Time to Tackle Obesity

Last year's docudrama Super Size Me caught people's attention, but the issue of diet and obesity has been under the professional's microscope for some time. Some 30 years ago, more than 30 per cent of the Australian/New Zealand population smoked, causing a significant health problems. Public health awareness campaigns and pack-labelling regulations were introduced to help people quit, or to discourage people from taking up the habit in the first place. Such measures have been successful in lowering tobacco consumption. But today the country faces a new and acknowledged public health risk. With more than 50 per cent of the population overweight or obese and at risk of developing serious weight-related illness, the parallels are obvious. At the highest level, awareness campaigns must be developed and, perhaps, legislation instituted to limit the epidemic, as with tobacco. The dangers to personal health and the public system are just as real.

The Health Risks

Both obesity and smoking are significant public health threats, which can take years off your life. But while smoking rates have dropped over the past 30 years, the rate of overweight and obesity has trebled in some age groups, most significantly among children. The health improvements that have come about from getting Australians to stop smoking are offset by the obesity. Studies suggest that obese people can expect to die 10 years before their counterparts of average weight. The overweight and obese population is at greater risk of developing chronic diseases that can lead to premature death in the same way smoking is linked with a number of diseases (see table below). These health problems will no longer belong to just the ageing population, for we can expect see a generation of overweight young people developing conditions such as diabetes and hypertension relatively early in life. In the near future, preventable behaviours of choice, such as poor diet and physical inactivity, may overtake tobacco smoke as the leading cause of death.

Pointing The Finger

So who is to blame? Many people see obesity as a private issue, and that it is a matter of personal responsibility. But most health experts realise complicating, more universal issues are involved. Just as we once lived in a culture that thought smoking was “cool” and accepted massive amounts of money from sponsorships and advertising, now its tendency is to encourage overindulgence and inactivity. Observe the pervasiveness of the “death by chocolate” and the “supersize meal deal,” for example, and our fast food culture. There is also a high dependence on vehicular transport requiring no walking or climbing, while a myriad of devices like remote controls and mobile phones also save us from even having to stand. Our social environment makes it hard to eat well and be active, because food—especially fast food—is cheap and plentiful, and movement has been engineered out of daily life. n While individual responsibility is important, other influencing factors include government policy, education, public health care, community health organisations, social attitudes, mass media and the food industry. are you addicted? The argument that nicotine is addictive, removing smokers from responsibility for their inability to quit, has led to suggestions that fast food is addictive in a similar way. A brain-scan study of hungry people showed their brains “lit up” when they saw or smelled their favourite junk foods, in much the same way as the brains of cocaine addicts react when they think about their drug of choice. And just as smoking is a bad habit, fast food can also become a bad habit. When people work long hours, it is not unreasonable that they feel too busy or tired to prepare healthful meal. So a habit of choosing high-fat, fast food becomes the norm.

Legal Minefield

If fast food is ever proven to be addictive, there will be significant legal implications. After the successes of tobacco litigation, the fast-food industry is now in the sights of lawyers in the fight over obesity. Already, McDonald's restaurants has been taken to court, accused of misleading people through advertising and other publicity that its food products were nutritious. In 2002, an American man unsuccessfully sued four fast-food companies, including McDonald's, alleging the food made him obese and gave him heart disease and diabetes. Other cases have followed, including a case where two teen-age girls alleged McDonald's caused their obesity, heart disease, high blood pressure and elevated cholesterol. McDonald's quotes on its web site that the decisions people make about what, how often and how much they eat “are wholly beyond McDonald's control.” But they do market to children with playgrounds, kids' meals, toys and birthday parties, luring children into poor habits of nutrition, overindulgence of foods that are ultimately unhealthy. When you consider that juries are less likely to hold young children liable for their own actions than adults, there is reason to believe that McDonalds may have a case to answer. There is also the case of disclosure, where people cannot make healthful choices if not presented with the information they need to do so. To prevent a class-action lawsuit, some major fast-food chains are now displaying nutrition information more prominently, such as on menu boards or on the wrappers. Recently, McDonalds have also added a range of “healthier” meal choices to their menu, and also advised people not to eat their food more than once a week. McDonald's and other fast-food companies are not totally responsible for the problem of obesity. While it has been proved that smoking causes lung cancer, it is more difficult to determine how much of a role a hamburger plays in a heart attack. Foods are not harmful necessarily in moderation, whereas cigarettes are.

Finding A Solution

As an individual, you can take responsibility for your actions, and make some changes to your lifestyle to lose weight, or prevent the storage of excess body fat. Some key healthy lifestyle strategies include:Diet - Minimise your kilojoule intake by eating less high-fat foods, kilojoule-laden drinks and highly processed foods, while increasing your intake of water, fruit, vegetables and whole-grain foods. Physical activity—Incorporate regular movement and planned physical exercise into your life on most days of the week.Age - As you get older and your metabolism naturally declines, compensate by eating a little less and exercising a little more.Psychological factors - Many people use food to medicate feelings of anxiety or depression. Try to find other methods of dealing with problems in your life other than with food. If you gain a little weight - from medication, illness, pregnancy, quitting smoking or overeating—do something about it. Try to lose the weight soon (responsibly of course). The longer body fat sits on your body, the more your body adapts to it being there—and the harder it is to lose. Some of the strategies used to successfully change people's attitudes and behaviour toward smoking can be employed to help in the fight against obesity. For example, working with individuals was found to be an unsuccessful strategy in the war against smoking. Ultimately, success came by making changes to the environment in which smokers live, making it harder for people to smoke. This was achieved by preventing cigarette advertising and sponsorship, increasing taxes and the price of cigarettes, banning smoking in public places, and educating others about the dangers of second-hand smoke.Public policy - In relation to obesity, some public health policies that governments and the food industry could consider include:

Some of these issues have already been debated in the popular media. Ultimately, the best solution is a combined approach from individuals, governments and food manufacturers. We can learn much from the successes and mistakes dealing with cigarettes, and tackle the obesity problem head on.