Yes Doctor,huge U.S. multi-nationals are difficult to say "no" to. We certainly have it coming at us from all angles, technology, junk food, lack of advice from dieticians. It seems as though it will become a self fulfilling phrophicy.

Let's face it, the almighty dollar rules our world, those who have a concerntration of dollars, sell junk, which the public health systems must deal with at a later date, no wonder our hospitals are struggling to cope, inadequetely resourced from Costello, trying to deal with the after effects of big mac's.

We need more these days than to be shown the pyramid by dietaticians, we need them to ask what food do you enjoy, then design a recipe regieme around the healty food we enjoy. If this does not happen, the eventuallity of consuming ever increasing amounts of junk, because we cannot afford "real food" such as fruit and vegetables, will certainly explode.

It is correct to say that we need to get people to change their lifestyles in order to expend more energy and to eat less. However, it is more a case of working out how to do this within the context of today’s world than a funding issue.

It is no good complaining that primary school children no longer walk to school. This is difficult if not impossible for most. Young children need to be accompanied when crossing roads. Only the few who live very close to school, do not have siblings who need to go to different schools or preschool or childcare or swimming lessons etc., don’t have to push heavy strollers laden with school bags up steep hills or along busy roads breathing in toxic fumes and who have a parent or nanny who has an hour or so to spare in the morning and does not need to get to work. A better solution would be to require all schools to start the day with some sort of exercise such as aerobics or running around the oval. This would also have the effect of improving behaviour in class especially among boys. There should also be provision for children who need afterschool care to attend sports or dance classes.

A walking school bus system would be good but is reliant on volunteers – maybe this is where funding could come in. Pedestrian crossings are also needed – I see nine-year olds having to take chances across busy roads on a daily basis – usually someone stops for them but one day they won’t. Why do we have 40-zones along busy streets with pedestrian crossings that serve only to annoy drivers then no crossings along residential streets that are used as rat-runs.

I would also like to see a bicycle proficiency program in late primary school (as happens in the UK) so that children can be encouraged to cycle once they reach high school. Then we need safe cycleways or shared footpaths so they can avoid busy roads

cont'd.

It is also useless telling people that they should not eat fast food and should be preparing fresh food everyday. This is often impractical and neglects to mention that it is quite possible to take inexpensive shortcuts that are quite healthy. For example, using frozen vegetables or lean mince with shop bought pasta sauces. My children are allowed the occasional Macca’s but without the French fries and definitely no promotional toy. I would like to see a system where the healthier alternatives can be quickly identified in the supermarket – not just low fat which usually means lots of sugar.

Junk food advertising has rightly received attention. However my children’s school, and I imagine many others, has a ‘healthy canteen’ and spent weeks teaching the merits of good nutrition and exercise then the following week sent the children home with a large box of Mars chocolates to sell for a fundraiser with a promise of a prize for any child who sells them all. They were surprised when parents complained. Schools need to practice what they preach. They made a great deal of money which is no doubt why schools readily give up their principles for the mightier dollar. Perhaps some other companies can come up with some healthier fundraising alternatives?

While the Coca Cola mentality pervades this country (blindly following the example of the USA), this government will continue to rake in the big bucks from the Corporates like softdrink manufacturers, legislating to allow the addition of caffeine in softdrinks, as they have done. If you have adults and children craving your product that's better than spending advertising $'s and risking that they miss the adverts.

While Coca Cola and other major corporates continue to inject massive amounts of political donations into the coffers of all of the major parties, we will continue to see political decisions like this one that has been designed against the interests of the health and welfare of the general public but in favour of the corporates.

He who pays the piper clearly calls the tune in Australia's parliaments.

You alluded to another problem Dr Moodie, that has crept into our schools over the past 20-30 years or so. At lunch breaks school playgrounds would erupt into life, with children rushing out to play cricket, football, basketball or whatever was going. Today, with schools concerned about litigation through accidents, etc. children are encouraged or required to limit their involvement in such activities unless teachers are directly supervising during sports periods.

Handball is often the most arduous activity in the playground today, with Tamagotchi the next in line. Any wonder the obesity levels are rising.

Dr Moodie, your commentary seems to fly in the face of the recent studies by the NSW government which argue that children are LESS sedentary than they were 10 years ago. Questionable research on that reporting process aside, I'd be interested in a research project that surveyed how much of an impact the use of caffeine in softdrinks has had on the population generally. With the amounts of such drinks consumed by children each day, I imagine the effects on their calorie intake would be significant.

Considering the other stimulant and addictive effects it would have on children, it can hardly be considered as anything other than a breach of care by government on a growing health issue.

This appears to be a class problem. My son has been to two large private primary schools in the past seven years, in which I have seen nothing to suggest to me that these children are any fatter than the children were at the state schools I attended 40 years ago. Maybe we need to ask what these parents and children are doing right that their less-well-off counterparts are not. It's not just a matter of the cost of food either: junk food is expensive.

