An unwillingness to confront obesity is costing the country dearly. Imogen Neale reports.
Obesity has become the killer epidemic we don't talk about, and political correctness is partly to blame, says an obesity and diabetes expert.
Otago University's Professor Jim Mann said obesity rates have increased dramatically in New Zealand – particularly among young people.
Almost 15 years ago it was estimated that obesity killed around 3200 Kiwis a year – more than 10 times the country's annual road toll.
The most recent Ministry of Health figures show that one in five Kiwi children is overweight and one in 12 is obese, according to their body mass index (BMI) rating. Almost 50% of the adult population is overweight or obese based on that rating.
According to the OECD Health Data 2011, New Zealand's obesity rate is lower than the United States and Mexico, but higher than all other OECD countries.
Health risks associated with obesity include type 2 diabetes, asthma and sleep-related breathing problems, heart disease, strokes and some cancers. Overweight or obese children are also more likely to be stigmatised.
Mann said the obesity is now so endemic it has become boring, and parents need to take a hard look at their children.
"Not only is it boring, but there is something that goes in parallel with being boring and that is that people don't recognise it," he said.
Mann believes people don't recognise it because society has a new "normal".
"Parents do not identify their children, who are appreciably overweight, as being overweight and fat, simply because it's so much the norm," he said.
The same is true for adults.
Anecdotal evidence would suggest he is right, with theatre seats, cemetery plots, hospital beds, coffins and underwear being up-sized to meet a growing demand.
Mann says the National government's "we will not regulate, it's up to individuals" approach isn't working and he's disappointed it did away with healthy eating guidelines in schools within weeks of coming into power.
The programme cost $4.5 million to develop and required schools to promote healthy food and nutrition, and make only healthy options available.
Mann said the government should help to create an environment where healthy choices are easy to make.
"We can't just sit back and say `we need to hand out a few pamphlets'."
The epidemic has to be addressed at all levels – from daily family choices to industry regulation.
"We do have the cure for the obesity problem, it just needs to be implemented."
How would Mann make the obesity campaign more exciting?
"I don't think I'd go quite as far as taking a cigarette approach and saying `fatness kills you' [but] the risks of obesity are getting to be comparable to the risks of smoking.
"This is the whole fallacy of the nanny state's philosophy. We say seatbelts are compulsory because they kill people and accidents are a cost to society. Well, obesity kills people and the consequences are a huge cost to society."
Research commissioned by the Health Research Council of New Zealand last year explored the cost-effectiveness of 12 international obesity intervention programmes.
It found neither of the New Zealand examples "appeared highly cost effective" – with one costing $1392 per child. It also noted many programmes were not evaluated on results.
School-based programmes for children and general health screening and advice for adults were found to be the most cost-effective way to prevent obesity.
The government's response to obesity is called The Healthy Eating – Health Action strategy (HEHA).
A number of submissions made to the 2006 Health Select Committee Inquiry into Obesity and type 2 diabetes said the strategic framework did not go far enough.
Many called for more every-day government intervention, such as restricting advertising around unhealthy food choices and a tax break on all fruit and vegetables.
How much do obesity and obesity-related diseases cost the country?
An exact figure is hard to come by, but an Auckland Regional Public Health Service report put the 2000/1 annual cost at $247.1 million, excluding "downstream costs" from resulting chronic diseases such as diabetes ($280m) and coronary artery disease (up to $467m).
One thing the research does agree on, however, is the importance of nipping the disease in the bud, as obesity in childhood is a predictor of adult obesity.
- Sunday Star Times
Should fluoride in water be the responsibility of central government?