Healthcare costs for overweight and obese adults hit $308 million in the Hunter New England region last year.
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These costs - which apply to those aged over 25 - are predicted to rise by about 3 per cent a year to $349 million by 2023, with current obesity trends and expected population increases.
The figures are outlined in a new report by the Newcastle-based NSW Regional Health Partners.
The report, titled "The Addressing Overweight and Obesity Project", said the costs provide "compelling evidence for continued and enhanced investment" in the prevention of obesity and people becoming overweight.
University of Newcastle Professor of Nutrition and Dietetics Clare Collins said the cost raised important questions that need answering.
"You could ask the public, how do you want to see your hard-earned tax dollars spent?" said Professor Collins, who contributed to the report.
"Do you want to see it spent on this projected rise in healthcare costs? Or do you want to see more treatments for those who have obesity?"
The report highlighted a lack of services for "severe complex obesity".
It found that obesity prevention programs for children over the last decade had made a difference, but those programs must be maintained.
Furthermore, it called for increased services for the problem of weight gain generally.
"There is the opportunity to improve health outcomes ... as well as reduce current and future healthcare costs associated with obesity and its co-morbidities by investing in targeted prevention," the report said.
This includes interventions for people who are overweight "with the aim of preventing further weight gain".
Professor Collins said improved health services in this area would involve curbs on junk food in the poorest suburbs where there "tends to be an over-abundance of fast-food outlets".
Other measures would be programs that "make it easier for our most vulnerable families to get their fresh vegetables and fruit".
"Now's a good time to be having these conversations."
Doctors have seen people's health improve during the COVID-19 lockdown, including those with diabetes.
This has been attributed to people exercising more, cooking more at home and spending less on fast food.
A lot of discussion has occurred about overweight and obese people being more vulnerable to coronavirus.
"People have been willing to get back into their kitchen and only go to the supermarket every one to two weeks, rather than every day," Professor Collins said.
"Now's the time to build on that."
She said GPs require more knowledge and skills about the use of nutrition to improve health. Many GPs are required to keep consultations short. Traditionally, they don't tend to focus much on nutrition.
"It's not their fault, but there hasn't been enough practical support for people in terms of nutrition.
"Now is the time to be talking about this and looking at what services should go federally and what services NSW Regional Health Partners can offer and support.
"What portion of the budget should be going to these areas?"
She said healthcare costs for the obesity epidemic must be honestly factored into budgets.
"The costs will expand through sheer demand if we stay on the same trajectory we're on now," she said.
The Hunter Region had "a more vulnerable population" to obesity, based on socio-economic status.
The report shows that average overweight rates in the Hunter New England area were 71 [adults] 77 [men], 65 [women], 24 [children], 26 [boys] and 22 [girls].
These figures were for every 100 people in each bracketed demographic. The figures are "age-standardised", a method used in population health to better understand problems.
Average obesity rates in the Hunter New England area were 38 [adults], 38 [men], 37 [women], 8 [children], 7 [boys] and 10 [girls].
"We've looked at the hardcore facts of what it means for our region," Professor Collins said.
"And now it's a chance to say what does our region need? And it looks like our region needs action in parts of the population that have not had services."
NSW Regional Health Partners healthy weight project officer Celia Rae said obesity rates for adults and children were much higher than the national average in the Hunter New England region.
However, an analysis of obese and overweight children combined told a different story. It found these rates were lower than the national average.
"We've poured a lot of money and hard work into obesity prevention for children over the last 10 years," Ms Rae said.
"This statistical analysis doesn't prove it, but it suggests that's starting to work. Obviously we need to sustain that and keep delivering those programs."
But in a troubling trend, obesity rates [not including those who are overweight] in the Hunter New England area were higher than the national average.
"That suggests that the programs we've been delivering in the last 10 years are not necessarily helping our kids with obesity," she said.
Adult rates of overweight and obese people were higher than the national average for men and women and both sexes combined.
"This study determined higher rates of overweight [people] and obesity were associated with smoking and low levels of education in adults," the report said.
The report, which Hunter Medical Research Institute funded, said being overweight or obese increased the risk of developing a range of chronic illnesses. These included heart disease, stroke, diabetes, osteoarthritis and cancers of the breast, prostate, liver and colon.
For children with obesity, there is an increased risk of breathing difficulties, fractures, hypertension, early signs of cardiovascular disease, insulin resistance and psychological effects.
Childhood obesity is also closely associated with obesity, disability and premature death in adulthood.
"We think people's weight-related health is worth improving," Professor Collins said.
One of the report's main findings was "a substantial gap in the treatment of severe complex obesity".
"Presently, bariatric surgery is only being performed in Hunter New England Health District within the context of gastric reflux. This means that the recommended treatment for the majority of patients with severe complex obesity is not available in the public system.
"Given the increased prevalence of obesity among socio-economically disadvantaged populations, this raises an issue of equity."
Bariatric surgery - which includes gastric banding, gastric bypass and gastric sleeve operations - is designed to make patients' stomachs much smaller, causing them to feel full after eating only a small amount of food.
"Future investment in intensive treatment interventions must be considered in any future planning and decision-making about obesity," the report said.
"There is the opportunity to improve short- and long-term health outcomes for children, as well as reduce current and future healthcare costs associated with obesity and its co-morbidities."
This would involve consolidating and expanding investment in obesity treatment for children and adolescents.
"Obesity in childhood is strongly predictive of obesity later in life."
The report said people became overweight and obese through "a sustained energy imbalance".
Put simply, the number of kilojoules consumed is in excess of the kilojoules required.
"In the last few decades, access to and consumption of larger portions of energy-dense, nutrient-poor foods and beverages has increased, while physical activity levels have declined," the report said.
Work was increasingly sedentary in nature, transport more passive and urbanisation had increased.
This had led to an environment that promotes people being overweight and obese.
Rates of overweight and obese people have risen dramatically since the end of the 1970s. Globally, the World Health Organisation estimated that the prevalence of obesity in 2016 had almost tripled since 1975.
More than 650 million adults aged 18 years or older were affected by obesity. Almost 2 billion adults were overweight.
About 41 million children under the age of five and over 340 million children and adolescents aged five to 19 were overweight or obese.
The World Health Organisation recommends improving knowledge and skills related to diet and physical activity, and limiting exposure to environmental factors that promote weight gain.
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