" means that clothes with the same size label have become larger in recent decades.

"And news stories about weight often feature pictures of severely obese people, which are unrepresentative of the majority of overweight people."

Sugar tax

Dame Sally also reiterated her belief that a sugar tax may be necessary to combat obesity.

At the start of March she told the Health Select Committee it may be needed, although she hoped not.

This caused some controversy as the government's approach has been characterised by working with industry to get them to make food and drink products healthier.

In her report she says this should continue, but if it fails to deliver a tax should be "considered".

She said children and adults of all ages are consuming too much sugar.

Nearly two thirds of adults and a third of children are overweight or obese - classed as a body mass index of above 25. This is about double the numbers in the early 1990s.

But research shows that half of men, a third of women and over three quarters of parents do not recognise weight problems.

Professor Kevin Fenton, of Public Health England, said he agreed with Dame Sally's comments.

"We share her concerns. Overweight and obesity costs the NHS over £5bn each year and is entirely preventable."

But Tam Fry, of the National Obesity Forum, said he would have liked Dame Sally to take a tougher approach to sugar.

"The report lets the food and beverage industries off the hook. It gives industry no deadline by which to show improvement with the likely result that her words will be quite ignored. How distressing."