Overweight and Obesity 2011

SEPTEMBER 2011
Population Epidemiology Unit
Division of the Chief Health Officer, Queensland Health







How do we define overweight and obesity?

The most commonly used measure for overweight and obesity in
adult populations and individuals is Body Mass Index (BMI).
2
BMI is
a measure of a persons weight in relation to their height. It is
calculated by dividing a persons weight in kilograms by the square
of their height in metres (kg/m
2
). BMI categories are displayed and
defined in the following graph.

Weight for height chart for males and females aged 1864 years
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Hei ght (cm)
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Underweight
BMI <18.5
Normal
BMI 18.5-<25
Overweight
BMI 25-<30
Obese
BMI ?30


While the BMI categories in the graph can help to determine
whether you are in a healthy weight range, they dont provide a
direct measure of your body fat. Despite this limitation, BMI
provides a useful population-level measure of overweight and
obesity as it is the same for all adults of both sexes.

Children and adolescents undergo many physiological changes
as they mature and grow. BMI can alter substantially in this
period making the standard adult BMI categories and their
related cut-off points unsuitable for measuring overweight and
obesity in children and adolescents. BMI categories in children
are adjusted for age and sex.
4



How did obesity become such a problem?

A small, persistent imbalance between energy
intake (food and drinks) and energy expenditure
(including physical activity) will lead to weight
gain over time. While genetics contributes to
individual susceptibility to obesity, the rapid
increase in the global prevalence of obesity can
only be explained by widespread changes in
lifestyle and the environment.

Over recent decades, urbanisation, economic growth and
globalisation of food markets have contributed to excessive food
consumption patterns and an increased reliance on technologies
that discourage physical activity.
5
The World Health Organization
has described the effect of these changes as creating an obesity-
promoting or obesogenic environment that promotes over
consumption of energy-dense foods high in sugar and saturated
fats and increasingly sedentary lifestyles with lower levels of
physical activity.
2,6



Overweight and obesity statistics in Queensland in 2011

In 2011, based on self report, 34.5% of adult Queenslanders (18
years and older) were overweight and 22.9% were obese.
3
By
physical measurement in 2007-08, 35.7% were overweight and
25.3% were obese.
7


Rates of overweight and obesity were higher in adult males than
females by both self-reported BMI (64.1%, 50.7% respectively),
3

and measured BMI (67.9%, 54.6% respectively) with similar
differences across most age groups.
7


Prevalence of overweight for males increases quickly with age.
The highest rates are reached by 3544 years and remain high
until 75 years and older. Female prevalence increases slowly,
peaking at around 55 years and older and remaining at this
level.
3


The occurrence of self reported overweight is similar in
disadvantaged areas of Queensland compared to advantaged
areas. In contrast, rates of obesity in disadvantaged areas are
double that of advantaged areas regardless of the age and sex
profile of the population.
1


Rates of overweight and obesity in 2011 were about 1020%
higher in regional areas of Queensland compared with cities
and about 30% higher in remote and very remote areas.
3
Rates
of overweight and obesity in regional Queensland including local
government areas and health service districts are published on
the Queensland Health website. A greater proportion of
Indigenous Queenslanders is overweight and obese compared
with non-Indigenous (rates are about 20% higher).
8


NOTE: The relationship between measured and self reported
prevalence is important. There is a tendency for people to over report
their height or under report their weight or both. While BMI estimates
from self report are generally lower than those obtained by
measurement, the pattern over time is very similar and therefore self
report BMI has been nationally adopted as a measure of trend.
1



How do we compare nationally and internationally?

Rates of measured overweight and obesity in males and females
aged 15 years and older in Queensland in 2007-08 were similar
to national rates. For males, Queensland rates were second
highest after New South Wales and third highest for females
(after South Australia and Western Australia).
7
Northern Territory
was excluded from rankings due to data related limitations.
Globally, obesity has reached pandemic
proportions. An estimated 1.6 billion
adults are overweight and at least 300
million of these are obese.
6
Comparisons of
rates of obesity internationally are limited by variable measures
and recency of data. However, based on the most recent release
of the Organisation for Economic Co-operation and Development
(OECD) health data and using the most recent national data,
Australia has the fourth highest rate of adult obesity in the OECD
after the United States, Mexico and New Zealand.
9



Perception versus reality



Despite the fact that the prevalence of overweight and obesity is
increasing, Australians are becoming less likely to perceive
themselves as overweight.
10
Recent research in Queensland has
also shown that parents of overweight or obese children
considerably underestimate their childs weight status.
11



FACT: Obesity has reached epidemic proportions both in Australia and internationally.
1
FACT: In 2011 more than half of the Queensland adult population weighed more than is recommended for good health (57.4%).
3

