OBESITY Introduction

OBESITY
Introduction:
Obesity is a major public health problem in Australia. It is the second highest burden of disease. Approximately 140 Australians die prematurely every day from an obesity-related disease, and more than 50,000 people a year, according to the non-profit group obesity prevention Australia. The Australian Institute of Health and Welfare shows that during 2011-12 almost two in three Australians are obese or overweight and 10% more adults are overweight or obese than in 1995. One-quarter of children and adolescents are overweight or obese. Nearly two- thirds of adults are overweight or obese, with the number of obese adults continuing to increase. More men than women were overweight or obese in 2014-2015. In children aged 5-17 years, the prevalence of obesity increased from 1995 to 2007-2008 and remained stable to 2014-2015. There are some groups are more likely to be overweight or obese than others such as indigenous Australians, Aboriginal and those who living outside major cities or who are in low socioeconomic groups are more likely to be overweight or obese. People who having excess weight those have higher rates of death and illness and diseases than people who have healthy weight. Obesity is a major risk factor for cardiac disease, type2 diabetes, etc. AIHW observed obesity and overweight as a risk factor for chronic disease. The main factor that influencing obesity is poor diet intake and inadequate physical activity. Obesity and overweight can be measured in a number of ways, but commonly used body mass index (BMI), it is an internationally recognised for measure obesity at a population level for both adults and children. According to Accredited Practising Dietitians (APDs) have many tools to look at your risk of being obesity such as BMI, Body Shape, Waist Measurement, Waist-to-hip ratio.
There are many reasons behind increase weight such as eating more foods and drinks than is body requirement, eating junk foods and high calorie food, sedentary lifestyle, genetics, eating foods likes cake, pastries, more potato items and drinks like sugar-sweetened beverages and alcohol. Australia’s Healthy weight week (AHWW) create awareness among people to maintain healthy weight by using following ideas such as: to eat balance diet, including fruits, vegetables, cereals, dairy products, legumes, nuts, and seeds, avocado, Drink plenty of water each day, limited consumption of foods that contains saturated fat, extra sugar and salt, Do regular exercise. Regular monitoring of health may help to prevent illness or diseases. The Australian government in 2010 taking preventative action plan for healthy weight given following activities that are funding the National Partnership Agreement on preventive health, establishing the Australian National Preventive Health Agency, Launching social marketing campaigning Australians to adopt a healthier lifestyle; and clinical guidelines on obesity.

Evidence:
Australian statistics and trends shows more than a third (35.3%) of Australian adults were overweight, and more than quarter (27.5%) were obese. while one in four children was overweight or obese in 2011-2012 (Australian Bureau of statistics (ABC) 2013). Victorian data mirrors these trends, with 31.2% of adults estimated to be overweight, and 18.8% obese, throughout the state in 2014 (DHHS 2016). It is estimated that, if current trends in obesity increasing day by day it will reach upto 73% in 2025 among Australian adults (Walls et al.2012). Hence, it evidence that obesity is biggest issues among Australia. Socioeconomic inequalities in obesity have persisted among Australian adults since 1980 (Gearon et al. 2015) and, if current trends in weight gain continue, are likely to widen over the next 10-15 years (Backholer et al. 2012).
Obesity have an enormous impact on health care spending. Australian government spend estimated $8.6 billion for obesity including $3.8 billion in direct costs and $4.8billion in indirect costs. Estimated reach around $120 billion a year, which is equivalent to 8% of the economy’s annual output. Hence, it refutes that obesity is a challenge for healthy society.

Policies:
Policies for tackling obesity and creating healthier food environments February 2017:
Unhealthy diets leads to various health problem in Australia. Identifying obesity and improving population diets requires a comprehensive government response at the commonwealth and state/ Territory levels. This policy gives following recommendations for NSW such as monitoring food environment including unhealthy foods and public sector settings, Restrict the promotion of unhealthy food by the NSW government, menu labelling, implement a healthy food procurement and provision policy, introduce stronger incentives and accountability mechanisms for schools to comply with healthy food provision policies.
Obesity policy coalition: overweight, obesity and chronic diseases in Australia:
Australian government announced the assembly of the National Preventive Health Taskforce in 2008 which focus to tackle the chronic diseases caused by tobacco, alcohol and obesity and this includes 27 recommendation action designed to reduce and control the obesity in Australia by 2020.
This policy implemented in 2009 and after the eight years the overall progress has been disappointing, with preventive health not high priority for the current government. The NSW government commitment to reduce childhood obesity through actively monitoring rates of overweight and obesity, increasing community education and introducing resources a healthy canteen strategy. Local government also key drivers of health promotion and policy. For instance, the Victorian public health and wellbeing plan include action by municipalities to reduce sugary drinks.
WHO commission on ending childhood obesity policy in 2016:
WHO given following recommendation to tackle the obesity around the world such as promote intake of healthy food, promote physical activity, preconception and pregnancy care, early childhood diet and physical activity, weight management. WHO sets action plan to implement various programmes that are an effective tax on sugar-sweetened beverages, establish cooperation between member states to reduce the impact of cross-border marketing of unhealthy food, increase access to healthy foods in disadvantaged communities, adequate facilities and public spaces for physical activity during recreational time, diagnose and manage hyperglycaemia and gestational hypertension, manage appropriate gestational weight gain, improve the nutrition literacy and skills of parents and carers.
National obesity prevention strategy 2017:
The policy change is necessary to see a drastic improvement to not only reduce morbidity and mortality rate, but also to see the increase wellbeing and economic benefits. The policy action include legislate to implement restriction on unhealthy food, set clear reformulation targets for food manufacturer, retailer, develop and fund a comprehensive national active travel strategy, investing in educational programme and guidelines.
Obesity policy A National Epidemic and its Impact On Australia:
This policy focus on obesity by the Federal and State Governments and it included establishing obesity as one of nine National Health Priority Areas, the creation of various taskforces, community and social marketing programs, with funds allocated from the, federal Government to the States and Territories. This policy following action to be taken such as For Australia – wide action to harmonise and complement the state/ Territory efforts to prevention, and to directly support treatment of obesity for instance, prevention can be achieved through programs which educate parents and young children in food and health literacy and treatment of obesity to apply safe obesity therapies, pharmaceutical intervention. The Australian Medical Association, and the various medical colleges to formally recognise obesity as a disease. It is recognition of obesity as a disease is important to reducing stigma and increasing community engagement in practices and policies that reduce obesity rates.

