The World Health Organisation and the OECD have expressed concern at the rates of obesity and its cost to individuals in terms of their health and costs to governments in terms of health care. Obesity is now seen as a major epidemic.

In Australia, overweight and obesity affects more than half of the population. This epidemic is common at all ages, in all parts of Australia and throughout all population groups. It is a worldwide problem and has been observed over the last twenty years in most, if not all countries.

Approximately 9 million Australians over the age of 18 were estimated in 2001 to be overweight or obese, (ie Body Mass Index BMI* > 25) with 3.3 million in the high-risk obese group (BMI > 30).
Levels of overweight and obesity have increased rapidly in the last twenty years.

The problem is of enormous health, social and economic concern because overweight and obesity cause a wide range of debilitating and life-threatening conditions such as cardiovascular disease,
Type 2 diabetes, stroke, cancers, osteoarthritis, kidney and gall bladder disease, and respiratory and musculoskeletal problems. In addition, obesity can destroy self-esteem, lead to social discrimination and contribute towards mental illness.

Overweight and its associated illnesses also create a huge financial burden for governments and society as a whole. Latest estimates suggest that the true costs of obesity may now be as high as
$1.3 billion per year and rising fast.

Overweight is a consequence of both ‘over-eating’ and ‘under-activity’. Poor nutrition, sedentary lifestyles and obesity together are estimated to account for in excess of 10% of the burden of disease,
and equal tobacco as being the most important avoidable cause of ill-health in Australia today.

Excess weight is now more common among lower socio-economic and socially disadvantaged groups, particularly amongst women. Aboriginal and Torres Strait Islander adults are about twice
as likely to be obese as non-indigenous Australians.

Focusing first on young people and families

In Australia between 1985 and 1995 the levels of obesity in children tripled and since then the problem has continued to worsen. There are now an estimated 1.5 million young people under the age of 18 in Australia who are overweight or obese.
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Childhood overweight is associated with increased risk factors for heart disease such as raised blood pressure, blood cholesterol and blood sugar. Of great concern is the appearance of Type-2 diabetes in adolescents—even primary school children—with its potential for complications such as heart disease, stroke, limb amputation, kidney failure and blindness. The most significant longterm consequence of obesity in childhood is its persistence into adulthood. Overweight young people have a 50% chance of being overweight adults, and perhaps not surprisingly children of overweight parents have twice the risk of being overweight than those with healthy weight parents. Obese adults who were overweight as adolescents have higher levels of weight-related ill health and a higher risk of early death than those adults who only became obese in adulthood.

Focusing on supportive environments

There is no single cause of obesity and for some, obesity is due to genetic predisposition. However, over the past twenty years there has been both a decline in physical activity in children and an increase in unhealthy eating. For example young people watch, on average, 2.5 hours of television per day and between 1985 and 1995 energy intake increased by 15% amongst boys and 12% amongst girls. Changes to our social, cultural, physical and economic conditions are driving these behaviours. Therefore, an approach is needed which creates living environments that support healthy eating and physical activity as well as encouraging young people and their families to adopt healthier lifestyles.

Focusing on prevention

Obesity develops over time and once it has developed, it is difficult to treat. The prevention of weight gain, beginning in childhood, offers the most effective means of achieving healthy weight in the population. This is where action to combat Australia’s weight problem needs to start and is the focus of this national agenda. However, individuals who are already overweight or obese need appropriate support through community-based interventions.

Although overweight and obesity is a significant health problem the solution does not lie predominantly with the health services. Effective prevention needs responses from all parts of society to encourage more active living and healthy eating—starting at the very beginning of life with breast-feeding.

* BMI is defined as weight in kilograms divided by height in metres squared