Issue 6 / 21 February 2011

I RECALL seeing a TV comedian talking about obesity figures that showed Australia riding high in the international rankings.

“Is there anything we’re not good at?” he quipped.

Well, if there was a gold medal for obesity, new figures suggest Australia would be a serious contender.

A landmark global study of more than 9 million people in nearly 200 countries shows the United States still outweighs other high-income countries, with an average body mass index (BMI) of 28.5 for men and 28.3 for women.

But Australia is not far behind, at 27.6 for men and 26.9 for women.

It’s a sobering thought that being overweight is now the norm in this country.

In a series of papers, published in the same issue of The Lancet, the researchers looked at worldwide movements in average BMI, systolic blood pressure and serum total cholesterol between 1980 and 2008. Average BMI increased globally over the period, leading the researchers to estimate that 1.46 billion adults were overweight by 2008.

When it came to measuring the biggest rise over the period, Australia came in third among high-income countries, behind the US and the UK.

The situation is even worse in some nations that will least be able to afford the catastrophic health consequences of this tsunami of obesity: the average woman in Nauru now has a BMI of 35, and rising.

For developed countries such as Australia, though, there may be a surprising glimmer of hope in the new data.

While we keep getting fatter, the global study shows that some key associated risk factors are actually improving, at least for cardiovascular disease (diabetes is another question).

Between 1980 and 2008, mean systolic blood pressure fell in Australia and New Zealand by 3.9 mm Hg per decade for women and by 2.3 mm Hg per decade for men.

Serum total cholesterol is, unsurprisingly, highest in wealthy countries, including Australia, but it also fell slightly in these countries over the period, despite increasing in other parts of the world.

This could just be a medical success story, albeit one with a mixed prognosis: Australians seem to be getting better at managing some of the risk factors that accompany our expanding waistlines, despite our marked failure to actually tighten our belts.

Given the intransigence and multifactorial nature of the obesity problem, it is some consolation that good medicine appears to be at least helping us to live more healthily with that extra weight.

But if anything underscores the need to make prevention a key part of the on-again, off-again process of national health reform, it is data such as these.

If we want to avoid the devastating health consequences ― and crippling financial costs ― of the obesity epidemic, we need to devote some serious resources to effective management of associated risk factors as well as finding creative ways to address its root causes.

Jane McCredie is a Sydney-based science and medicine writer, and author of Making girls and boys: inside the science of sex, published by UNSW Press.


Posted 21 February 2011

5 thoughts on “Jane McCredie: Time to put the weights on obesity

  1. Max Whisson says:

    I have been very disappointed in the knowledge demonstrated by dieticians and indeed clinicians. I moved on from GP when the obesity pandemic was at an early stage but it was obvious to me then that asking a person to eat less and exercise more was a very ineffective treatment. At that time research colleagues were demonstrating the low GI of fructose and the production of the metabolic syndrome by rapid intake of this sugar. It seems clear now that the obesity pandemic is caused primarily by the wide availability of foods, particularly drinks, sweetened with fructose, usually combined with innocuous glucose as sucrose, but astonishingly this seemingly obvious and very serious threat to human health is almost completely ignored by most experts in the field.

  2. Carmen Abaffy says:

    Root causes of obesity are deeply seated in the society and until the measures like taxing the junk food are established it is unlikely we shall make any shift and any progress. And paradoxically whilst we are getting more overweight we are also finding that we are deficient in healthy nutrients.

  3. Rod McClymont says:

    As a clinician with a special interest in helping children and adolescents and their families deal with obesity and a keen reader of the research literature I offer the following comments on Dr Whisson’s contibution.
    Whilst fructose and glucose intake has a role in the obesity epidemic, particularly in American youth, it is but one of several changes in the environment, habits and food intake that contribute. There is a keen interest in the role of dietary fructose by many experts in the field of obesity and much on-going research. Recent findings supporting evidence for fructose having a quite different effect on the CNS and central pathways of energy metabolism and appetite compared to glucose is one area of current interest.
    The obesity epidemic is a worldwide phenomenon. Fructose intake is a contibutor in some populations but many other changes over the last few decades are involved.

  4. Dr Joe says:

    “…asking a person to eat less and exercise more was a very ineffective treatment”. It is the ONLY treatment.
    Why is this whole issue made so much harder than it needs to be? It is physics 101. Energy can be neither created nor destroyed – it can change form. If people consume more energy than they expend the excess is transformed into fat.The solution is to consume less or expend more.
    Even if people choose not to “comply” the laws of physics remain the laws of physics.

  5. Dan Chan says:

    The combination of diet and increased physical activity level is proven to be the best way of losing weight but often a large proportion of people who lose weight will also gain back their weight over the years. It is possible that this regain of weight is due to the changes the person took on to lose weight did not become a common part of his lifestyle where he enjoys doing. How a health professional informs or tells someone to modify his lifestyle can make a big difference. The client or patient needs to knows the HOW (to do it) and WHY (should I do it?). Some convincing needs to take place but ultimately, it is still the person himself who takes charge of his life. The perfect world will never exist with people not doing the right thing due to their upbringing, habits over the years, lack of knowledge, disinterest, medical conditions or foolishness (sorry if I missed covering something).

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