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A proposal has been put forward to start weighing children at school as a strategy to reduce the incidence of childhood obesity. This is a method of surveillance of children's bodies.

"The proposal, made by the Global Obesity Centre (GLOBE) at Deakin University to a Senate committee examining the issue, argues the data could map childhood obesity around Australia to better target where the problem is at its worse."

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Updated July 21, 2018 16:08:28

Children's height and weight would be measured every two years unless parents opt out as part of an ambitious proposal to tackle Australia's obesity epidemic.

The proposal, made by the Global Obesity Centre (GLOBE) at Deakin University to a Senate committee examining the issue, argues the data could map childhood obesity around Australia to better target where the problem is at its worse.

The prevalence of overweight and obese young Australians aged 5 to 17 was 27 per cent in 2014/15, according to the Australian Health Survey.

But GLOBE's Steven Allender said the rate of obesity was likely higher.

"The information we have is really quite inaccurate," Professor Allender said.

"We've got millions of children that are suffering from something that will affect the rest of their lives and we have no real understanding of the size of that problem.

"The second point is that there will be areas, groups, communities in Australia that are actually doing really well and their kids' health is good and improving, and we don't know where they are so we can't work out why that is."

The proposal would likely create unease among parents, with one advocacy group saying measuring and weighing children could impact their mental health.

"As a parent, I am anxious to know how children will be weighed and measured," said executive director of The Parenthood, Alys Gagnon.

"I would be anxious to know if it was being done in a healthy, positive way."

Professor Allender acknowledged such concerns but said steps would be taken to reduce any negative impact on children.

Primary schools would be the "logical place" to take measurements, he said, but trained clinicians instead of teachers would take the measurements and children would not see the results to avoid comparisons.

Names would not be recorded to ensure there are no breaches of privacy.

Professor Allender said an opt-out approach, rather than an opt-in, was necessary to ensure high rates of participation.

"Nobody's being forced to do anything, it's still an active decision," Professor Allender said.

Professor Allender said his submission was based on a model that was working in the United Kingdom and many in the United States.

The submission also calls for greater restrictions on junk food advertising and a 20 per cent price hike on sugary drinks.

"We're creating environments for our kids where it's harder and harder to be active," Professor Allender said.

"Our kids live in an environment that's saturated in junk food marketing."

Federal Health Minister Greg Hunt said in a statement he would refer GLOBE's proposal to the Australian Health Ministers' Advisory Council to consider.

"The primary responsibility for children's health rests with parents and the states who run the schools," Mr Hunt said.

"The importance of exercise and good eating for kids cannot be underestimated in giving them a lifelong platform to good health."

The Select Committee into the obesity epidemic will hold public hearings in Sydney and Melbourne in August.

First posted July 21, 2018 15:20:55

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Call for children to be weighed and measured at school to tackle obesity epidemic

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Updated July 21, 2018 16:08:28 Children's height and weight would be measured every two years unless parents opt out as part of an ambitious proposal to tackle Australia's obesity epidemic. The proposal, made by the Global Obesity Centre (GLOBE) at Deakin University to a Senate committee examining the issue, argues the data could map childhood obesity around Australia to better target where the problem is at its worse.

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The Wellness Industry has created an obsession with health. Where is the line between striving for physical health and obsessing over physical appearance?

Bordo (2012, 250) argues that the images used in fashion magazines (and on social media and wellness blogs) to sell a product or a lifestyle "are not only or primarily about the desirability or attractiveness of a certain body size and shape, but about how to become what the dominant culture admires, how to 'get it together', be safe from pain and hurt". The wellness industry promotes a lifestyle that will ward of illness, disease, and death, but these things are all ultimately unavoidable.

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Instagram as a form of self-surveillance

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Instagram as a form of self-surveillance

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This is a screenshot from the Instagram page of "fitspo" star, Kayla Itsines, who currently has 10.1 million followers.
The before-and-after photos are designed to demonstrate the effectiveness of Itsines' workout program, the 'Bikini Body Guide'. In the guide, Itsines encourages participants to take a "before" photo of their body, and to track their progress by taking weekly body photos. This is an example of self-surveillance, as well as public surveillance if participants post the body progress photos on social media for other people to view, critique or praise.

