Monica's Essay

Challenges For The Future: Childhood Obesity

As citizens of te 21^st century, we face numerous challenges that must be addressed in order to safeguard a viable future for forthcoming generations. Few issues are more pertinent than the wellbeing of those who will one day inherit our legacy – today’s children. As humans strive towards the universal goal of reliable and plentiful sustenance, we are inadvertently exposing ourselves to diseases of excess. Although not as sensational or immediately alarming as SARS or global conflict, childhood obesity poses a significant threat to future citizens of the world. Despite being conventionally considered a disease of wealthy nations, obesity is also imposing a burgeoning burden on low and middle-income countries. With the exception of parts of sub-Saharan Africa and the former Soviet Union, obesity is now the most common paediatric disease on Earth. More locally, one in four Australian children are now overweight or obese. However, the most frightening of these statistics is probably yet to come, as the rate of obesity is expected to continue to rise around the globe.

The consequences of paediatric obesity extend beyond the low self-esteem and psychological ill health that result from teasing and bullying. In children, obesity is associated with a plethora of conditions, including high blood pressure, sleep apnoea, asthma, diabetes and liver disease. With up to 80% of obese children likely to become obese adults, as they grow up they will be at risk of further complications such as heart attacks, strokes, depression and arthritis. In addition to direct health care costs, obesity also incurs much greater intangible and indirect costs in terms of ill health, reduced quality of life, loss of productivity and premature death. As childhood is a crucial time for the establishment of lifelong habits, current trends point to the likely ascendency of obesity as a major problem in years to come. By the same token, childhood also presents a unique opportunity to stave off these grim predictions.

Simply put, obesity arises as a consequence of the disparity between caloric intake and activity output. Although obesity is easily explained in terms of biological and behavioural mechanisms, it is predominantly a social and environmental disease. This is manifest in the neologism “obesogenic environment”, which describes the ready availability of affordable, palatable, energy-dense food, coupled with lifestyles that require minimal physical activity for subsistence. Identifying underlying causes of obesity provides targets in the fight against childhood obesity. This challenge can only be conquered through population-wide public health programs that proactively prevent childhood obesity, rather than by simply treating established disease. Not only is prevention more cost-effective, it is one of the few viable strategies for tackling obesity in children, for whom the majority of conventional adult weight loss treatments are unsuitable.

A multi-sectoral approach is necessary to transform today’s obesogenic environment into one where healthy diets and lifestyles are more accessible and appealing. Schools feature numerous opportunities for intervention, such as health and nutrition education classes, structured physical exercise, and limiting the availability of non-nutritious food. The influence of television and other media should not be underestimated, both as a promoter of and weapon against childhood obesity. For instance, the vast majority of food-related advertisements during children’s television viewing times endorse foods that are high in sugar and fat. However, the power of the media can and should be harnessed to educate and motivate children to make positive food and lifestyle choices. One such example is Sportacus, a television character who recently halted the rise in childhood obesity in Iceland for the first time in ten years.

Governments are in a unique position to lead the fight against obesity by legislating school-based interventions and regulating the marketing of unhealthy foods to children. The obesogenic environment may be modified on a societal level by introducing levies to increase the prices of transportation and non-nutritious, energy-dense food, and thus discourage unhealthy lifestyles. The provision of safe and accessible outdoor play areas would facilitate habitual physical activity, as would alteration of transport infrastructure to promote walking and cycling. Community action groups and non-government organisations are instrumental in raising public awareness and providing impetus for positive change.

Making such widespread changes to the physical and social environment is no small task, and requries the commitment of governments and civil society, as well as the private sector. While many of the aforementioned solutiosn have been initiated in parts of world existing efforts are vastly disproportionate to the scale of the problem. Only with concerted, collaborative international strategies to target the causes of obesity can we hope to solve this problem on a global scale. The tragedy of the current situation is that an essentially preventable condition threatens to inflict an immense burden on the future generations. The beauty is that together we can feasibly meet this challenge to prepare healthy children for a healthy future.