Volume 188 - Issue 11
Overweight and obesity in Australia
Authors: John A Hawley and David W Dunstan
Med J Aust 2008; 188 (11): 678-679. || doi: 10.5694/j.1326-5377.2008.tb01835.x
Published online: 2 June 2008
Published online: 2 June 2008
To the Editor: Australians are fatter than they have ever been before. The prevalence of overweight and obesity (body mass index ≥ 25.0 kg/m2, or waist circumference > 80 cm for women or > 94 cm for men) in Australian adults is approaching 60% for both sexes and has more than doubled in the past 25 years.1
A prudent public health policy to fight the growing obesity epidemic would undoubtedly be to target strategies that avert this condition in the first place. So we were perplexed by the Australian Medical Association’s recent proposal to the Victorian Government to fund five public hospitals to provide 3000 obesity-related operations (ie, bariatric surgery) over the next 3 years.2 It appears the blueprint for the new millennium is to invest taxpayers’ money in modern technologies in an attempt to arrest overt clinical disease states.
To attack the growing burden of obesity by investing in strategies that target secondary and tertiary treatment is an admission that we may win battles on a few fronts, but lose the war. We propose placing greater emphasis on implementing and enforcing primary prevention strategies to fight obesity. Primary defence mechanisms can decrease obesity prevalence by preventing the condition in the first place! Indeed, the health care industry is paradoxical in that its principal goal is to end health problems and human suffering, and by so doing put itself out of business.3
We need to attack the environmental roots of obesity, namely our sedentary lifestyles and caloric excess. Emphasis on secondary and tertiary prevention is too little, too late and will not reverse the growth of obesity — the funds to treat obese individuals are finite, while the number of Australians with the potential to become overweight or obese is not!
In a letter to President Roosevelt voicing concerns about the Manhattan Project (the project to develop the atomic bomb during World War II),4 Niels Bohr wrote:
A weapon of an unparalleled power is being created which will completely change all future conditions of warfare. Unless some agreement about the control of the use of the new active materials can be obtained in due time, any temporary advantage, however great, may be outweighed by a perpetual menace to human security.
Obesity-related disorders impact on daily living. While bariatric surgery may provide a “magic bullet” for a few individuals, the time has come to legislate for minimum health standards, and to provide support for people to effect lifestyle changes to meet these requirements. Otherwise, obesity will remain a permanent threat to Australian society.
References
- Cameron AJ, Welborn TA, Zimmet PZ, et al. Overweight and obesity in Australia: the 1999–2000 Australian Diabetes, Obesity and Lifestyle Study (AusDiab). Med J Aust 2003; 178: 427-432.
- Obesity surgery would improve the bottom line. The Age (Melbourne) 2008; 6 Jan. http://www.theage.com.au/news/editorial/obesity-surgery-would-improve-the-bottom-line/2008/01/05/1198950123936.html (accessed Jan 2008).
- Booth FW, Gordon SE, Carlson CJ, Hamilton MT. Waging war on modern chronic diseases: primary prevention through exercise biology. J Appl Physiol 2000; 88: 774-787. 0_i1091833
- Bohr N. Letter to President Franklin D Roosevelt (3 Jul 1944). http://www.spartacus.schoolnet.co.uk/USAmanhattan.htm (accessed Jan 2008).