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Lack of disabled bodies in the wellness industry

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Lack of disabled bodies in the wellness industry

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Disabled bodies are excluded from the world of "wellness" because they can never achieve the level of perfect health that wellness gurus aspire to. Most (if not all) proponents of this type of wellness are thin, fit and able-bodied.

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The economic cost of obesity in Australia

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The economic cost of obesity in Australia

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Fat bodies are commonly discussed within the context of economics, due to the cultural belief that people who live in fat bodies are a drain on the economy. This article describes the "obesity epidemic" (and fat people as an extension) as a "huge societal and economic burden".
The photo used at the top of the article is an example of the "headless fatty" that is often used to accompany media stories about "obesity". Using a photo of fat people without their heads and faces is dehumanising and suggests that all fat bodies are the same.

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Australia is ranked as one of the fattest nations in the developed world.

The prevalence of obesity has more than doubled in the last 30 years and by 2025, it is estimated that 70 percent of Australia's population will be obese or overweight.

It is not simply about the failure of individual willpower though, and while education and raising awareness is key for prevention, treatment for the 5 million plus Australians who are obese is absolutely urgent.

But beyond the individual health risks and quality of life associated with obesity, there is a huge societal and economic burden through the direct and indirect costs it generates.

According to the Australian Bureau of Statistics the total annual cost of obesity in 2008 including health system costs, loss of productivity and carers' costs was estimated at around $58 billion.

It gets worse.

The cost to Australia's collective well being is $120 billion as estimated by the Herald/Age Lateral Economics Index.

Fat Nation: HuffPost Australia's Obesity Series The Shocking Statistics Behind Australia's Obesity Problem The Deeply Unsexy Crisis We Can No Longer Ignore

A recent evidence-based report from Obesity Australia in partnership with PwC looked at more immediate costs borne by various key stakeholders including state and federal governments, the individual, employers and health insurers (reduced well being and forgone earnings were not included) and found the total cost of obesity in Australia from 2011 to 2012 was $8.6 billion.

Experts agree tackling the disease of obesity requires a much broader engagement across all levels of society.

"Easing the individual and societal burden of obesity requires a multidisciplinary approach -- behavioural, pharmacological, surgical and above all environmental changes are needed," Professor Stephen Simpson, academic director at The Charles Perkins Centre told The Huffington Post Australia.

If you are overweight or obese, you are twice as likely to have depression. You are at higher risk of comorbidities associated with obesity and as a result, visit both the hospital and GP more than a non-obese person.

The PwC report showed while the situation of obesity in Australia is dire, long-term and cost effective intervention will save us money.

Direct costs including general practitioner, allied health, hospital care, pharmaceuticals and weight loss intervention made up $3.8 billion while the indirect costs including absenteeism, productivity and government subsidies made up $4.8 billion.

The PwC report found there was $3.8 billion in direct costs and $4.8 billion in indirect costs.

Obesity-related doctor visits also take longer than average which adds to a marginal cost of $255 million per year in GP visits due to obesity.

Based on a study that looked at specialist visit costs, the PwC report found that additional specialist costs from 2011-2012 was $297 million due to obesity, of which the Commonwealth covers 81 percent.

Hospitals around the country are struggling to manage with the ever-increasing intake of obese patients.

There is an estimated additional cost of $1.2 billion in hospital care but this does not include the specialised equipment and infrastructure hospitals must invest in for obese patients.

Bariatric equipment, reinforced beds, pressure mattresses, lifters, shower chairs and specialised toilets are crucial for the safety of the patient and hospital staff who are at higher risk of manual handling injuries with an obese patient.

Ambulance services need to invest in trucks and equipment designed for transporting severely obese patients while additional staff are often needed to assist.

These costs are covered by state and territory governments and are estimated to be high given most of these specialised products are two to three times more expensive than the regular type.

Professor Michael Cowley, director at Monash Obesity & Diabetes Institute, who specialises in developing drugs for obesity said that when it comes to treatment not every intervention is appropriate for each obese person. However, bariatric surgery is proving effective.

Australians spent an estimated $368 million in 2011/12 on weight loss intervention, including bariatric procedures. This figure excludes government and private health insurance contributions to bariatric procedures.

Despite their success, Cowley said we need more drug therapy -- given approximately two-thirds of Australians are overweight or obese and there is very little to be done for patients except provide surgery.

The indirect or "hidden" costs of obesity are perhaps the most shocking as Australian employers and businesses grapple with the huge loss in productivity and performance due to obesity.