The problem of obesity has many faces. The key issues of nutrition and exercise are often correctly identified but most of the population have a basic knowledge of these yet do not apply them to their lifestyles. Clearly a behavioural element to obesity is critical but often neglected.

Our health system is not designed to address obesity. We prefer to wait until patients develop chronic disease and then ameliorate the long term complications than to address at risk patients. GPs get higher payments when their patients fall ill. They are, for the most part, not allowed to claim on the Medical Benefits Scheme unless their patients have a medical problem.

Lets turn this around. Pay general practices (lets call them Wellness Centres) when their patients are well (not when they are sick). Enable Wellness Centres to employ nutritionists, exercise physiologists, nurse educators, psychologists and lifestyle coaches to tackle obesity (and smoking, stress, depression, anxiety, falls, and other preventable diseases) in the early stages not waiting until they get ill.

Let every Australian citizen have a Wellness Plan outlining a healthy lifestyle and how to prevent illnesses. And give the Wellness Centres the ability to follow-up patients. Lets use e-mail, phone, SMS and other technologies to continually reinforce healthy lifestyles. Lets free up very scarce GPs from dealing with preventable illnesses and use their talents and skills far more wisely. Lets have walking groups leaving from Wellness Centres and yoga, tai chi and Pilates classes based in them.

And lastly lets find some politicians and bureaucrats with some real vision about health and not illness.

Walk into any supermart and there will be aisles upon aisles of prepared packaged food.
It is cheaper and easier to toss a packet of something into a pot, add water and Presto! two minutes and dinner's ready.
For a change of your own two minute cooking, get some take away, no worries.
The price of meat is astonishing, I pay as much for two lamb chops as once I paid for a whole side of lamb.
Still a wholesome stew or pot of home made soup is good, better than better. And packaged or fast food is soulless, tasteless, junk.

GeorgeT: I dare say it has something to do with taking responsibility for one's actions/life (or for those of the people in your care). Whilst it's a generalisation, I would suggest there's perhaps a relationship between taking an active interest in the education of one's children (ie. not letting them be at the mercy of the state system) and taking an active interest in the health of one's children (ie. not letting them be at the mercy of mass marketing of food, electronic entertainment, etc.).

Yes, food manufacturers and outlets may be somewhat nefarious, but I think the problem is in large part due to the real deeper change in our culture -- a move towards a problem always being someone else's fault (that should be legislated against) and never our own.

A malignant hobgoblin that crouches on the top shelf of the refrigerator, sternly waggling its finger whenever you go back for a second helping of dripping?

Failing that, a man from the ministry of health to hand out nice gold stars to put in your workbook whenever you choose lettuce.

Perhaps the idea of letting people think about legislating over what and how we eat is symptomatic of an insipid society. One more idiotic step towards that great grey suburb of the soul where everything is made nice and safe for us. All according to current world best practice of course. Oprah Winfrey as law.

Since consideration is being given to ceding control over our bodily functions to expert bureaucrats, are spuds in the dieticians good books this week, or not?

Mind you, I haven't seen my nether regions without the aid of a wing mirror for 15 years now. Maybe there is something to it.

Tell your children they are not entitled to eat whenever they feel like it. Snacking between meals is not going to happen in your house. You are the leader, the boss, the King of the Castle. No one eats after six P.M. No junk, no crap.

Get off your ass, clean your room. Go outside and play. Eat an apple.

Is that so tough?

No, unless, you are the problem. No one wants to be the bad guy anymore.

Obese children are the result of irresponsible parents. Obese people are the result of lack of control and responsibility. As we live in an era that supports and encourages irresponsibility, nothing will change until society collapses under the weight of irresponsibility.

Blame multi nationals, blame work hours, blame the convenience of poison take away foods, blame bureaucrats, blame politicians, blame doctors. Have I left anyone out, if so blame them. But whatever you do, don't take responsibility for you or your children's obscene and destructive lifestyle.

After all you have the right to deny your own responsibility and feel good about it. Even when you are lined up to receive an organ transplant, or joint replacement, or heart bypass, you have the right to blame everyone and everything for your condition. Plus you have the right to expect the health system will cure your gross neglect of your body and restore you to pure health. Who cares if your old age is filled with pill taking, constant trips to the doctor or seeing your kids die before you, as their organs collapse under the weight of chemically saturated food and drinks. Not you, you have the right to not care.

Those that follow good dietary and lifestyle practises, spend their lives and retirement having a good time. Not constantly forking out for drugs, trying to cover the symptoms of a lifestyle thats slowly killing you.

The first place to start is in schools, with proper education in health, food preparation and combinations as well as how and why our bodies work as they do. Until you start at the bottom, you can throw as many quacks as you like into the system, all you do is make pharmaceutical companies richer.

I pretty much agree with that, Alchemist. It doesn’t apply to absolutely everyone, but it is a good generalisation.

