Prevalence and perceptions of overweight and obesity in Aboriginal and non-Aboriginal young people in custody

Leigh Haysom, Devon Indig, Elizabeth Moore, Louise L Hardy and Paul A van den Dolder
Med J Aust 2013; 199 (4): 266-270. || doi: 10.5694/mja13.10407


Objective: To describe prevalence of and risk factors for overweight, obesity and self-perceived weight gain of Aboriginal and non-Aboriginal Australian young people in custody at baseline and over 12 months of follow-up.

Design, setting and participants: Prospective cohort study of youths in custody in New South Wales, from August 2009, with follow-up at 3, 6 and 12 months.

Main outcome measures: Body mass index at baseline, categorised as overweight or obese using international cut-points; waist-to-height ratio (WHtR) at baseline, categorised as increased metabolic risk (≥ 0.5) or low metabolic risk (< 0.5); and self-perceived weight change at follow-up.

Results: At baseline, 452 youths were incarcerated, 361 (79.9%) consented to participate, and complete anthropometry measurements were taken for 303 (67.0%). At 3, 6 and 12 months, there were 231 (76.2%), 158 (52.1%) and 143 (47.2%) participants, respectively. Two-hundred and sixty-four (87.1%) were male, 151 (49.8%) were Aboriginal, and 145 (47.9%) had been incarcerated for < 3 months at baseline. One hundred and forty-five (47.9%) were overweight or obese and 112 (37.0%) had a WHtR of ≥ 0.5 at baseline. However, only 72 (24.1%) perceived themselves as overweight at baseline, and 154 (71.6%) perceived a weight increase since incarceration despite improvements in diet and exercise. Longer incarceration time was strongly associated with overweight and obesity in Aboriginal youths at baseline and with self-perceived weight gain in non-Aboriginal youths at follow-up.

Conclusions: Overweight and obesity were highly prevalent but poorly recognised in young people in custody. A longer incarceration time had the strongest association with overweight obesity and self-reported weight gain. From a population health and policy perspective, changes to the liberal food environment and the approach to increasing physical activity in custody are warranted.

  • Leigh Haysom1
  • Devon Indig1
  • Elizabeth Moore1
  • Louise L Hardy2
  • Paul A van den Dolder3

  • 1 Justice and Forensic Mental Health Network, Sydney, NSW.
  • 2 Prevention Research Collaboration, University of Sydney, Sydney, NSW.
  • 3 Illawarra Shoalhaven Local Health District, Wollongong, NSW.


This study was funded by the Justice and Forensic Mental Health Network and the Centre for Aboriginal Health (NSW Health). We thank staff from Juvenile Justice NSW and Justice Health who provided operational support for the 2009 NSW Young People in Custody Health Survey, and the young people who kindly participated.

Competing interests:

No relevant disclosures.

