How Can We Stop Australians Getting So Fat?

Over the past three decades, the Australasia region has outpaced other regions of the world with the largest absolute increase in adult obesity. Poor diet and high body mass index have overtaken tobacco as the leading risk factors for disease and early death in Australia.

Exercise picture from Shutterstock

It's clear that much more needs to be done, but where should we best focus our efforts? Should it be on education and campaigns imploring people to eat better and do more exercise? Or on policy changes that will pull the levers to promote behaviour change at the population level?

The simple answer is that we need to do both. Australia's world-leading approach to reducing smoking illustrates the power of graphic social marketing campaigns that emphasise the importance of individual behaviour change.

But Australia's success has come about from combining these powerful and emotive campaigns with hard policies such taxation increases and mandated smoke-free environments, which have worked cumulatively to reduce the prevalence of smoking.

The so-called obesogenic environment is well recognised as a key driver of the obesity epidemic in Australia and globally. If we do not acknowledge the need to fundamentally change our environments to foster healthy lifestyles, it's unlikely we will see improvements.

We can't expect this to happen without some dramatic changes to how we approach food policy. While highly processed foods are cheap, aggressively marketed and readily available, we should not be surprised that they make up around one third of the energy in our diets, while vegetable intake continues to fall not just in adults, but also children.

Importantly, we also need to consider that the associated burden of chronic disease falls disproportionately across the population, with those with low socioeconomic status most at risk.

At present the ultra-processed food industry is a major obstacle to meaningful change. They have consistently opposed stronger regulation, including policies that will reduce the consumption of energy dense, nutrient poor, highly-processed products. The industry knows that if people eat less, they make less profit, so oppose policies which will impact their bottom line.

The industry fought the implementation of front-of-pack traffic light labelling and worked to undermine the new star labelling system -- which, as a consequence, will be a self-regulatory scheme. Their response to recommendations to regulate unhealthy food marketing by the Preventative Health Taskforce resulted in more self-regulation, which is the equivalent of students marking their own homework.

The charade has been perpetuated by companies continuing to add further layers of complexity, none of which deliver a meaningful reduction in the amount of unhealthy food marketing children are exposed to. The progressive watering down of the voluntary rules means companies can now define Kit Kats and Coco Pops as "healthier" options, appropriate for marketing to children, despite being completely at odds with the recently reviewed dietary guidelines.

Despite this, we are now seeing a growing community awareness of, and opposition to, the industry's self-serving tactics. In the absence of a national strategy to address obesity we have seen a number of communities fighting to try to stop chain fast food outlets being placed in their towns, including Tecoma in the Yarra Valley near Melbourne.

Many of these efforts have been frustrated by rigid planning regulations that prevent local councils from prioritising the health and well-being of local residents when considering these types of developments. But Victoria and South Australia have established prevention systems which provide resources to local governments, including to Ararat, which was the focus of ABC's Four Corners earlier this week.

With financial support and commitment from other levels of government, a community like Ararat can support healthy eating and active lifestyles in a range of settings, including schools and workplaces. The community-focused approach empowers local governments to determine approaches that work within their locality and to improve the health and well-being of the families who live there.

These grass roots changes offer hope for the future. But we must invest money and resources to support these types of initiatives and scale up that success -- Ararat is just one example.

It would be a triumph of hope over experience to think that we can change the behaviour of Australians without creating environments that make the healthy choice, the easy choice. The deterioration of diets and the continuing rise in chronic diseases has been nothing short of drastic, so it will take equally bold and decisive action to make a real difference to improving the health and well-being of Australians into the future.

We also need to look to government for leadership in implementing the recommendations of the World Health Organization and other bodies to restrict the promotion, availability and price of ultra-processed foods to make a substantive impact. This overdue step would make up the core elements of a national strategy to address excess weight and obesity. We cannot wait -- now is the time.The Conversation

Jane Martin is Executive Manager of the Obesity Policy Coalition and Senior Fellow, Faculty of Medicine, Dentistry and Health Sciences at University of Melbourne. Jane is affiliated with the Australian New Zealand Obesity Society and World Obesity Forum. Jane was part of the Front of Pack Labelling Project Committee 2011-2013.