How can we expect others to value our point of view, our input into discussions, our ideas or our intelligence, if we present ourselves as obese, overweight, pot-bellied or thunder-thighed adults, demonstrating to all the world that we are incapable, or don’t have the will-power, to look after ourselves??

Despite the advertising power of multinationals and the appeal of the unhealthy produce of many of them, there is still a lot of media presentation and advertising about good healthy alternatives and the basics of good diet and exercise. So we can’t too heavily blame the multinationals or the media (although a bit of criticism is warranted here and there).

I don’t think we need to call for more education on the matter (surely the basics are already covered in schools!?). We need to fairly and squarely place the onus on individuals, and parents where overweight kids are concerned

Yes we have strict regulations on the quality of fuel we put into our cars,but no regulations on the quality of fuel they can sell for our bodies.

The solution is good diet and exercise.Why not increase health premiums for those who don't obey the fundamentals of a healthy life style?

Part of the problem is that, although obesity is easy to recognise, many people do not realise that either they or their children are in the overweight category. Once overweight it only takes a bout of mild depression and comfort eating to slide into obesity.

My children are on the thin side but not underweight. Yet it is impossible to buy clothes that fit their waistline in outlets such as Kmart or Target as they are far too big. It is also impossible to buy sensible portions of cake or meals out and children and adults alike quickly get used to overeating. Children’s meals always come with adult sized portions of chips and a free soft fizzy drink but you usually have to pay extra if you prefer water, milk or juice. Ask for a 'healthy' sandwich and it will come with a thick layer of butter whether or not you requested it. After a while overeating and being overweight seem normal.

Some of the statistics we are given just do not make sense - according to our local paper this week 60% of adults and 25% of children in Western Sydney are obese - obviously I must live in a pocket of thin people as I know very few I would consider obese - overweight maybe. It is no wonder people do not take the problem seriously.

Perhaps doctors should make a point of weighing people - especially children - at every visit and indicate whether they are overweight. Private health insurance companies could give a discount to those with a body mass index in the healthy range – and a further discount for non-smokers.

I find some of the comments here a bit judgmental. We have no right to dictate how people should live their lives so long as it does not impose on others. There is however good reason to provide support and guidance in the form of education and promoting healthier choices

sajo: I think it's true to an extent that it's hard to recognise being overweight for most people, although I think it's still fairly obvious to people when they're overweight and definitely when they're obese. There's certainly a stark contrast between the general body type/shape in most countries (including continental Europe even) and those in the English speaking world, which I think we ignore largely. Also, if we look at old movies or TV shows, it's plainly obvious that even well into the 80s people were relatively thin.

I would suggest that if there is indeed a market for slim children's clothes, then there must be people out there selling such clothes. Maybe there's a business opportunity there for you! As for food portions, again, there must be businesses out there that provide proper children's meals and healthy meals in general. If you patronise them, then they'll stay in business and maybe similar establishments will open.

As to your last paragraph, I would say that the way people live their lives does impose on others in this country. People who take care of themselves see their tax dollars that go into health syphoned off to deal with diseases of lifestyle (which are largely preventable), and this is only going to get much worse in this country. I think such people have a right to be judgemental when other people are wasting their money.

shorbe,

"I think it's true to an extent that it's hard to recognise being overweight for most people,"

Tubs finds it dead easy to recognise when people are over weight. The excess perspiration, wheezing and undulating rolls give the game away.

Tubs is not so sure about the benign influence of those evil prying multi-nationals peddling sensible portions however. The big red floppy jackboot of Ronald McDonald has been pressed mercilessly against the back of the neck for more than half a century, choking the life out of us all. No, they know which side their enchilada is oiled on. They do not change their spots. It is all some sort of devilish conspiracy to... sell us more food. Luring us back onto the hard stuff in the process.

You will submit and consume and we all know food is the real enemy, unless of course, you don't.

Slater & Gordon shares look good this week.

Simply an observation on the intake side:

it's easy to target McDonalds et al as the culprits for high energy intake and they should take some of the blame. However I regularly notice young adults at supermarkets who are laden with packets of snack foods, dips and soft drinks presumably to take home for snacking on (or as meal substitutes). Never an apple nor banana in sight. It comes down to the choices people make and how well they are informed of the ramifications of those choices.

By the way, I'd also suggest that a very high source of empty energy is alocholic drinks but when are they ever mentioned?

shorbe

I was making the observation that nowadays clothes and food are marketed towards the overweight. Consequently overeating and being overweight are seen as normal.

I can buy slim fitting clothes for my children - just not at the cheaper chainstores. I can pick and choose from cafe menus but it is far more expensive and causes more arguements than the 'value meal' with free drink and dessert included. If you ask for a smaller slice of cake at a cafe you still pay the same. People will always go for the option that provides best value for money in the short term. Basically you have to spend more money and go to greater effort to make healthier choices. I am prepared to do so but wonder why it should be necessary. Maybe there should be system of 'standard food portions' in the same way as with alcoholic drinks

A message to fat people -

Don't eat so bloody much and get more exercise. It's your body, just stop shoving food down your throat. If it's your kids who are the problem, stop over feeding them and get them into more exercise too.