  • 1. Indig D, Vecchiato C, Haysom L, et al. 2009 NSW Young People in Custody Health Survey: full report. Sydney: Justice Health and Juvenile Justice, 2011.
  • 2. 2003 NSW Young People in Custody Health Survey: key findings report. Sydney: NSW Department of Juvenile Justice, 2007.
  • 3. Morley B, Sully M, Niven P, Wakefield M. National Secondary Students’ Diet and Activity Survey 2008. Melbourne: Cancer Council Victoria, 2010.
  • 4. Hardy L. SPANS 2010: NSW Schools Physical Activity and Nutrition Survey: executive summary. Sydney: University of Sydney, 2011.
  • 5. Herbert K, Plugge E, Foster C, Doll H. Prevalence of risk factors of non-communicable diseases in prison populations worldwide: a systematic review. Lancet 2012; 379: 1975-1982.
  • 6. Garcia G, Logan GE, Gonzalez-Heydrich J. Management of psychotropic medication side effects in children and adolescents. Child Adolesc Psychiatr Clin N Am 2012; 21: 713-738.
  • 7. Ucok A, Gaebel W. Side effects of atypical antipsychotics: a brief overview. World Psychiatry 2008; 7: 58-62.
  • 8. Curtis J, Henry C, Watkins A, et al. Metabolic abnormalities in an early psychosis service: a retrospective, naturalistic cross-sectional study. Early Interv Psychiatry 2011; 5: 108-114.
  • 9. Australian Institute of Health and Welfare. Making progress: the health development and wellbeing of Australia’s children and young people. Canberra: Australian Institute of Health and Welfare, 2008. (AIHW Cat. No. PHE 104.)
  • 10. Abbott RA, Lee AJ, Stubbs CO, Davies PS. Accuracy of weight status perception in contemporary Australian children and adolescents. J Paediatr Child Health 2010; 46: 343-348.
  • 11. Khambalia A, Hardy LL, Bauman A. Accuracy of weight perception, life-style behaviours and psychological distress among overweight and obese adolescents. J Paediatr Child Health 2012; 48: 220-227.
  • 12. Chang V, Christakis N. Self perception of weight appropriateness in the United States. Am J Prev Med 2003; 24: 332-339.
  • 13. Cole TJ, Bellizi MC, Flegal KM, Dietz WH. Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ 2000; 320: 1240-1243.
  • 14. World Health Organization. Physical status: the use and interpretation of anthropometry. Geneva: WHO, 1995.
  • 15. Browning LM, Hsieh SD, Ashwell M. A systematic review of waist-to-height ratio as a screening tool for the prediction of cardiovascular disease and diabetes: 0.5 could be a suitable global boundary value. Nutr Res Rev 2010; 23: 247-269.
  • 16. Garnett SP, Baur LA, Cowell CT. Waist-to-height ratio: a simple option for determining excess central adiposity in young people. Int J Obes (Lond) 2008; 32: 1028-1030.
  • 17. Australian Bureau of Statistics. Census of Population and Housing: Socio-Economic Indexes for Areas (SEIFA). Australia, 2011. Canberra: ABS, 2013. (ABS Cat. No. 2033.0.55.001.)
  • 18. Saunders JB, Aasland OG, Babor TF. Development of the alcohol use disorders identification test (AUDIT): WHO collaborative project on early detection of persons with harmful alcohol consumption. Addiction 1993; 88: 791-804.
  • 19. Zubrick S, Garton AF, Silburn SR. Western Australian Child Health Survey. Perth: Telethon Institute for Child Health Research, 1994.
  • 20. Udry JR. The National Longitudinal Study of Adolescent Health. Chapel Hill: University of North Carolina, 1998.
  • 21. Axelson D, Birmaher B, Zelazny, et al. The Schedule for Affective Disorders and Schizophrenia — Present and Lifetime Version for Children (KSADS-PL) 2009 Working Draft. Advanced Centre for Intervention and Services Research, Western Psychiatric Institute and Clinic, 2009.
  • 22. Australian Institute of Health and Welfare. Australia’s health 2012. Canberra: AIHW, 2012. (AIHW Cat. No. AUS 156; Australia’s Health Series No. 13.)
  • 23. Kenny DT, Denney-Wilson E, Nelson P, Hardy LL. Eating habits of young offenders on community orders and associations with overweight and obesity. Nutr Diet 2008; 65: 198-204.
  • 24. Indig D, Topp L, Ross B, et al. 2009 NSW Inmate Health Survey: key findings report. Sydney: Justice Health, 2010.
  • 25. Thivel D, Blundell JE, Duche P, Morio B. Acute exercise and subsequent nutritional adaptations. What about obese youths? Sports Med 2012; 42: 607-613.


remove_circle_outline Delete Author
add_circle_outline Add Author

Do you have any competing interests to declare? *

I/we agree to assign copyright to the Medical Journal of Australia and agree to the Conditions of publication *
I/we agree to the Terms of use of the Medical Journal of Australia *
Email me when people comment on this article

Responses are now closed for this article.