Australia Obesity Epidemic: Have we failed to control it?

Fifty to sixty percentage of Australian population is either overweight or obese. Despite the fact that the expected percentage may go high up to 80 per cent by 2025, unfortunately we have failed a make national obesity strategy. It is estimated that 1 million Australian adults currently live with clinically severe obesity, which means having a body mass index (BMI) of 35 or higher and a co-existing obesity-related medical condition. It is obesity that is severe enough that it requires medical treatment. An estimated 28% of children and adolescents in Australia are overweight or obese. The incidence is higher in n certain groups such Aboriginal and Torres Strait Islander peoples,  Obesity can cause numerous physical and mental health problems in any age particularly in children and teenagers are concerning. Obese children are more likely to remain obese as adults. That’s why controlling childhood obesity will have significant and longstanding impact on reducing obesity rate. Obesity increases chances of developing range of medical conditions For example; the rate of type 2 diabetes is continuing to rise in adults, children and adolescents. Other problems occurring at a higher rate in overweight individuals include sleep apnoea, heat intolerance, and asthma, breathlessness on exertion, tiredness, joint pain, flat feet, hypertension, high cholesterol and gall stones. Being overweight can also make a child more vulnerable to decreased self-esteem, depression, bullying and eating unhealthily to attempt to control weight. Obesity does have impact even after our death. As Australians are getting bigger and the funeral industry has to make changes to accommodate our growing girth. Coffins are larger, cremators have bigger openings, and graves are sometimes widened to accommodate larger bodies.

The main cause of childhood overweight and obesity is energy imbalance. Over time, if children eat and drink more than they need and use in day-to-day activities, their bodies will store this extra energy as fat. There are many factors that have contributed to the increasing rates of childhood overweight and obesity, including: Food choices – choosing foods that are high in fat, sugar and/or salt that provide little nutrition and more energy than the body needs (such as cakes, biscuits, confectionary, chocolate, pastries, pies, potato chips, soft drinks, cordials, sports and energy drinks).

The obesity promoting environment; the modern luxury but inactive lifestyle is also responsible for increasing rate of obesity among Australians. – Many Australian children are not physically active enough and spend too long sitting (watching television, playing the computer and other electronic devices). And the modern environment is one that makes it harder for families to be active and make healthy food choices:

    • Changes to the food supply have led to increased availability and promotion of cheap, processed foods which are which are high in energy and low in nutrients.
    • The portion size of many packaged foods and foods prepared outside the home has increased. The cost of these foods has also decreased when compared to more healthy options.
    • In general, children are spending less time outdoors and being active. This may be due to safety concerns or poor access to green spaces.
    • Where we would once walk or cycle to get to places, many people now travel by car.
    • Children are spending more time using sedentary entertainment and recreation options such as watching the television and using the computer and other electronic devices rather than getting out and being active.

We Australian have failed both at the national level by not making national obesity strategy, and have also failed to tackle at the medical needs of the obese individual leading to  a significant financial burden on our health system, directly and indirectly.  Severely obese patients have complex conditions requiring services from a range of healthcare professionals, including endocrinologist, specialist weight loss clinics, bariatric surgery, clinical psychologists, expert dietician services, specialist nurse services and exercise specialists. People referred for specialist obesity services may have complex conditions such as type 2 diabetes, cardiopulmonary diseases and depression. The patients with severe obesity often had multiple health conditions that cannot be met by a GP alone

Unfortunately the access of specialist obesity clinics or medical health services in the public health system to the vast majority of Australians living with clinically severe obesity is very limited. The reason could be only the small number of specialist obesity services available, patient access is limited by strict entry criteria, prolonged wait times, lack of regional and rural services and out-of-pocket costs,.  So the thousands of people who may benefit from specialist healthcare are currently not having their needs addressed by the public health system which demands for significant improvements to how obesity is treated. Above all the currently available small numbers of services are located in major cities and also under resourced. So there is high probability if you are not living in a city close to the big hospital, you are going to miss out of these services. Most of these hospitals have prolonged wait times … people are on the wait list with referrals dating four, five, six years.  This pushes severely obese patients to private. This is well reflected by the data that approximately 88 per cent of bariatric surgery is performed in private hospitals.  So the current specialist obesity services are provided as on an “ad-hoc basis” and experts believes a broad commitment across the health system is required to meet rising demand.

