Diabetes and obesity - the new pandemic

Australia is in the throes of an unprecedented epidemic of obesity and type 2 diabetes. This is part and parcel of an accelerating global phenomenon affecting most developed and developing nations - and the epidemic is in acceleration mode!

The 2000 AusDiab study undertaken by the International Diabetes Institute showed that that more than 60 per cent of our adult population are overweight or obese as are 20 per cent of our children. It is a tripling in numbers over the last 20 years.

The cost of type 2 diabetes in Australia is in excess of $A3 billion. This represents over 5 per cent of Australia’s health care expenditure and nearly 0.5 per cent of gross domestic product. The cost to Australia in health costs and workforce impact is well over $7 billion annually.

Obesity is the single most important challenge for public health in the 21st century. Over 1.5 billion adults worldwide and 10 per cent of children are now overweight or obese. The world’s waistline is bulging and some pundits have applied the name Globesity! Is it getting worse, you ask? Definitely. It is sweeping the world with a rapidity that is terrifying.

Obesity is the driving force behind type 2 diabetes, which has significant cardiovascular complications and renal failure, blindness and amputations. This is leading to decreased life expectancy from type 2 diabetes, cardiovascular disease and some forms of cancer. This is replicated in many nations and this “diabesity” pandemic is now set to bankrupt health budgets all over the world.

Just three months ago, over 2,300 scientists met in Sydney for the 10th International Congress of Obesity http://www.ico2006.com/. A major aim of the congress - the theme was “From Science to Action”.

Were there any major messages emerging from the congress?

These are exciting times in obesity research. In the last decade, fat has moved from the view that it is inert “blubber” to the fact it is probably the most active endocrine (hormonal) organ in the human body. It makes a vast range of chemical substances vital to body function - from control of appetite, energy balance, our immunity and blood clotting to regulation of insulin and other hormones.

Fat in the abdominal cavity, the (in)famous “Aussie Beer Gut”, makes chemicals that cause type 2 diabetes and heart disease. This message has not escaped the pharmaceutical and biotechnology industry with massive resources now being directed to this area.

Another a major topic was the call by many for bans on marketing and TV advertising to children in the light of the disturbing increase in childhood obesity in most countries. While this seems sensible, the evidence that it translates into reduced obesity rates is not yet available. Certainly stronger guidelines are needed and we may need to implement legislation for food labelling. Currently, labels cannot be understood by consumers. Health claims are often misleading. The real message is that a much broader approach to obesity prevention is vital.

Our own state and local governments may have contributed to this epidemic by allowing developers to create urban social problems most noticeably manifest in the ubiquitous MacMansion. These urban sprawls are a characteristic feature of new developments without proper attention to sidewalks, bike paths, public transport corridors, playing fields and friendly exercise areas that are essential and accessible to people who want to maintain a healthy lifestyle.

It is very encouraging that obesity and diabetes have moved from Cinderella status to implanting themselves firmly on government radar screens. They are now part of the political agenda. Tackling obesity and diabetes has been taken to a new level. Our federal and state governments, through COAG, have recognised the need for action to tackle them through the “Better Health Initiative”. Our Federal Minister of Health and Ageing, Tony Abbott, and our prime minister have been powerful advocates of action despite reluctance to address banning TV advertising.