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Weight Management

 

When all else fails lets try fat but fit

Reported August 15, 2008

One in four of the 300 obese patients studied by these Germans were found not to have an increased risk of heart attacks or diabetes.

They are overweight but they are not unhealthy.

It might not be an adequate solution to the nation's obesity problem, but so far its the simplest on offer.

The implication that we should stop seeing fat as the enemy and instead promote health at any size has growing support with some researchers.

And it might be the only solution in a nation where 67 per cent of men and 52 per cent of women are already overweight or obese.

Solving the problem of our creeping waistlines should, theoretically, be simple: eat less and exercise more.

But getting us to change behaviour is proving impossible.

Scientists now tell us dieting makes us fat because it triggers a famine response in our bodies, lowering metabolic rate - the rate at which we burn energy.

The battle against obesity is about to be put front and centre on the national stage after Health Minister Nicola Roxon announced this week she was planning to give hundreds of millions of dollars in bonus payments to states that cut their childhood obesity by 5 per cent over the next decade.

But most of the policy solutions to obesity vying for space on our political agenda are complex and rely on diet, even though the research shows fitness - not fatness - is a more important predictor of whether you will die of a heart attack.

Grocery manufacturers keen to avoid having new government rules imposed on them are foisting a new labelling system on already confused customers.

This new system spells out what proportion of your recommended daily intake of energy and vitamins is in each serve of their food.

It sounds simple until you realise that harried mothers will have to get out their calculators and perform quadratic equations to plan the family menu if this system is to be taken seriously.

Then there is Roxon's idea of setting up vegetable gardens in schools so kids can grow their own food and gain an interest in eating fruit and vegetables.

I tried it myself last summer when I helped my kids grow lettuce and strawberries and tomatoes in pots - and for the first time ever I had my kids eating lettuce.

But it takes about 13 weeks for the vegetables to grow and the kids developed a refined taste for the juicier homegrown strawberries than the cardboard fruit in supermarkets.

 

Then there are the proposed bans on junk food advertising on television, which I doubt will have much impact on people filling their shopping trolleys with chips and chocolate.

Some even propose we replace our crockery sets with smaller bowls and plates so we eat smaller servings.

One doctors' group wants the government to subsidise weight loss programs.

We've got walking school buses and school canteen menus with healthier offerings, but still the nation's kids are getting larger.

Sydney University dietician Jenny O'Dea says we're creating a moral panic about obesity that could be doing more harm than good by demonising the overweight and deterring them from seeking help - being fat doesn't always mean you're unhealthy, O'Dea says.

Researchers at the Cooper Institute in Texas found that fitness, not fatness, is a more important predictor of whether you will die of a heart attack.

Instead of focusing on diet we should be focusing on fitness, she says.

But governments that try to get us off the couch and onto the treadmill will be wasting their money if it is spent on a new mass advertising campaign like the old Life. Be In It campaign.

The Medical Journal of Australian found last year that these public health messages were absorbed by the public, but don't change our behaviour.

A pioneering NSW health fund, Australian Health Management, has found that the best way to get us to change our behaviour is to give us a personal coach.

For every $1 it spent on paying for this coaching for its members, it saved $3 on medical and hospital bills.

In many cases this personal coaching wasn't aimed at making fund members lose weight, but at stopping them putting on any more weight and keeping them fit.

With one in six of the nation already obese and research showing that diets don't work, perhaps the best a new national obesity program can aim for is the promotion of benign obesity: how to stay healthy when you're already fat.