Getting to grips with obesity

An array of programs targeting fitness and healthy eating have so far failed to translate into reduced obesity levels. This article discusses the current trends and the developed world’s search for solutions to a problem with dire health, social and economic consequences.

In the obesity debate many people question why the issue is such a big deal - after all, we are living longer, so, superficially at least, it may seem that we’re doing well. But, the percentage of our lives spent as disability-free-years, or free from chronic illness, is decreasing. Where 20 years ago a woman might expect to live, on average, to 78 with about eight years disabled, now the life expectancy is 82 but evidence shows that the number of years lived without chronic illness and disability have not increased.

These extending years of disability are not only costly in human terms but, on a nation’s health budget, they are an onerous financial burden. With so many people in an ageing demographic, the baby boomers and those who follow, we can clearly see growing numbers suffering chronic illness and less and less people around to look after them.

Overweight, obesity, and physical inactivity are clearly major risk factors for chronic illness such as heart disease, diabetes and some cancers.

Despite the fact that this health crisis is occurring, no country around the world has yet successfully halted overweight and obesity trends.

Technological advances and automation have seen an enormous reduction in incidental activity over the bulk of a typical day. We have work places that are all but designed to kill people - purposely discouraging any movement.

Quality of diet is important as is not overeating, but exercise is critical and the challenge is to increase physical activity to counter the results of reduced incidental activity.

No food for example can increase the size and strength of the heart, increase blood vessel compliance, stimulate growth of new blood vessels, nor strengthen muscles and bone without parallel physical activity programs.

An essential element of addressing inactivity is working out how to bring activity back into our way of life.

In reviewing studies worldwide including those of the Australian Government, CDC, World Health Organisation and Chochrane Reviews, there emerges recommendations of the most cost-effective and results-based options for increasing physical activity.

Highly rated among these “best-buys” are school-based programs where intervention is most effective - particularly when compared to efforts to change adult behaviour, which is far more difficult.

Although there is much argument about what level of influence the school programs will have when children mature into adults, what we do know to be fact is that at least 80 per cent of obese children will become obese adults.

Other strong recommendations emerging from international and Australian reports is the re-designing of urban public space to encourage people to be active and fostering of group-based activity or “buddy systems” which call for social interaction - these prove particularly effective with professional guidance.

Increasingly “artificial” measures have been used to alleviate the resulting health consequences of our overweight population: measures such as lipid and blood pressure-lowering drugs, heart bypass operations, stents, liposuction, stomach stapling and other surgical procedures.

Those who can afford it often look in the first instance to drugs and surgery for answers while for those with limited financial resource options are more restricted and they join the victims of the widening health-wealth gap.

The health-wealth gap is a major concern in fitness issues. Incidence of obesity, heart disease and cancer among the poorer segments of society are well documented as significantly higher than for well off individuals who can afford better education - they are better informed, have more money for food choices, health care and physical activity such as health club and gym memberships.

Tracing trends identified in data collected in Australia over the last decade, we can demonstrate that the distribution of health-wealth is widening. Extend the trend, unabated, into the future of 30-40 years and hypothetically we could see a society separated into virtually two populations that interact less and less, rarely inter-breed, while suffering very different types of diseases. There is much evidence to show that we are at the start of this scenario now.

Despite an enormous number of initiatives implemented to address fitness and diet, overall levels of physical activity continue to decline while the population’s weight is on the rise particularly in extreme levels of obesity.

Seeking answers at Sport Knowledge Australia’s “Fat Policy - Public Health and Education” seminar in Sydney on April 17 will be senior sport administrators, fitness experts and policy analysts. They will be joined by representatives from sport, public health and education to identify what can be done to change society’s behaviour and workshop a strategy for comprehensive integrated policy to address physical activity and obesity.