As with doctor and hospital visits, studies show people are more likely to have been absent from work or school in the last two weeks as BMI levels increase.

The PwC report estimated a cost of $477 million in absenteeism and $544 million in presenteeism (when the worker shows up to work but does not perform to their ability).

Cowley said workplace productivity is an important driver for recognition from employers that they need to do more in the workplace.

"We can work with health organisations, communities and community organisations to try and do things at home but the workplace is where a lot of us spend most of our time so there's a huge potential for healthy lifestyle messages to be better delivered here," Cowley said.

Costs to the individual including depression, disability, quality of life and premature death are difficult to pin down.

"Unfortunately, overweight or obesity are frequently linked to negative social consequences that may include offensive remarks from others, bullying, insulting media and social media portrayals, and discriminatory behaviours in the work place and health settings," Dr Janine Clarke, psychologist at Mend Psychology and The Sydney Act Centre and mental health researcher at the Black Dog Institute told HuffPost Australia.

Research shows that weight-based stigma can start as early as kindergarten.

In 2009, there were 1,043 deaths for which obesity was either the underlying cause, or an associated cause of death.

The median age at death due to obesity was 55 for men and 65 for women.

So the question is this -- how do we put a price on life?

The PwC report -- which looks ahead to 2025 and costs a number of interventions including parental education, school curriculum, food labelling, tax on unhealthy foods and bariatric surgery -- is estimated to cost $1.3 billion, leading to savings of $2.1 billion.

While these interventions will help to slow the growth rate of obesity they won't allow Australia to meet the World Health Organisation of freezing obesity at 2010 levels.

If nothing is done however, we can expect a total of $87.7 billion in direct and indirect costs by 2025.
This part of a special series by The Huffington Post Australia about the nation's obesity crisis. If you have an idea (a big one, or a small one -- even a nutty one) email us at HuffPost Australia.

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This Is What Obesity Is Costing Australia

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Australia is ranked as one of the fattest nations in the developed world. The prevalence of obesity has more than doubled in the last 30 years and by 2025, it is estimated that 70 percent of Australia's population will be obese or overweight.

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Orthorexia is the name given to healthy eating that has become obsessive and destructive to a person's health. This article from the Dietitians Association of Australia describes orthorexia as the desire to eat in a "pure or perfect" way. It explores how the "clean eating" endorsed by the Wellness Industry equates food with morality. The article says that "eating healthily should have a positive effect on health", whereas for those suffering from orthorexia, the pressure to eat "perfectly" leads to mental, emotional and physical health issues.

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You've cut out the Friday night take-aways, the wine sipped with dinner, your morning mochas and you are feeling great! You have lost a bit of weight, your skin is glowing and you are full of energy.

You feel so good that you wonder about making a few more changes. You might try out some of the health trends that are appearing on your social media feeds. You always see gluten-free, raw or vegan creations popping up on your Instagram and Facebook. Gluten is the first to go, a few weeks later, you cut out all dairy, finally you decide to stop eating any animal products.

You feel healthy, pure and clean. You haven't touched chocolate or anything you deem 'unhealthy' for months and feel completely in control.

But, you are starting to find it hard. At first, you felt full of energy, but now you struggle to make it through the day without feeling tired. And you have had to turn down a few social events because you don't feel comfortable eating any food you haven't prepared yourself. In fact, you notice yourself becoming anxious around meal times. You seem to be spending most of your day planning your next meal and are constantly concerned about eating the 'right' foods.
What happens when the desire to eat healthily turns into an obsession?
Orthorexia is a condition where an individual is driven to eat in a way they see as perfect or pure, often involving strict and inflexible eating behaviours. The word orthorexia is Greek, with 'orthos', meaning 'correct or right'. While orthorexia is yet to be officially recognised as an eating disorder, health professionals are recognising the eating behaviours as being part of the eating disorder spectrum.

Orthorexia starts out as a true intention to eat healthy foods, but over time, an obsession starts to develop around eating as healthily as possible. The person might strive for a perfectly 'clean' diet, shunning all food they have not made themselves, cutting out food groups, or only eating specific foods in the belief they are superior. They experience psychological distress when they cannot fulfil the set rules they have created around their diet.

A person with orthorexia may experience nutritional deficiencies due to eating a limited range of foods, they can feel low in energy and tired for the same reason, and avoid social events for fear of having to eat foods outside of their comfort range.