Try this simple pseudo script -

var "fuel intake" = "food";
var "fuel expenditure" = "exercise";
var "fat" = "poor health";

If "fuel intake" > "fuel expenditure", then "fat" happens;

If "fuel intake" = "fuel expenditure", then "fat" doesn't happen;

If "fuel intake" < "fuel expenditure", then "fat" goes away;

It's just that simple folks. And for crikey's sake, stop blaming good food manufacturers for your own gluttony. There's nothing wrong with a yummy Maccas and Coke in moderation.

Good luck.

sajo: I'm not knocking you, and in fact I agree with you in many ways. All I'm saying is that there are two ways to change specific or general business practices. One is to legislate. The other is via the market. I always prefer the latter (for a number of reasons that I won't go into now), which is why I say as expensive as it may be, it's important to support the businesses one likes and make the rest suffer or change. A case in point as to how the fringe gained acceptance into the mainstream is how most eating establishments now offer some sort of vegetarian cuisine (even if the options and quality are poor). Those in the food industry realised there was a market and responded accordingly.

There have been two recent articles in the Herald on obesity. One reports that a study of more than 5000 NSW children revealed "conclusive evidence that excessive eating - not lack of exercise - is behind rocketing levels of childhood obesity, challenging the Federal Government's refusal to restrict food advertising aimed at children", http://www.smh.com.au/news/national/shocking-truth-of-childhood-obesity/2006/04/21/1145344273755.html

Dr Michael Booth and colleagues found that children are tending to exercise not less, but harder than they used to:

"This flies in the face of what I think was an urban myth that children were inactive," said Dr Booth, who was so surprised that he ordered a recalculation. "Like everyone else, I believed the urban myth …"

The other article was by SBS economics correspondent Peter Martin. He writes at SMH when economics editor Ross Gittins is on leave, http://smh.com.au/news/opinion/out-of-the-frying-pan-under-fire/2006/04/25/1145861346925.html

Martin drew findings from researchers at the Harvard Institute of Economic Research. He writes:

QUOTE
Forty years ago most of our food was prepared laboriously at home. In 1965 it took a married woman who was not in paid employment two hours a day to cook, and then clean up after, a family meal. After decades of innovations, including vacuum packaging, deep-freezing and microwave cooking, it now takes half the time.

And the food is more processed.

As an example, Cutler says that Americans ate large quantities of potatoes before World War II, but the potatoes were usually baked, boiled or mashed. Chips were too hard to make, even for most restaurants. Now french fries can be peeled, cut, cooked and frozen in a few central locations using sophisticated technologies. Today the french fry is the dominant form of potato and America's favourite vegetable. Since 1977 potato consumption in the US has climbed 30 per cent, almost exclusively in the form of potato chips.

Cutler reasons that if it takes less effort to do something we like, we will do more of it. Only about a third of Americans reported eating two or more snacks a day in 1977. By 1996 it was almost a half.
END QUOTE

The HIER paper is at http://post.economics.harvard.edu/faculty/dcutler/papers/Why_Have_Americans_Become_More_Obese.pdf

When I was a young boy, my mother [after having 3 children] was openly proud of her size 10 figure. She told me to stand up straight and be proud of myself. I was encouraged to be body conscious.

I always "listened to" my body. When I was 3, I refused to eat butter. when I was 6, I refused to drink milk. I enjoyed lean meat, but would not eat fat. I didn't want white bread, I preferred brown. My mother let me get away with this, because I always ate plenty of fruit and vegies.

As I got older, I gradually went off cake. I think my body was telling me something.

My father was a heavy smoker. When I was 13, he explained to me how smoking was harmful to health, expensive and very addictive. I didn't want to start something which took away my freedom to choose for myself. My elder sister was also a heavy smoker. Our house stank. My mother hated the smell and so did I.

When I was 16, my mother told me that the best way to meet girls was to learn to dance. How right she was. Because I knew how to dance, I didn't need to go to the pub with my mates before the dance to get some Dutch courage. So I never became a habitual heavy drinker.

I think dancing should be taught at school. Not everyone can be great at sports, but anyone can learn to dance. There's a style for everyone, Latin, rock-n-roll, line-dance, it's endless.

I have always lived a very active life and have never been overweight. About a year ago, I put on one and a half kilos and 4 cm around my waist. I talked to a natural therapist. She advised me to stop eating wheat products. In 3 weeks I was back to normal. I have gone back to eating wheat, but in moderation. If I couldn't wear the trousers I've been wearing for years, I would be horrified.

[Cont]

One of my friends commented on my flat stomach. I don't know what metabolic type he is, but I suggested no wheat, just for 3 weeks and to see how he went. He said it would be too hard. We make our own choices, don't we?