This article was originally published on The Conversation. Read the original article.

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Comments

    At present the ultra-processed food industry is a major obstacle to meaningful changeThis pretty much sums it up though, doesn't it..? The industry as a whole, just like the cigarette industry, has put profit ahead of conscience. Until this attitude changes, or the powers that be, grow a set, nothing will happen..! What we really need is to change the way our economy works as a whole... At the moment we all live in a world, where the economy will collapse, if all of a sudden if we just stopped buying crap we really don't need, but feel compelled to buy anyway..!

    Last edited 15/10/14 11:22 am

      But hey, at least they halved the size of Killer Pythons.

        WHY BRING IT UP AGAIN???
        do you know how pissed i am at this

          Don't even get me started on the size of red frogs!

    Simple maths = burn more calories than you consume?

      Sure. If it only were that simple. Sadly, life is complicated.

        It is that simple, don't blame life. There is an epidemic of acopia, people just think it's all to hard because they are unwilling to try or have developed poor resilience. You can also be in a slight caloric surplus and loose weight on a good resistance program + good diet.

          If people were machines, it were that simple. However, people aren't machines. People aren't made of math. Life is complicated. There are so many factors at play: gut bacteria, the brain's reward system and food manufacturer's deliberate "contamination" of their products to make them addictive. Common sense goes a long way, but there's more to it than just that.

            I can eat avg 2300 calories, and gain weight. The next week, I can eat avg 3800 calories, and lose weight. On the same activity levels. I'm experiencing this right now (and have many times in the past). Thats including 900g of meat/poultry a day.

            It's the foods you eat and how well those foods facilitate the absobtion of the sugar/fats contained in food. Calories in vs calories out is a huge oversimplification. If people understood that they could feel full by eating comparative truckloads of unrefined, unlabled food, they'd lose weight.

          People only have so much will power, it is a limited resource. Regular exercise and sticking to a diet requires will power

        No, the answer really is simple: "Eat food. Mostly vegetables. Not too much" (Michael Pollan -- Author --The Omnivore's Dilemma")

        Last edited 16/10/14 1:53 am

        Not really. 100 calories of strawberries is different to 100 calories of McNuggets which is different to 100 calories of orange juice.

      It's not quite that simple. People with great metabolisms or who run 17km per day will still suffer from a high fat and high sugar diet. We mislabel this problem as an obesity epidemic when really it's just a unhealthiness epidemic.

        They can still eat a high fat/high fat diet.
        As long as they burn more than they consume, they'll lose weight.
        I can eat maccas and lose weight, so....ya.
        (NB. I fidget a lot)

      This argument has always reminded me of the "simple maths, we have to spend less than we earn" economic argument. I'm not saying we should try to eat our way out of trouble but I think what biology has in common with economics is that it is not simple maths.

      Everyone knows how to lose weight. The question that needs answering is why things are going in the opposite direction. It's not simple, as people keep saying, or we would not have the problem of obesity. The food industry will not help. Period. We are a capitalist society and their primary aim is to make profits, not look after the population.

      This is true for the vast majority of the population. The laws of physics are inviolate. You cannot mysteriously generate matter from nowhere. If you have mass on your body, it's because you put it there through consuming it. Similarly, you cannot mysteriously generate energy from nowhere - if you undertake any kinetic action, the energy required to perform that action comes from the chemical energy within your body, which will be consumed - thus reduced - in the process.
      If you exert effort, you will burn energy, and thus, fuel. If you do not replace it, your matter will reduce. This is hard and fast. There are no exceptions.

      There is an unfortunate group of people for whom eating less still won't reduce weight and can in fact shut down their organs and kill them. For these people, their body suicidally insists on retaining fat but devouring muscle and organs first. These people with thyroid conditions or similar... they are in the MINORITY. Broad-stroke policies should not revolve around this tiny minority.

      Significantly more people are morbidly obese than have this excuse. Those are the people who need to accept the reality of the simple maths.

        You can't generate matter from nowhere, but recent research suggests that two mice can consume the same diet and do the same amount of exercise, with one staying healthy while the other gains weight because they eat at the wrong time of day, or because their gut bacteria have been affected by artificial sweeteners. Reducing caloric intake (particularly if artificial sweeteners are used to help achieve that) or exercising more might not help someone who just can't process sugar well.

