First medical guidelines to treat obesity

WEDNESDAY, DECEMBER 24, 2003

In response to Australia's obesity epidemic, the National Health and Medical Research Council (NHMRC) recently launched the nation's first guidelines to help doctors treat and manage overweight and obese people.

Available as a book and website, the guidelines are intended to help reduce an estimated 50 per cent of patients treated in Australia who are either obese or overweight, and sick because of it.

Australia is regarded to have the fourth highest incidence of obesity in the world, with numbers of obese and overweight people doubling in the past 15 years. Being overweight or obese is known to contribute to type-2 diabetes, cardiovascular disease, stroke, hypertension, gall bladder and respiratory diseases, among others.

While body mass index (BMI) is the accepted measure of obesity and overweight status, the NHMRC guidelines advise caution in using this tool, saying it is not always a reliable indicator for body fat distribution.

BMI equals weight (kg) divided by height (m2). By World Health Organisation standards, overweight in adults is defined as a BMI of 25 to 30; obese is defined as a BMI greater than 30.

The guidelines warn against quick fixes and acknowledge that managing your weight is no longer as simple as "eat less, move more". They address a number of social, genetic, psychological and emotional factors.

In regard to assessing diet, the guidelines state that meal and snacking patterns should be considered, not just nutrient intake. Specifically, "energy density" in foods is identified as a key factor, not only in the form of fatty foods, but carbohydrates also.

The position echoes statements made in a recent report by Professor John Catford from Deakin University and Professor Ian Caterson from University of Sydney. They cited the rise in "high energy" food products for their impact on obesity and overweight incidence.

Published in the Medical Journal of Australia, the report lists a number of social, behavioural and economic trends weighing in on the obesity issue, including:

- agricultural subsidies and other incentives for high energy products
- lower prices for processed food of much greater energy density
- greater availability of high-energy convenience foods, take-aways and softdrinks
- heavy marketing of high-energy foods, drinks and take-aways

To view the NHMRC's obesity guidelines, visit http://www.obesityguidelines.gov.au/