I go dancing 4 or 5 times a week and I swim a fast 100 metres every morning. Apart from gardening and home maintenance, which I enjoy, that's my regular exercise. Some of the dances include supper. As I don't like white sandwich bread, butter or margarine, cake, sweet biscuits, sweet pastry, little pies or sausage rolls, I usually go without supper and it doesn't do me any harm. Sometimes one of my overweight friends will notice that I'm not eating and ask me what's wrong with me.

I don't give myself a hard time. I like chocolate, a couple of glasses of wine with my dinner, fish and chips and pizza. And I'm having a glass of Coke right now. But these things are treats, I don't live on them.

I think we need to stop pretending. People, particularly young people, need telling straight. A person can be big and have a beautiful nature, but big is not beautiful, it's unhealthy. If you smoke, tobacco or pot, then you have an unpleasant smell. If you give in to peer pressure, then you're being gutless.

Before I retired, I had term insurance. Because I didn't smoke, I got a 40% discount. I have no-claims bonus on my car. And discount on home and contents because I have deadlocks and an alarm system. But the govt will not allow health insurers to give discounts for healthy lifestyles.

So what do we do? I don't deny a person an unhealthy lifestyle if that's what they choose. But they should pay for their unhealthy choices by paying extra tax on them,to be put straight into health and education funding. And we should stop pussyfooting around and tell it exactly how it is.

Shorbe – your theory is fine except should we accept that the healthy ones are the fringe and the overweight the mainstream? Market forces adapt to popular demand which at the moment is leaning towards the obese. If that is what we want then fine but if not we have to do something to alter the balance.

I am not sure what the answer is – if having healthy children isn’t enough incentive then I am not sure what is. Schools and childcare centres are generally quite good at providing or ensuring mostly healthy food is eaten (except for chocolate and doughnut fundraisers!). The problem lies squarely at home. The only way to make a difference is to play to people’s inherent laziness and make the easiest or cheapest options healthier. If this requires legislation then so be it.

It also needs to be recognized that it is very easy to fall into the trap of overeating and underexercising. Like many others I found the weight piled on through pregnancy and find it requires far more effort to keep the weight off than before I had children. Being at home with babies can be a lonely and sometimes depressing time and many mothers find themselves comfort eating. They don’t smoke or drink or take drugs or even sleep properly and their social lives become essentially non-existent. Many people respond to stress or depression through eating and it may be that for some people we need to address these issues rather than just calling them irresponsible

Tested and proved. A good after school snack ,strips of celery and carrot crisped up in iced water and HOME MADE pop corn just as it comes out of your own machine, no sugar added. It has a pleasant nutty flavour and is pure vegetable. Very satisfying, filling and non fattening.

Perhaps a tax on processed food is the way to go. I find any Kellogs product is fluffed, salted and sugared into what I would call junk food although it is marketed as a health food supplying some major percentage of the daily requirement of some obscure or readily available ingredient such as iron. Kraft, Nestle, Arnotts,and many others also practice this charade. Look at the supermarket shelf space tied up with Kellog products. In poorer countries supermarket shelves are filled with whole grains, pulses and un-processed food. The processed food is restricted to a small high priced corner. I find it obscene that Coco-cola is cheaper than water. The people who package and sell bottled water must be making a killing. I suggest any product that has added salt or sugar attract a large tax impost.

sajo: Excuses, excuses. I'm a vegan. I'm very much a part of a fringe group, but I deal with it. I don't expect to bring in the nanny state. There's a really simple way around this -- make people bear the consequences of their actions by paying the real costs of their healthcare, instead of expecting other people to pick up the tab. I'm really opposed to this idea of "sin taxes" though. Why should someone who can handle an occasional bit of junk food be lumped in with the habitually irresponsible and slugged extra for such food?

Retirement villages and nursing homes are filled with elderly people who have long passed their three score and ten.
All would have lived through the'Great Depression'and WW2 when food was either scarse or rationed.
They lived through times when cheaper cuts of meat were the only things affordable and most homes had a vegetable garden, a few chooks and fruit trees. They ate what ever was available and they ate a healthy diet because there was no such thing as convenience food or take away unless it was fish and chips occasionally.
Todays more affluent have a wide choice but laziness is served up far too often and the results certainly show.
I doubt that today's generation will have the long lives of their grandparents, they just do not get the proper base to build on.

shorbe, I think you may be onto something here.

>>There's a really simple way around this -- make people bear the consequences of their actions by paying the real costs of their healthcare, instead of expecting other people to pick up the tab.<<

And the way to do this is, of course, not by simply telling everyone "OK folks, from now on it's User Pays Healthcare". That would be political suicide.

It will be through a system of compulsory medical insurance.

But not the wimpy kind we have today, which is effectively a government-mandated rate card with little bearing on reality.

What shorbe has foreshadowed is a truly competitive Health Insurance system, whereby everyone pays the premium that reflects exactly their propensity to incur costs.

So twenty-something vegans will be charged the actuarially-derived amount (plus brokerage and administration fees of course) that covers them for their likely medical costs. A septuagenarian carnivore who smokes and drinks, however, would pay a teensy bit more.