Obesity is an international epidemic causing an enormous health burden to patients and an economic burden to public health systems. There is an immediate need of better resources and greater investment be dedicated to the issue. The two existing federal programs — the Healthy Food Partnership and the Health Star rating seemingly are not working effectively, as despite their implementation obesity rate have increased exponentially. The Healthy Food Partnership aims to improve the dietary habits of Australians by making healthier food choices easier and more accessible and by raising awareness of better food choices and portion sizes. The Health Star Rating is a front-of-pack labelling system that rates the overall nutritional profile of packaged food and assigns it a rating from ½ a star to 5 stars. It provides a quick, easy, standard way to compare similar packaged foods. The more stars, the healthier the choice. Both of the above programs are initiative of Australian Government and are run in collaboration with food industry bodies and, public health groups. Interference by the food industry may be the reason of failure of these programs. Ideally these programs should have been run by the experts without any representation from the food industry.

“Truth Decay: in Health research is adversely affecting us in making health policies to tackle obesity. Truth Decay is described as the rise in use of opinion over fact in political debates and public discourse, not trusting experts. This benefits certain section of the food industry to use the filtered research to influence policy makers and consumers. Global Obesity Centre (GLOBE) at Deakin University has proposed to a Senate committee examining the issue of obesity that Children’s height and weight would be measured every two years unless parents opt out as part of an ambitious proposal to tackle Australia’s obesity epidemic. World Obesity Day 2018 (11th October) is celebrated to create awareness about the prevalence, severity and diversity of weight stigma. Stigma occurs in a wide variety of settings and the media has been identified as one of the main perpetrators. Current media portrayals of obesity reinforce inaccurate and negative stereotypes about weight which can lead to weight stigma. World obesity Day is calling on all media outlets to end their use of stigmatising language and imagery and instead portray obesity in a fair, accurate and informative manner. Obesity is an end result of faulty complex system working at federal, state, corporate, family and individual level.  Obesity epidemic cannot be controlled by modifying individual risk factors or behaviours. It must be tackled at the organisational and policy level by appropriate and effective national programs. Lack of cooperation and interference from political and corporate section has contributed to our failure to develop a national obesity policy or a sugar tax policy. There is also a need to promote independence and transparency in research related to obesity to avoid “Truth Decay” and to make decisions based on facts and not opinions.

At family or individual level we can control our weight by changing our life styles;

    • Avoiding foods high in added sugar, salt and fat will help your family get the nutrients they need without the extra energy.
    • eat plenty of vegetables and fruit (including different types and colours)
    • enjoy reduced fat varieties of milk, yoghurt and cheese (reduced fat milks are not suitable for children under 2 years)
    • eat mainly wholegrain cereal foods and breads
    • eat lean meats and poultry, fish, eggs, tofu, nuts and seeds, and legumes/beans
    • drink plenty of water instead of sugary drinks like soft drinks, cordial and fruit drink
  • Have regular meal times (including breakfast) and wherever possible, enjoys meals together as a family.
  • Avoid being restrictive or controlling of your child’s food intake.
  • Encourage and support walking and cycling to school.
  • Organise outings with your family that encourage you to walk around and be active such as bush walking, visiting the zoo, expos or historic sites, and bike riding.
  • Choose ‘active’ toys and play materials that encourage movement and help develop skills like running, kicking, throwing and catching, such as balls, bats, tricycles and kites.
  • Reduce the time children spend watching television or using the computer or other electronic devices for entertainment. Try introducing some family rules around screen time.
  • Be a good role model and be physically active yourself.