Rob Moodie: The fat fight

A COUPLE of weeks ago while driving to Shepparton I stopped for petrol. I went into the convenience store to pay and, unusually, decided to have a good look around.

All that I saw was wall-to-wall sugar packed in gleaming wrappers ready to bring me joy; or sugar bottled or canned, full of bursting happiness.

One store does not make an obesity epidemic but this one was symbolic of the commercial reality that does.

Our lives have become so saturated by energy-dense nutrient-poor (AKA junk) products and their relentless advertising and sponsorship that we now consume them at toxic levels, resulting in widespread and highly resistant health, productivity and financial problems.

Recent evidence from the US (whose obesity patterns we strongly mimic) shows that obesity is likely to be causing more death and sickness than we had previously calculated. Data from AusDiab show that type 2 diabetes, one of the major consequences of obesity, is out of control.

Obesity has become one of the industrial epidemics of the 21st century. The Australian National Preventive Health Agency reports that obesity has dramatically worsened in the past two decades for children and adults, and those in remote Australia and with poor levels of income and education are more severely affected.

In 2009, the National Preventative Task Force and the AMA released wideranging and comprehensive approaches to tackling obesity. Yet when we look at the assessment sheet to date we deserve a “fail”.

Our workplaces are no leaner nor more active; our schools are yet to have physical activity and nutrition mandated as part their curricula; there is no ban on marketing energy-dense, nutrient-poor foods to our children; no taxation measures to stimulate healthy food and decrease junk food consumption; and no reduction in the relentless production, promotion and sale of junk food and drinks.

On the positive side, there are plans for a star system to indicate energy, saturated fat, sodium, sugars and one optional positive nutrient on front-of-pack food labelling, and the federal government has funded the states for prevention programs across communities, schools and workplaces.

One state government — WA — has had the guts (excuse the pun) to run a campaign (LiveLighter) to show the brutal truth of what toxic levels of sugar and fat do to us. It is the only bright light on the Australian landscape that provides us with compelling and actionable information.

The campaign encourages community discussion to force us, along with our governments, to take on two of the vectors of obesity and two of the most effective blockers to reduce obesity — Big Food and Big Soda.

When doctors counsel their patients to give up smoking, they can be sure that their patients will go out to an environment free of tobacco. They won’t be confronted, as they would have 40 years ago, by a barrage of up to 14 tobacco ads per hour on TV, billboards, and prominent sportsmen encouraging them to continue the habit. The result is we have seen smoking rates drop from 75% in men in the 1950s to 16% now.

Unfortunately, the same can’t be said for doctors counselling their patients and their families about dietary behaviour or physical activity. Every bit of encouragement and advice, and every attempt to reinforce the personal responsibility of their patients, is constantly undone and undermined by the obesity-generating environment that is contemporary Australia.

Our children constantly look up to the kings of Australian sport who have become emissaries for junk foods and sugary drinks that have no nutritional value.

When new Prime Minister Tony Abbott was the health minister he advised us to get our kids off the couch and away from the TV — he isn’t wrong, but he is only half-right.

Our obesity epidemic will only be solved — or at least managed more effectively — by a combination of personal responsibility and societal responsibility.

We need a whole of society approach, and it must be led by physician advocacy, focused as much on prevention as treatment — as has been done with other major health successes in Australia such as tobacco, road trauma and skin cancer.

Doctors can and must do more.

Professor Rob Moodie is professor of public health at the Melbourne School of Population and Global Health, University of Melbourne.