Image via Wikipedia
Obesity a National Threat
Picture of an Obese 146 kg Teenager on the right>>
The Australian Bureau of Statistic (ABS) do show that two-third of the Aussies are either overweight or obese. In 2008 24% of the Australian population was obese whilst an other 37% was overweight. Only 37% had a normal weight. Adding those figures you get an interestingly 61% of the people being either overweight or obese, compared with 57% in 1995. Children up to year 12 are today more likely obese and Australia’s remote and outer regional areas do count increasingly adults obese as well. Only 6% of the Australian adults take the recommended daily amount of both vegetables and fruit, regardless of weight. Costs of obesity for Australian society are on the increase with an anticipated cost of close to 60 billion dollar in recent 2008 (all associated costs included).
It would seem that men have gained weight at a higher rate than women. In the disadvantaged group of people one-third seems obese. Toddlers are generally getting increase obese with teens developing already diabetes and liver disease. Cases of 16 year – olds already in the rage of 140-150 kg as reflected in the above photo are not rare at all anymore.. It shows that extreme obesity is on the increase. In young age we see already adult patterns of high blood pressure and early stages of heart disease developing. Early onset of both diabetes and liver disease as result of obesity are on the increase in the age group of 15 and 16 year olds with families losing the normal picture of children being healthy and active.
We measure the weight ratio with a thing which is called the BMI (Body Mass Index). As soon as the BMI is greater than 30 we call the person obese and obesity is related with a significant increased risk on heart disease, diabetes, high blood pressure, dementia, asthma, osteoarthritis, kidney disease, mental disease, and early death. Those diseases represent very obvious costs, including costs for the healthcare system and carer’s. Not to speak about significant costs for the workforce in terms of sick days and reduced productivity, besides unnecessary suffering in far too many occasions. We are not only speaking here about Public Health issues as those direct costs are one-third only of the indirect costs for the total economy. The main issues and related indirect costs are predominantly connected with the drain on resources and the obstacles to optimal productivity, – as it would seem.
Together with the US the Aussies are front-runners in terms of obesity and associated disease. Obesity at widespread levels of this nature are an increasing danger for society.
If either country is unable to contribute to the reduction of the existing obesity figures, those who are obese will be increasingly unable to give to their country, to their families and to themselves, – with debilitating disease and death as an early result, besides staggering costs for society. A country will simply not thrive with an increasing number of “potato couches”. The costs of treating obesity and being overweight are on its own already close to 2.5 billion dollar a year in Australia. The loss of being not at work, unemployment and lost work productivity ( some of the indirect costs) are close to 8 billion dollar a year. In line with the International Obesity Taskforce predictions, one in every 3 adults will be obese by 2025 if the increasing trend till so far is not going to change.
Therefore obesity is one of the more serious topics on both the national health and the political agenda. Still we are living in a society where there is a rise of TV and/or computer viewing, a society where the numbers are trending up for both the preference of “take away” and pre-prepared food. A society with a trend increasingly towards sedentary jobs with less physical exercise in particular groups. Despite the awareness of Australian health authorities since the 1970-ties following various reports calling for action,- until 2002 there was hardly any activity from governments at State levels. In 2002 the State and Federal Health Ministers created a National Obesity Task force with the instruction to provide adequate intervention strategies within a time frame of close to 8 years. This was a multidisciplinary task force, including both food industry and sporting bodies, consumers associations, retailers, doctors and some others. State governments meanwhile did look after their own programs. The Federal Government in 2004 dedicated some 115 million dollars over 4 years to help programs with both a family and school orientated approach to enhance the awareness of healthy nutrition and the importance of physical activity. Family Physicians got incentives to look after patients with obesity within the context of chronic disease management, with obese people getting the option of being referred to an exercise physiologist paid by Medicare.
Still however the percentage of obesity levels is not reducing. Existing programs emphasising to educate people to help and change their habits and behaviour are simply not working because they don’t give enough incentives. GP’s and other health workers are considered the cornerstone in tackling the problems associated with obesity, but it does not resolve the problem on its own as outside the various consulting rooms both incentives and (really!) discouragements are lacking. The National Obesity Task Force itself has no uniformity in vision from the participants and within the context of the consultation process not being always that fruitful, long delays in government reporting are more often than rarely the case. Both State and Federal Government find it to hard to tackle the problem.
Unhealthy habits are difficult to tackle in society. This applies eg to smoking, but smoking however is getting even less tolerated at present. Like anti smoking campaigns are more radical than ever before, anti obesity programs need to be far more vigorous than ever before as well.