What are the signs of orthorexia?

Many people eat healthily or follow certain diets, making it hard to determine when being a 'health nut' can cross over into something more dangerous. Changes in your diet should be made gradually, and eating healthily should have a positive effect on health.

The Bratman Test for Orthorexia is a 10-question checklist developed by Dr Steve Bratman, who coined the term 'Orthorexia'. If you answer yes to four or more of the questions, you may benefit from seeking support around your eating behaviours.

1. Do you spend more than three hours a day thinking about your diet?

2. Do you plan your meals several days ahead?

3. Is the nutritional value of your meal more important than the pleasure of eating it?

4. Has the quality of your life decreased as the quality of your diet has increased?

5. Have you become stricter with yourself lately?

6. Does your self-esteem get a boost from eating healthily?

7. Have you given up foods you used to enjoy in order to eat the 'right' foods

8. Does your diet make it difficult for you to eat out, distancing you from family and friends?

9. Do you feel guilty when you stray from your diet?

10. Do you feel at peace with yourself and in total control when you eat healthily?

If you or anyone you know is experiencing sign of orthorexia, seek advice from a health professional.

First published in Oxygen magazine.

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Orthorexia: The unhealthy side of healthy eating

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You've cut out the Friday night take-aways, the wine sipped with dinner, your morning mochas and you are feeling great! You have lost a bit of weight, your skin is glowing and you are full of energy. You feel so good that you wonder about making a few more changes.

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This article is a good example of the messaging and rhetoric that is often used when talking about fat bodies. Calling "obesity" "deeply unsexy" equates having a fat body with being unattractive and undesirable. This type of verbiage is shaming and ultimately unhelpful.

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We think we look like this... but we don't.

It's not really news to us that we're fat. I mean, we know when we have trouble doing up the pants that fitted comfortably six months ago. And we know when we're eating that bacon and egg roll that it's not the ideal breakfast and certainly not the ideal morning tea.

And we know when we look around us we're not the only ones. Those other people in the line at McDonald's could do with a few more salads and a few less thick shakes, couldn't they?

And we know the kids should get out more and run around. But they're safe there on the couch... where we can see them.

And we know 3,000 steps in one day is pathetic but there's just so much work to do, and so many Facebook posts to keep up with -- so the last lunch-time walk just gets further and further in the past.

And it's hard getting home in time to make dinner and a KFC bucket every now and again isn't going to kill anyone. Once a month, or maybe twice last week...

And really, our kids aren't the fattest ones in their class.

And we're Australian -- the rest of the world thinks we're a bunch of bronzed beach babes, don't they? So we must be doing something right.

And what's the government doing about it?

Pass me a Coke. There's a 24-pack in the pantry that was on special.

No, it's not news that we're fat (yes, we -- statistically speaking, more people reading this will be overweight or obese than not).

As topics go, it sure ain't sexy.

Here are some seriously unsexy numbers:

In 2014-2015, 63.4 percent of Australian adults were overweight or obese -- up from 56.3 percent in 1995.

One in four Australian children are overweight.

Heart disease is our biggest killer.

And we visit fast-food outlets 51.5 million times a month.
Yeah, we know! Don't get all judgy on us...
Well how about this:

The ABS says in 2008 the total cost of obesity to our economy was $58 billion.

It costs hospitals, straining under our collective weight, an extra $1.2 billion per year.

We're losing productivity. We're less innovative. We're a drain on the budget. We're a preventable drain on the health system.

Still don't care?

Overweight people are less educated and earn less. They are less productive and report a lower quality of life.

They get diabetes at a far higher rate. They have more joint pain. It affects their relationships, their fertility and their enjoyment of parenting.

You'll get all the details of these facts in coming days as we roll out our coverage of one of the biggest single challenges facing Australian society.

Today's post lays out the barest of the shocking facts. Tomorrow, we examine the economic costs and the next day the measurable, and immeasurable, costs to individuals.

It's a national crisis. There's no denying it -- our bottom line is suffering.

It's a problem for individuals, schools, cultural and sporting groups, employers and the government -- and not one of these groups or people can fix it alone.

While we have the perennial argument about banning junk-food advertising, no one is expecting the health department to mandate our portion sizes for us or boot us off Netflix to head out for a run.

While we demand employers bring in healthy workplace practices, businesses are also being saddled with a workforce in less-than-its-best shape.

