Obesity has increased significantly in recent years in Australia putting it in the 21st worldwide rank and the 3rd rank in the Anglosphere for obesity according to the World Health Organization (WHO).
Overweight, often defined as weighing 20% more than your healthy ideal, affects more than 17 million Australians with 4 million falling in the obesity category with a Body Mass Index (BMI) higher than 30. Obesity was added to The Australian Federal Government list of ‘national health priorities’ in April 2008 raising it to the same attention standards of deadly diseases like diabetes, heart disease and cancer. Over 67% of Australian adults were overweight in 2007 according the WHO.
Obesity has been associated with coronary heart disease, cancer, gall bladder disease, skeletal-joint problems, diabetes, infections, and many other illnesses. Morbid obesity (i.e. weighing 100% above your healthy ideal weight) is associated with premature death due to a wide spectrum of illnesses.
What causes obesity?
Biopsychosocial factors- biological+ psychological+ social (family/friends)- have been found to contribute to the development of obesity. Research has shown that genetic factors and family history account for up to 60% of the variance in body fat. Lifestyle factors such as sedentary behaviour, high-fat food consumption, binge eating, and television viewing have also been associated with obesity.
Psychological and social factors such as stress, depression, access to a variety of highly attractive foods, and culture also play roles in the development of obesity and the development of binge eating patterns and, at times, of an eating disorder. The complex interaction between biological vulnerability in combination with psychological and social factors clearly demands an integrative biopsychosocial approach to prevention and treatment.
The question of how to lose weight and the pursuit of that goal has lead to a multimillion dollar weight loss industry. Sadly, the vast majority of those who attempt to lose weight, either on their own or in an organised and professionally run program do not maintain their weight loss. In fact about 95% of those who lose weight tend to regain all weight lost within five years.
Treatments for obesity include surgery, medication, and very low calorie liquid diets for those who are morbidly obese. Behavioural modification, problem-solving coping strategies, hypnotherapy, psychotherapy, group support, nutritional information programs, and exercise programs are also used to treat obesity. Multimodal approaches thus integrate medical intervention along with various forms of education and counselling. In addition to individual treatment, public health and informational approaches have also been used.
Psychological and behavioural interventions that focus on food intake, selection, and the role of emotions such as anxiety, depression, and low self-esteem must be considered as well as social and cultural factors like the access to high fat foods, and the ability and motivation to exercise. In general, multimodal treatments integrating biopsychosocial factors tend to be most successful when treating obesity.
Some treatment approaches are better for certain demographics. For example, Australian children under the age of 18 who have an obesity rate of 5-6% and an overweight rate of 23-24% best benefit from behavioural treatment. Because childhood obesity has been linked to shared lifestyle and polygenic factors, its most effective treatment approach is a comprehensive behavioural treatment program.
Furthermore, interventions such as medication can be used effectively in the treatment obesity. Although there is no magic pill that will allow people to eat whatever they want and never gain weight, a number of medications have been approved to help treat obesity. For example, Orlistat, which is a medication that inhibits pancreatic lipase, reduces dietary fat by approximately 30%. Research suggests that those on the medication are more likely to lose weight and regain less weight than control groups after treatment.
Research continues to find other biological interventions for obesity. For example, ciliary neurotrophic factor (CNTF) is a promising protein that activates the intracellular signalling pathways in the hypothalamus that regulates both body weight and food consumption. These medications, when used in combination with other biopsychosocial interventions, may be useful to the millions suffering from obesity. However, too often the public gets overly invested and excited about a promising “easy” way to control weight. Numerous medications, fad diets, and gadgets have been sold to the public only to be found to be ineffective or even dangerous.
It is worth mentioning that obesity in Australia more than doubled in the 20 years before 2003 according to The Medical Journal of Australia, and that if this rate of increase continues, one third of Australian children and 80% of Australian adults will be overweight or obese by 2020.
If you or someone you know struggles with obesity, Australia Counselling has counsellors and psychologists that can help you overcome issues related to obesity and overeating. Visit the Australia Counselling obesity page or eating disorders page to find a counsellor or psychologist in your local area.