But it would be totally fair, because the septuagenarian smoking carnivore would be "paying the real costs of their healthcare".

The next stage of "paying the real costs of our healthcare" would be when the insurance companies are allowed to sift through our DNA for possible genetic traits that might ultimately become a burden on fellow premium payers. It wouldn't be fair, would it, if the information that we would be genetically more likely to suffer a heart attack in our fifties did not affect our premium?

Sorry, shorbe. Your concept of "bearing the consequences" is unfortunately not confined to a few fatties.

Oh please, what a lot of self satisfied skinny people we are. Fat people, it's all your fault, just get up off your wobbly backsides, do some exercise and stop burdening the health system. Easy!

Well if its that easy, why are there any fat people at all? There is nothing acceptable about being fat. Not even the dimmest fatty could possibly think being fat is a good thing. All the beautiful people on television with glamourous lives, lots of them are fat aren't they? Film stars? Rock stars? Models? Athletes? Hmmm.

Likewise with the message about personal responsibility. Could it be any clearer? Does anyone actually know a fat person who says "no, its not my fault it is McDonalds". All those diet books, weight loss courses etc etc - what is the message: You can do it, exercise, take responsibility etc".

Which is all fine, but clearly this doesn't work for everyone. As the author of the original article says, despite messages about individual responsibility which are so prevalent, there are many aspects of modern society which encourage fatness. Addressing these will make it easier for people to deal with their weight problems. And just in case anyone thinks this is a rant by a disgruntled porker, I am as skinny as can be, and remain so despite eating whatever the hell I want.

Pericles: Don't put words in my mouth, so to speak. I didn't mention anything about genetics. I'm talking about behaviour based on free choice here. Whilst there is some overlap between the two, it would be pretty easy for the health system to determine whose problems were genetic and whose were self-afflicted. Penalising the latter does not imply penalising the former.

You missed one of my major points. Calls from some people to tax junk food, much like taxes on cigarettes and alcohol, are sin taxes. However, someone consuming an odd bit of junk food (especially if he or she leads a very active lifestyle) is not going to cause problems for himself or herself, or for society via the medical system. Yet such a person would still get sin taxed along the same lines as someone who doesn't use such products in moderation. Deal with the outcomes.

I was not my intention to "put words in your mouth" shorbe, I just trying to describe the slippery slope that we find ourselves on when it comes to a "user pays" philosophy.

First of all, no government is going to unravel the existing system by insisting that everyone "bears the consequences of their actions by paying the real costs of their healthcare", because there would be riots on the street.

Are injuries from a car accident the consequences of someone's actions, and if so, would they be liable to pay? For their own treatment? For any other injuries caused in the accident? Who would decide?

What about a twentysomething vegan bushwalker who gets bitten by a snake? Or falls off a cliff? If they had taken more care... etc etc.

As an alternative they might, however, insist that we all take out insurance. And once in the hands of the insurance companies - well, that was what I was describing in my last post.

As you point out, the government is also hooked on the concept of "sin taxes", which - like speeding fines - are just another way to raise revenue while pretending it is in "all our interests". If everyone gave up smoking, avoided alcohol, drove within the speed limits and shunned fatty foods, believe me, they would simply have to find different ways of taxing us. Someone would discover that tofu is bad for you, and whammo - a tax on tofu "in the interests of keeping Australia healthy".

So on the one hand we have a healtcare system that does not discriminate against fatties, drug addicts, drunks etc., but instead the government finds ways to modify our behaviours through the legal system and through taxation. On balance it seems just a little less drastic than the reverse, which is for the health system to discriminate and for taxation to be relaxed.

Regarding so-called sin taxes. I have maximum no claims bonus on car insurance. I get a discount on home and contents because I have an alarm system and deadlocks. I don't set out to qualify for these discounts to save money, but because it makes good sense to do the things which happen to result in earning these discounts. If I didn't earn these discounts, I wouldn't be paying a sin tax. I would merely be paying premiums which more accurately represented my attitude to driving and home ownership.

I have never smoked, so I've never paid tobacco tax. I am a light drinker, so I pay a small amount of alcohol tax. I eat an occasional take away meal, so I would pay an occasional small amount of extra tax if such things incurred extra tax. If I overindulged in such products to the point where it could reasonably be said that, on average, my intake was likely to seriously affect my health, then who should bear the probable extra cost on the health system? Obviously, I should. I wouldn't call this a sin tax, merely a logical and fair way of balancing the country's books.

I try to have a healthy lifestyle because I enjoy the feeling of being fit enough to be able to do the things I like to do. I have a very active life. And I take a pride in being slim and fit looking.

I'm not judgemental about other people's lifestyles. It's nothing to do with me what others choose to do with their bodies. But we're constantly being told that we have an epidemic of obesity and the evidence is all around us. If this trend is not reversed, it will be an ever increasing burden on our health service. Someone will have to pay for this and it should logically be the ones who are contributing most to this burden.

