This problem calls for a whole of community approach. Consider:
- many children now leave their (state) school never having played in a team game, never having learned the pleasure of winning, never having learned to obey a referee, or how to cooperate with people they may not like to achieve a common goal, or that it takes effort to win etc. The habit of physical exercise and participation in sport and the pleasures, the unique pleasures, it brings are denied by the absence of compulsory games in many schools.
- The harder we work, the less time and energy is available for physical recreation and exercise.Inactivity either causes or exacerbates all the the chronic conditions.
- Very few local governments have community development staff with fitness qualifications and a brief to create and support physical recreation programs in their community.
- The proportion of total health spending devoted to keeping people well is absurdly low. It is far more cost effective to prevent simple problems becoming complex than to cure those inevitably acute problems. Primary health care is the forgotten area of health and the future shortages of all classes of health professional will/must force concentrated attention on multidisciplinary primary health centres where every family member can receive regular health check ups to monitor/treat their physical, dental and mental health and well-being.
- Such clinics will depend on the emergence of nurse practitioners and advance practice nurses with post graduate qualifications and this will - at last - provide satisfying career paths for tertiary trained nurses
-

I find it curious that we are so sympathetic and tolerant to sufferers of Diabetes, as a defined 'medical condition that is largely preventable if human lifestyles are carried out more responsibly'. My comments are limited here to the avoidable diabetic conditions of course.

Diabetes Type 2 especially is very much caused and exacerbated simply because people do not place required limits on their own excessive eating or do not do sufficient exercize. Meanwhile society loses billions of dollars annually to what should be a much prevented medical but also consumer condition.

The individual's responsibility for his ill health or good health has been replaced and excused, because Diabetes is seen as a 'medical' condition only. It is also very much a 'consumer' condition. No stigma is attached to 'medical' Diabetes. That is odd if Diabetes is also viewed as a 'consumer' condition. Other consumer conditions such as problem gambling and smoking do carry stigma.

Compulsive gamblers are sanctioned and scorned for being 'out of control and excessive' with money. Cigarette smokers are equally socially sancioned. Why then are Diabetics not equally encouraged to attack their own consumer excesses? Why do we excuse them so readily?

I know that my line is... VERY 'hard line'! I also know that we must have human compassion for ALL vulnerable groups.

I live and work with Diabetics every day who ignore their treatment plans, ignore their own need for self-limiting of energy-based food products, ignore their need for self-testing...and we have to collect the 'medical' tab when they 'stuff up' and cause themselves inevitable but largely preventable harms.

It is time to place much more responsibility back onto the individual by taking Diabetes out of "medical/ unfortunate / forgivable" context and placing it in the context of "responsible consumer", where behaviour modification may be truly tackled. Although Diabetes may be in part genetically 'given', it is also largely avoidable. Up to 95% avoidable. All individuals should have to toe the line to help to reduce excessive social and economic costs and that should include Diabetics in my opinion.

School yard obesity could be cured by going back to schoolyard bullying.
In our sterile world where meat comes from Coles not dead animals,and lentils come from a can not from the earth,we should allow a bit of the "Oh look who is Fat."
Most of the fat kids soon found a way not to eat.
Children are now told by politically correct teacher,that fat people cannot help it,it is a desease.
Hard tough Sport is not taught as most parent prefer that little Johnny does not get scratched.
We do not see obesity in the third world and more and more sports people are coming from these areas.

A timely and important article. Two other pointers, time was when kids walked or cycled to school, or took the tram if there was one and then walked. Now Mum drives them everywhere in the SUV.
Secondly why do so many people feel it necessary to walk around clutching a bottle of C*K*, or have one with lunch, and the proliferation of coin operated machines dispensing the stuff everywhere particularly in schools. I read that C*k* is 60 times more acidic than water, ie., to nullify a given amount of the stuff you have to drink 60 times the volume of H2O.
My dentist recently told me of the young man whose idea of drinking was 100% C*K*, the acid had stripped the enamel off his teeth. The advertising of this product to vulnerable children should be restricted Tony Abbott.
Richard42

Hi All...

Gee, 'banpokies 1' , you've certainly given us Type 2, overweight fatties, a kick in the guts for sure ! I'm in your target group too.
I'm sixty three yo., and considerably overweight (obese), and I've been diagnosed a Type 11 Diabetic, for close to 25 years. Essentially, I could be best described as a sloth like creature, who avoids all forms of physical activity if possible. I neither drink nor smoke, and I guess that has helped me to avoid an early trip to the mortuary, thus far. In fact my Doctor says that I'll make an interesting and amusing Post-Mortem, when the time comes too? In another life when I was a Veteran, and a long serving copper, I possessed a reasonable level of fitness (particularly in the Army), but when I joined 'the job', shift work, poor diet, and I suppose a bit of stress, contributed to a steady weight gain. I did a bit over 28 years, retiring a couple of years ago (and yes, retiring medically unfit !!).

All that aside, 'banpockies 1' I would have to agree with you, absolutely. 'Us types', do have to accept 'ownership' of our own medical dilemmas, and not blame all and sundry for our various ills. And there is a financial aspect for the community too. Because of our lazy, slug like ways, the community through their taxes, have to fork out 'squillions' to provide the necessary medical care, where often, a simple 'lifestyle' change may avoid years of long-term bad health, with a consequent cost to the public.

I'm a little luckier than most though, I'm in receipt of a 100% Veterans Disability Pension from the DVA, so I generally don't have to put my hand in my own pocket all that often fortunatly.

In closing 'banpokies 1', I must vigorously reiterate herein, that I absolutely agree with your general proposition!

Cheers...O Sung Wu.

There seems almost to be a "meme" in our society which says "You are fat because you eat too much and don't exercise- You slob!"

In fact the reality is a lot more complex

Look here for an excellent article on the subject:-
http://www.nytimes.com/2006/08/13/magazine/13obesity.html?ei=5087&en=091c29f788379524&ex=1171771200&adxnnl=1&excamp=mkt_at4&adxnnlx=1165789297-LJuM4f030HTkjYqnp1ty9g
and
here for other possible causes:-
http://forums.hypography.com/medical-science/6740-obesity-why-we-getting-fat-epizza.html?highlight=Ny+Times

Interestingly the recent International Conference on Obesity at Darling Harbour, Sydney was totally ignored by local(Australian) media.

--
me dad michael