        Last edited 18/10/14 10:21 pm

          Right. That's the condition(s) that I mentioned in my comment above. And it's a significant minority. People who have it are usually pretty well aware of it and how they're different from the rest of the population... the rest of the population who DO need to be reminded of the very simple laws of physics keeping them overweight.

          Everyone else who doesn't have these conditions seem to like to use the existence of these rare conditions as an excuse for why it's pointless to try or why simple-but-difficult solutions aren't good enough, and why we need wonder pills and surgeries and people controlling their willpower FOR them, and other ridiculous magic bullets; anything to escape the depressing reality that losing weight will make you uncomfortable, requires willpower, requires likely unwelcome change to behaviours and habits, and will take anywhere from months to years.

            It's fair to say "thyroid conditions or similar" are experienced by only a small part of the population but I'm talking about different and likely far more widespread issues, you don't need to have a rare disease to have difficulty processing sugar, it looks like you just need to eat when your gut isn't ready or drink a diet coke.
            One of the problems with the simple maths argument is that it doesn't say that when and what you eat can be just as important as how much, and it encourages counter-productive behaviour such as consuming sugar substitutes and skipping meals.
            But the biggest problem is that it implies that anyone who has failed to lose weight is morally weak or not smart enough to do some basic maths. Telling people that is a great way to undermine their confidence and make them stay fat, and I think that's why we hear this argument so often. If you're selling a diet, preying on girls with low self esteem, or competing for jobs or mating opportunities, you have a lot to gain from everyone else being fat.
            Genuine advice usually takes the form "I/my friend tried this and it worked for me/them so it might work for you too." advice that takes the form "this works for everybody and if it doesn't work for you it's your own fault." is at best lazy and more likely hiding an ulterior motive.

            Last edited 21/10/14 12:01 pm

    First week of eating healthy will make you feel crap because your body is craving and used to all the rubbish you're eating. By week 3 though you feel amazing.

    I'm not saying never eat crap, but really eating a large mcdonalds meal with extra burger in one sitting is ridiculous, and eating crap for nearly every meal is pretty bad as well. Bonus: You'll enjoy the crap you do eat more when you're treating yourself 1-2 times a week. When it comes to serving sizes it can actually be pretty hard to go out on your own and eat properly, as what we've come to think of as one serving is probably enough food for two people.

    I've just got back on the eat healthy and workout regime after a few months out of action with a broken arm and torn ligament in the other arm. 12kg down in 6 weeks and feeling bullshit amazing.

    Last edited 15/10/14 10:16 am

    Ive noticed people tend to have an unrealistic expectation of how much they should be able to eat. I recently heard someone describe dieting (Hate the term dieting, food management?) as starving yourself but its not about that at all, its about eating the right amount.

    Not only is the more food available with higher calories (making it easier to go over) but people seem to think large meals breakfast/lunch/tea/dessert + snacks is the medium of the scale.

    Debunk the idea that you should be proud of yourself no matter how fat you are. Point the finger at parents who feed their children crap.

    Read 'The Fat Switch' by Richard J. Johnson, which gives a detailed explanation of the various causes of obesity based on extensive scientific research over several decades.

    Yes that's right. It's the government's responsibility. It's society's fault. The fast food companies and the advertisers are to blame. Everyone but the individual that won't stop gorging on this garbage.

    There is no legislative solution to this problem. You can't pass a bunch of fresh laws and taxes to fix obesity. You have to burn the whole thing to the ground and start again, because it starts in Australia's me-first, full entitlement, no responsibility society. Let me give you an example of the thought process - "I deserve whatever I want whenever I want. No one can tell me what to do or how to live. It's my body and I eat what I feel like eating. But wait, I'm getting fat and I don't feel as valued as I deserve to feel now that I'm fatter. Magazine covers and TV ads show people mocking me with their slim bodies. I deserve to feel better about myself than this. Government should have controlled what I have access to. Government should have made sure I didn't overindulge every night for the last ten years. Society won't stop making me feel bad now that I'm a sinful fatty. This is all someone else's fault. I deserve better than this."

    Last edited 18/10/14 12:27 am

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