If such a tax was introduced gradually and with well publicised reasoning, there wouldn't be rioting in the streets, no more than there is when tobacco taxes are gradually increased.

Pericles: In your hypothetical situation of a car accident, obviously, people make silly mistakes (that may, unfortunately, be fatal), and then there are people who just take outrageous risks (eg. drink driving, speeding, etc.). I don't think we should penalise the former, as "we're all only human". The latter should be heavily penalised, however. Who would decide? Well, we already have a system in place that does that.

Again, there may be freak mishaps (and let's remember that most injuries actually occur in the home), and then there are activities that are clearly dicing with death (eg. parachuting).

I wouldn't have a problem with people having to take out insurance. If you want a government model, you could have restrictions on using genetic testing. If you want a free market model, it would be up to consumers to avoid using companies that used genetic testing if they thought it was wrong (and there would be enough customers that it would work for both customers and ethical companies).

You're probably quite right that the government would find ways to tax us regardless, which seems like it's almost a fatalistic argument or the beginning of an anti-government argument. I think, in many ways you're right about this with tax, although I think I would come out better off under my system. As a side issue, whilst I am very much in favour of developing and implementing alternative fuel sources, even if we could all generate enough free, clean solar power to run our houses and cars, the government would gouge us for owning such things.

I have no problem with the health system discriminating or taxation being relaxed. You're talking to someone who would ultimately like the state to disappear up its own... However, I guess we won't agree on that.

Rex: I'm with you on this, but expecting someone to pay his or her own way rather than passing that onto someone else is very "un-Australian" of us -- it's the "little Aussie battler's" right to stick his hand in someone else's pocket (preferably ours)!

There's an emotional aspect to being overweight that is being missed here. People self-medicate with drugs and alcohol to make themselves feel good. Food acts like a drug in that it produces a pleasruable response in the brain and we also associate it with nurturing. Many, many people eat for comfort so deal with personal pain or depression and eat when they are stressed. The fact that we are working long hours is problematic too. If you work full-time and then need to attend to kids before and after work too, there is precious little time to focus on yourself and exercise.

In my experience the size of the person is a good indicator of their socio-economic station. Often, the larger you are, the poorer you are. Poor people are very good at saying they aren't hungry when they haven't eaten all day.

Pericles said that junk food was expensive, yes but the working poor consider McDonalds to be an expensive indulgence and they know which fish and chip shop has humungous serves of $2 chips. How else can you feed a family for $2. Don't tell me about the carcinegenic qualities of chemically cleaned cooking oils. Don't forget to include gas and electricity in your calculations.

Rex told us that he swims a brisk 100 metres per day. People who are watching their budget aren't willing to spend $3 on pool entry for a 30 minute swim.

Many heavy people, excluding present company, reward themselves with food after a particularly trying day. The supermarkets know this and sell hot cross buns from New Year until Easter - as well as Easter Eggs. How many of you did not have your first hot cross bun or egg until Easter?

Time and time again surveys show that about 25% of primary school children don't eat breakfast.

If we are serious about childhood obesity and the dangers of the 25% of malnourished children in Australian schools then it might be time to consider school lunches in all those areas where more than 20% of the population is on social security benefits. And presumably not allow the canteen to supply hamburgers, fries or coke.

If your enslaved to the system, you get what it dishes out. Make all the excuses you like about emotions, comfort food work hours, tiredness and poor people. It makes no difference, Its how you approach your life and how much responsibility for your own life you want to take. The decision's should be up to you.

But don't expect others to constantly pay for peoples repeat stupidities with their health. Money for health should be in the areas of education, traumatic, repairing and preventative medicines. Pharmaceutical medicine is useless in most cases, as surgery can be by removing the symptom and not stopping the cause. As long ans health revolves around money and multinationals aren't made responsible for their implication in the health of the populace, there will be no change and more money will be thrown at it and more companies will get rich. But it wont improve unless you educate and prosecute businesses that contribute to the problem, to take responsibility for their actions.

We should have macca's hospitals and kfc hospitals and dairy product hospitals, all operated by the companies and they should be free. That way public money can be used for improving and fixing our bodies when required. Bet that won't happen.

BTW, its cheaper to live as a vegan and have a much healthier life style and good health, than it is to go to the shop, then the doctor. The foods so much better and varied.

It's a matter of personal priorities, Billie. I live in a modest house, with a large pool in the back garden. I drive the car I can afford and I live the lifestyle I can afford. Many people choose to have homes, cars and holidays which cost more than mine. Many people smoke, regularly drink large amounts of alcohol, or spend lots of money on gambling. I choose not to do these things.

When I was a child, we had no money. My mother had to work, not for extras, but for necessities. My father smoked, drank and gambled heavily. He died of self imposed lung cancer at 52, when I was 16. Life suddenly became easier for us.

My mother was proud of her petite size 10 figure, after having three children. And she kept herself healthy. She tried to pass these concepts onto her children and it worked with me.