And yes, individuals have to take responsibility for what we put in our own mouths and what we teach our children to put in theirs.

What's the answer? Well, I have to admit we don't know.

I often bore dinner party companions to sleep with my insistence that cooking should be compulsory for all school students for the full 13 years of school. That's just one idea.

But we're going to spend this year looking for as many answers as we can find. Small ideas. Big ideas. Ideas that are already making a difference.

We need to have an honest conversation about what's gone wrong and what we might do as a society, as families and as individuals, to turn it around.

Yes the government has a vested interest in whipping us into shape -- but it can't do it for us.

No it's not news, but we can no longer pretend it's someone else's problem.
If you have an idea (a big one, or a small one - even a nutty one) email me at tory@huffingtonpost.com.au

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The Deeply Unsexy Crisis We Can No Longer Ignore

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We think we look like this... but we don't.It's not really news to us that we're fat. I mean, we know when we have trouble doing up the pants that fitted comfortably six months ago. And we know when w...

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Series 3: Eating Disorders

Some quotes from the episode:
"You could look perfectly fine, but behind that there is so much going on in your head" - Kate

"If I can control what I eat for lunch then I can deal with all the other stuff in the world because I've got control over this small part of my life".

This episode shows eating disorder sufferers describing the self-regulation and thoughts of control that were pervasive throughout their illness.

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Confronting prejudice and discrimination by offering searing insights into the lives of diverse Aussies who live in judgement. The show that asks the hard questions and allows interviewees to answer with candour and humour.

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Jessica Sepel is said to be "living a healthy life". She is a thin, white, able-bodied, conventionally attractive woman. This is the image of good health that is put forward repeatedly by the wellness industry, and it is not inclusive of bodies that lie outside of these social boundaries.

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Sepel acknowledges her past experiences with disordered eating.

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In this portion of the article, Sepel states that it is the wellness industry's fault that many people are confused about what food to eat for good health.

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However, a recipe of Sepel's is included with the article for "Green Detox Soup", a soup made almost entirely of green vegetables, which is a typical example of "wellness food". The name of the "detox" soup invokes a message of control and self-regulation. This contradicts with the opinions expressed by Sepel in the body of the article.

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Jessica Sepel on the cover of Australian Natural Health magazine

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Jessica Sepel on the cover of Australian Natural Health magazine

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Sepel is a wellness blogger and nutritionist.

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An article about the cosmetic products and procedures that are safe for pregnancy.

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Alcohol labelling - "It is safest not to drink while pregnant" - is designed to encourage self-regulation of drinking behaviour by pregnant women.

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This is an article in Pregnancy Life & Style magazine. It displays pictures of a baby in utero with accompanying text about the development of unborn babies. This type of article is included in every issue of this, and other, pregnancy magazines. Howson (2013) argues that "ultrasound technology displaces the source of women's knowledge about pregnancy from embodied or corporeal experience - what it actually feels like to be pregnant, for instance, nauseated, breast tenderness - to the expert". Including this type of article in pregnancy magazines has the effect of homogenising the pregnancy experience, and encourages pregnant women to observe themselves and to be hyper-aware of the changes happening to their bodies week by week.

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An advertisement for "Tummy Shield", an alternative seat belt that is designed for pregnant women. The image of the unborn baby superimposed onto the pregnant belly is highly emotive, and is an example of the way pregnant bodies are perceived as fragile and weak.

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An advertorial about gum disease in pregnant women. It states that half of the surveyed pregnant women "admit that they have ignored or dismissed the early signs" of gum disease.

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Bordo, Susan. 2012. "Beyond the Anorexic Paradigm: Re-Thinking 'Eating' Disorders." In Routledge Handbook of Body Studies, edited by Bryan S. Turner, 244-255. Florence: Routledge.

Howson, Alexandra. 2013. The Body in Society: An Introduction. Oxford: Polity Press.

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Some examples of the regulation and surveillance of pregnant bodies

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Some examples of the regulation and surveillance of pregnant bodies

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Howson (2013) argues that "new technologies further define the pregnant body as a pathological body in need of medical supervision". The modern pregnant woman is bombarded with messages from medical professionals, the media, and friends and family about what they should and should not do with their bodies. They are told what food to avoid, how much exercise to do, to avoid alcohol and caffeine, to beware of many household drugs and chemicals, and much more.