Barriers regarding overweight and obesity in regional Victoria:
General practitioners (GPs) play a major role in contact with patients in discussions about obesity. Key barriers to effective communications between GPs and patients about obesity that are proper language, lack of time, trust and relationship, inappropriate treatment.

Framework:
Conceptual framework:
The National Preventative Taskforce (2008) proposed that a monitoring system reporting excess weight could include prevalence of obesity, factors influencing weight status, health consequences associated obesity. The individual behaviour directly associated with weight, environmental factor, also associate with exercise and nutritional behaviour as well as weight status. For example, unhealthy diet and sedentary lifestyle leads to obesity. In this conceptual framework the associated factors are age, genetics, lifestyle and so on.
Theoretical framework:
In this framework American public health association (APHA) used two scales: one scales represent the environment and second scales represented the individual agency for behaviour change. The latter was identified the generation and reproduction of health inequalities in the society.
Framework for obesity prevention by Australia and New Zealand health policy:
This framework thinking about the role of law in responding to population weight gain in Australia. It focuses on two questions, first what law trying to influence. The challenge is to identify a model of determinants of obesity for legal purposes and could be the instrument of public health policy. Secondly, what type of strategies and tools can law provided for obesity prevention. The challenge here is to identify a model of law that can work at various levels.
Applicability:
Obesity prevention advocacy in Australia: an analysis of policy impact on autonomy that described seven years on, the majority of the recommendations made to the government inquiry into obesity have not been implemented, despite aligned recommendations in recent state-level priority-setting efforts. This policy assessing obesity-related policy options and viewing the options through an autonomy lens may predict stakeholder resistance, and the interplay setting and target behaviour in the association between autonomy and acceptability gives rise to further opportunity to explore policy options tailored to these variables.
An interactive insight into overweight and obesity in Australia: In 2014-2015, children and adolescents aged 2-17 living in outer regional/ remote areas were more likely to be overweight or obese than those living in Majority cities- about one in three (36%) of those living in outer regional were obese compared with 1 in 4 (25%) of those living in major cities.

Conclusion:
In this policy paper, I have taken obesity as a health issue due to high prevalence rate of obesity and overweight and associated diseases. Government initiated or policies, plan and strategies to outcome this problem. These policies are applicable for different age groups, locality and society. Policies and plan work for greater extent but in same situation it is not applicable. Then government start new policy and plan to overcome to burden of diseases. The policy should simple, accurate, and apply to whole population, having government funding, services, so that it must be successful.

Reference:
1. Australian Government, Australian Institute of Health and Welfare ‘A picture of overweight and obesity in Australia’ viewed 24th Nov 2017
2. AIHW Australian Institute of health and welfare overweight and obesity
3. Dietitians Association of Australia DAA, ‘The facts on overweight and obesity in Australia’
4. Obesity and healthy eating in Australia Evidence Summary, VicHealth
5. Overweight, Obesity And Chronic Diseases In Australia, obesity policy coalition, policy brief
6. Policies for tackling obesity and creating healthier food environments, Scorecard and priority recommendations for Australian governments, February 2017
7. Obesity policy coalition, ‘WHAT WE DO’
8. Policy Brief, Overweight, Obesity And Chronic Diseases In Australia
9. World Health Organization, ‘ENDING CHILDHOOD OBESITY’ implemention plan: Executive Summary 2017
10. Australasian Society of Lifestyle Medicine, ‘Obesity Prevention Consensus: 8 action areas to address obesity in Australia,
11. Obesity: A National Epidemic and its Impact on Australia
12. Barriers to effective conversations regarding overweight and obesity in regional Victoria, Contraception, October 2017
13. American Public Health Association, ‘A framework for Evaluating the impact of obesity prevention strategies on socioeconomic Inequalities in weight, published on October 2014
14. Australia and New Zealand health policy, ‘What’s law got to do with it? Part 1: A framework for obesity prevention, published 2008
15. Obesity prevention advocacy in Australia: an analysis of policy impact on autonomy
16. AIHW, ‘An interactive insight into overweight and obesity in Australia, 24 Nov 2017