Despite the lack of money, my mother made sure we got good food. Fish and chips were a treat, not a staple. Our neighbours, with a lot more money coming in and a non-working mother, almost lived on fish and chips.

When I was 16, my mother told me that the best way to meet girls was to learn to dance. How true, it worked then and it still works nearly 56 years later. I dance 4 or 5 times a week. It's cheap, healthy and pleasurable. Not all dancers can stay slim of course, but we tend to be relatively trim, fit, active and take an interest in our personal appearance.

I lost my wife 4 years ago. I don't like cooking but I know that I can quickly and easily make a nutritious meal for a fraction of takeaway price.

All the things I do for my health are easy and inexpensive. Almost anyone could do the same. It's just a matter of personal priorities.

I don't force my opinions on others, but neither should I have to pay for their lifestyle choices.

Rob Moodie:

The good Doctor has sparked our Social conscience like no other. Perhaps because two thirds of us are overweight - bordering on obesity ! Striking a chord immediately resonates some 'soul-searching' New Year's resolutions that have since 'hit the dirt' from when, on our fifth martini, and the World was a kaleidoscope of unimaginative ' good-will', we would at the time - like Robbie, proclaim " happily eat my hat, as well as 10 B Mac's in a row " ?? So what has changed ?

Tony Abbott still has his head in the clouds since taking a dive with a 'conscience vote' in the abortion debate on RU486. His Ministry has been bedevilled with too many contentious issue's and in order to ' appease everyone', he is without doubt ' a lame duck ' Health Minister in the Howard Government. Obesity will just have to wait - the next Cabinet reshuffle ?

OECD Health data 2003 defines Obesity rates, as a percentage of the population with a Body Mass Index (BMI) over 30.

Why do stats about Overweight and Obesity differ ?
Has it anything to do with rankings being higher in developed Nations ? Is it possible, Asian Nation's, at this point of time, are not saturated with Hungry Jacks, Macca's,KFC, Pizza Hut, Subway, Big Rooster et al ? Controversial stats from ASSO ( Aust Society for the study of Obesity ) Obesity prevalence per population :

Country Period Ages Male Female
Aust 2000 25+ 19.1 21.8
UK 16+ 22.1 22.8
China 20+ 2.4 5.3
Japan 20+ 2.0 3.3
NZ 15+ 14.7 19.2
US 20+ 27.1 34.0
How many Adults overweight ? US 2/3 with BMI >25
Has Overweight and Obesity changed over the years ?
Obesity 31.5 % to 33.6 %. Age 25/74 (BMI >30)
Overweight 13.3 % to 30.9 % age 20/74 (BMI >25)
Life expectancy of moderate obesity can be shortened by 2 to 5 years. White US males 20/30 age BMI > 45 shortened by 13 yrs, females 8 years.
Queensland University Research confirm 7000 people die from heart disease because..

continued..

of overweight: 2/3 Males. 1/2 Females.
No one in Aust has undertaken the assessment yet. In the US, budget costs: $ 117 B direct. $ 56 B indirect.
Economic burdens : Increase Health Insurance, disability insurance,sick leave, higher premiums,additional stress on health systems, hospital expenditure, special beds, lifts, operating tables, wheel-chairs, staff to accompany patients.

Obesity is a much more serious health problem than imagined - in terms of chronic illness and health spending.The rise in the number of morbidity obese patient's has caught sections of Health care unable to provide appropriate and sufficient services.

Diets & Dieting: Atkins, Vegan,Balanced,GI,low carb,Jenny Craig and fad CSIRO Total Wellbeing Diet

TWB Diet by Dr Manny Noakes. Published in May 2005, with much fan-fare and millions of Tax payer's dollars in promo and ads, it created controversy in many a household !

Is it better than other weight loss diets ? More importantly is our foremost elite Research Establishment fair dinkum On every count CSIRO diet is no better than other diets. Researcher's compared 22 obese subjects on their diets with another 21 on high cars for 68 weeks evaluation. The participants were monitored by dieticians throughout the ordeal. Body measurements, composition and dietary were rigidly tabulated and controled. After 16 weeks, weight and fat loss was the same ( around 8.5 Kg)irrespective of diet composition. The CSIRO diet was no better tan existing diets with both groups weighing approx 3.5 % less than when they began.

It recommended veges, fruit and dairy foods to meet daily targets for vitamins, minerals and fibre.

It also recommended up to 300 g of red meat content ?

Surprise..surprise CSIRO research was funded in part by the Meat and Livestock of Aust.

For the consumer oriented, eating large quantities of animal protein is less ecologically sustainable than a diet high in plant food. Red meat increases your dollar budget substantially. Meat has the potential for increase of bowel cancer.

Nutritionist Dr Matt O'Neill, Dr Rosemary Stanton, NHF et al, have all expressed reservations about the efficacy and long term ramifications of this wunderkind magic potion.

Cheers