Produced by the Royal College of Physicians of Edinburgh and Royal College of Physicians and Surgeons of Glasgow

WEIGHING IT UP DOWN UNDER: OBESITY - AN AUSTRALIAN PERSPECTIVE

  • Dr A Dunbar, Honorary Senior Lecturer and General Practitioner, Greater Green Triangle University Dept of Rural Health, Flinders and Deakin Universities, Victoria, Australia

Summary

Whilst Australia has been recognised with sporting achievement, obesity levels in Australia are now similar to those in the UK and US. Dr Ann Dunbar provides an overview of attempts to combat obesity in Australia.

Key Points

  • Australia combines sporting success with increasing levels of overweight and obesity.
  • National obesity prevention initiatives have been developed, but have not yet had a measureable beneficial impact.
  • Local initiatives, as in encouraging children and their parents to eat better and exercise more, are having some impact.
  • Improved diet will require co-operation between health professionals and the food industry.
  • Increased exercise will have to be encouraged.
  • Smoking restrictions, seatbelt enforcement and random breath testing of drivers for alcohol have all brought public health benefits? Will the reduction of obesity also require legislation?

Declaration of interests: No conflict of interests declared

Australia is seen as a highly successful sporting nation but paradoxically is succumbing to sedentary activities. The incidence of obesity and overweight is following the same trends as North America and UK.

The AusDiab study surveyed lifestyle factors, socio-economic factors, obesity and the incidence of diabetes between 1999 and 2000. It was a cross sectional study of over 20,000 people from 42 sites throughout Australia, and showed that 67% of males and 52% of females aged 25 and over were overweight, with 19.1% and 21.8% being considered obese. Perhaps even more worrying were the figures from the Sentinel Site for Obesity Prevention in Victoria which reported last year that 26.7% of children aged between seven and eleven are overweight with 7.9% of this total considered to be obese. This compares badly with the national data from 1985 giving figures of 12.1% overweight with 1.7% obese.

A recent report from the Organisation for Economic Co-operation and Development (OECD) ranked Australia fourth in the world for obesity and growing at the fastest rate. As in every other country where obesity is an increasing problem, the healthcare costs for individuals and states mount with the growing levels of associated morbidity. So what has gone wrong in Australia and what is being done about it? The Federal Government has set up a National Obesity Prevention Group and similar initiatives exist at State level. There is no doubt that obesity is much higher on the health agenda now, and increasing amounts of health funds are being directed towards research. This is, as yet, not being translated into significant improvement in the overall figures. The promise of funds by politicians lags behind their delivery, and there is a suspicion that hospital deficits take priority over funding for prevention.

There are local centres of excellence that are having some impact. For instance the Sentinel Sites for Obesity Prevention are seeking to produce effective collaboration between health professionals and the community in order to try and prevent obesity in children. Here and in other areas of Victoria an increase in nutritional advice and back up is helping schools to provide guidance on healthy lunches, and educational