VERY fat people should avoid long-haul flights, as the reduced air pressure and oxygen can cause major cardiovascular and respiratory problems, warns a doctor from the Travellers' Medical Service, in Petworth, West Sussex. Writing in the Journal of the Royal College of Physicians, the doctor describes the case of 'Miss Pickwick', (after the Pickwickian syndrome of obesity, named after a Dickens character) a fat woman who spent a large part of her holiday in a US hospital suffering respiratory and cardiac failure after taking two long flights. She was flown back to Britain with resuscitation and life-support facilities.