The old ways do not seem to work.
Options for political discussion are: creating financial incentives for changing eating behaviour, gradually increased taxation ratio’s for people with risk behaviour (e.g.smokers, drug users, people with good mobility and a BMI greater than 30 in the adult population, subsidising sporting facilities and healthy food choices, involvement of employers with legislation supported financial incentives to give both weight-loss and nutrition programs to employees. Private health funds could load people with higher BMI’s with an increased premium, whilst evidence on lowering BMI’s could result in discounted premiums. There are now Pharmaceutical Benefits Schemes (PBS) for anti smoking drugs like Champix. For people being seriously obese, – similar PBS subsidies should be available.
Unhealthy habits are the manifestation of poor lifestyle choices and whilst it can’t be denied that people have a free choice, it can’t be tolerated that this free choice should be allowed resulting in all sorts of associated conditions impacting the national budget being shared with others. Very obvious, – many people can’t help it that they are ill, get an accident, or have a chronic condition. Furthermore people can’t help it when they are getting old and have to sustain age related illness.
Obviously people who smoke by choice, people who are obese by choice (=not changing unhealthy lifestyle habits),- likewise people who use drugs by choice, people who cause accidents by speeding etc deserve healthcare, – but the healthcare or the taxation ratio needs to come at an increasing cost for them, and not at a cost for those who can’t help it to be ill as due to not long-term self-inflicted bad choices. Simply spoken bad life style habits need to be made utterly unattractive and painful for the wallet for those not being ready to change eventually.
The aim of the national political agenda should be a reduction of both the direct and indirect costs related with obesity as one of the major health threats, where free choices allow this health threat to grow or to cut. Free choices should not encroach the rights of others and I would rather see a law enforcement with active discouragement of bad lifestyle choices ( smoking, drugs, excessive food of the wrong nature, excessive alcohol use etc) than seeing the morbidity and death levels rise as a result of an increasing obese society with disproportional healthcare costs draining the national budget, – affecting e.g the budget on education and positive economic stimuli for the middle class and the country.
The concept of an increasing obese society by allowing this free choice is simply not acceptable. Drastic measures are required with vigorous and fair legislation at the core of national leadership with e.g increasing tax ratio’s for people with a BMI greater than 30 without an endocrine base and normal mobility.
The education needs to start at primary school and the law enforcement needs to target those groups still able to change, as the trend is that an increasing number of kids up to year 12 is already obese. The fact that only 6% of the population is using the recommended dose of fruits and vegetables is a trend which needs to increase for the better, with subsidising healthy food choices and taxing unhealthy food by legislation.Weight and exercise programs need to be subsidised as well but those costs need to be paid from the tax revenues from (what I would like to say) “the unhealthy stuff”. Family focussed education programs including the combination of practical parenting and nutrition information are able to revitalise families with an emphasis on regular daily exercise and for children engaging in sporting activities rather than video games.
The question what to do with other risk behaviour impacting on the national budget by free choice is not within the scope of this article, but will be a natural response if it proves that certain “free choices” are encroaching on both the rights and national budget of others. We have a duty to help the poor and the uneducated to overcome their burdens and to give to society, – likewise we have a duty to manage those groups of people who by lifestyle choices on the long terms create not only a burden for themselves, but also a burden for society. As “healthy people” we don’t need to ask what the country can do for us, but we need to ask what we are able to give to society to lift the burdens of people who do surround us, whether it is nearby or far away, and as such we help to make a more sustainable society on the long-term where negative trends will be better managed or controlled, – if the last is required for the benefit of others.
The dangers of obesity are underestimated with adult disease patterns hitting the younger age group and the general population getting “fatter”.
- Weighing negatives in the war on obesity (utsandiego.com)
- Health care costs steadily increase with body mass (eurekalert.org)
- Increase in body mass relates to increase in health care costs (medicalnewstoday.com)
- 10-year-old schoolgirl weighs 22 stone, new figures show (telegraph.co.uk)
- 10-year-old Birmingham schoolgirl weighs 22 stone (telegraph.co.uk)
- Healthy Obesity: An Oxymoron? (psychologytoday.com)
- Social workers take children from families who overfeed them (express.co.uk)
- A Big Fat Crisis: top 5 obesity myths (smh.com.au)
- Are You Really Overweight? (quickweightlosstipss.wordpress.com)
- Obesity Causes Bone And Muscle Loss In Men, Study (asianscientist.com)