Building healthier bodies can start with healthier towns
With the majority of middle-aged Australians either obese or overweight the direct contribution of their excess fat to poor health outcomes is potentially staggering.
Over the next 20 years it is likely that overweight and obese Australians will experience 700,000 more hospitalisations and 120,000 more deaths related to weight-related diabetes and cardiovascular disease (including heart attacks and strokes) compared to the same population who remain healthy and slim.
The calculated cost to society in terms of health care alone is $6 billion. The cost of losing loved ones and productive members of our society is probably incalculable.
At a national level, our disputed claim as the fattest developed nation on earth has at least put some perspective on our collective weight gain and fall from grace as a truly active nation of budding athletes.
Even if we are not the fattest in the world, would we really be happy to win a bronze medal at the fictional Fat Olympics?
Those who visit our shores (particularly those from European countries where cycling and walking are the norm) are struck by how big we have become.
The options being considered by the Federal Government and their recently formed Preventative Health Task Force are many and varied. We have already seen a campaign to “measure up” and consider the impact of increasing weight on our individual health with increasing awareness of the same.
However, this is unlikely to be successful when “fat” has become the norm and our collective eyes have been recalibrated to accept and embrace greater girths. More radical policies and health initiatives may be required. Some experts have advocated increased availability to radical surgical options once considered the option of last resort for the morbidly obese - for example, gastric banding.
At the same time, there have been suggestions that more draconian policies in respect to the cost of health insurance will need to be implemented in the not-too-distant future, such as the obese paying higher premiums, or denying access to certain surgeries until reaching an agreed weight.
These are drastic. More palatable options will focus on community interventions to both encourage and reward healthier lifestyles; remembering that healthier eating and increased exercise not only increases the likelihood of weight loss but tackles the other two modern drivers of preventable cardiovascular disease - high blood pressure and high cholesterol.
Similar to “Tidy Towns”, there is merit in the idea of promoting “Healthy Towns” with the provision of sporting facilities and other recreational services to those communities prepared to tackle issues of local food supply - like getting rid of some fast-food shops, or access to healthy lifestyles by means of programs like free fitness coaching.
These would be best supported by initiatives that can monitor a communities’ health overall and reward them for achieving key milestones like, for example, a collective loss of weight.
Baker IDI has engaged more than 2500 adults in regional communities in Victoria to monitor their heart health. This includes a number of basic parameters including their overall weight and waist circumference. A six month trial of intervention in Colac, Victoria has shown that the associated Protecting Healthy Hearts Program (funded by the Department of Health and Ageing) can not only engage and retain a large number of adults in one community, but promote positive life-style changes, including sustainable weight loss, that will prevent future cardiovascular events.
The challenge will be balancing a carrot and stick approach to weight loss that doesn’t disadvantage the most vulnerable individuals and communities.
It is a paradox that the poorest people in our society are most at risk of being obese. As a result, the politics of food advertising and consumption will need to be carefully managed.
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