FACT: Over the past 30 years the prevalence of overweight and obesity in Australian children has more than doubled.
1
Overweight and Obesity 2011
SEPTEMBER 2011


Obesity in children and young people

Obesity rates in children are a concern.
Globally, it was estimated that at least 20
million children under 5 years were overweight
in 2005.
6
The prevalence of overweight and
obesity in Australian children increased
substantially during the past 40 years and is
projected to approach adult rates within 30
years.
12


In Queensland, 26.1% of children aged 515 years were
overweight or obese in 2007-08, based on physical
measurement. This compares with 26.5% in 2009 based on
estimates from proxy reports (information collected from parents
and carers).
1


Rates of proxy-reported overweight and obesity in 2009 were
comparable in girls and boys aged 515 years and across all age
groups. However, the rates of overweight and obesity in children
living in disadvantaged areas of Queensland were more than
double that in advantaged areas.
1


Overweight and obesity in childhood, especially in older children,
can be a precursor for obesity and severe obesity in adulthood.
Furthermore, childhood and adolescent obesity is associated with
a higher risk of premature death and disability in later life.
1

There is evidence that in addition to the physical risks,
overweight and obese children are at greater risk of social
isolation and development of psychological disorders than those
in the healthy weight range.
13



How does overweight and obesity impact on health?



Overweight and obesity is now the largest single contributing risk
factor for premature death and disability in Queensland,
overtaking tobacco. Obesity reduces life expectancy, with the
average survival for obese people reduced by 24 years and for
the severely obese a reduction of 810 years.
1

High body mass is the dominant risk factor for a number of
chronic diseases, with about 40% of disease burden due to type
2 diabetes, 30% to coronary heart disease, 11% to stroke and
10% to colorectal, breast and uterine cancers.
1


In addition to major chronic illnesses, being overweight or obese
increases a persons risk of respiratory problems (sleep apnoea
and breathlessness), chronic musculoskeletal problems (lower
back pain and osteoarthritis), gall bladder disease and impaired
fertility.
4


Economics of obesity

Obesity is expensive, and a major
contributor to the burden on healthcare
systems. In Queensland, the total health
system cost for obesity in 2008 was
estimated to be about $391 million.

Obesity puts people at higher risk of a number of disabling
chronic conditions, resulting in the loss of healthy life. In 2008
overweight and obesity in Queensland was estimated to cost
an additional $9.961 billion in lost wellbeing, and together with
other financial costs, results in a total of $11.614 billion related
to obesity.
1






Toward Q2 target progress

The Queensland Government is committed to making
Queenslanders Australias healthiest people. Reduction of obesity
is a key target in achieving this commitment. The Toward Q2 goal
is to reduce the rate of adult overweight and obesity by one-third by
2020. If this goal is achieved, the prevalence of overweight and
obesity in Queensland adults in 2020 will be
33%.

However, between 2002 and 2011, the
prevalence of self reported adult overweight and obesity increased
by 1 percentage point per year. If current upward trends continue,
about 65% of Queensland adults (3.7 million) will be overweight or
obese by 2020, nearly double the Toward Q2 goal.
1



Proportion of self reported adult overweight and obesity,
Queensland, 20022011 and projections to 2020 Q2 target

Between 1995 and 2007-08 the proportion of people who
measured as overweight remained steady, but the proportion
measured as obese increased by about one-third from 19.2% to
25.1% in Queensland.
1


Overweight and obesity is perhaps the most important challenge
facing the health system but it is also largely preventable. While
good nutrition and regular exercise can influence a persons
weight, the focus cannot be on changing individual behaviours
alone. Reversing the long term upward trends in overweight and
obesity will require concerted and sustained action across all
sectors of the community through multi-strategy interventions.
1


References
1. Queensland Health. The Health of Queenslanders 2010. Third Report of the
Chief Health Officer Queensland. Queensland Health: Brisbane; 2010.
2. World Health Organization. Obesity: Preventing and managing the global
epidemic. Report of a WHO Consultation on Obesity. WHO: Geneva; 1997.
3. Queensland Health. 2011 Self reported health status survey. Population
Epidemiology Unit, Preventative Health Directorate: Brisbane; 2011.
4. World Health Organization. Obesity: Preventing and managing the global
epidemic. WHO Technical Report Series 894. WHO: Geneva; 2000.
5. International Obesity Task Force and European Association for the Study of
Obesity. Obesity in Europe. IOTF and EASO: London; 2002.
6. World Health Organization. Overweight and obesity. Fact sheet no. 311. WHO:
Geneva; 2006.
7. Australian Bureau of Statistics. National Health Survey: Summary of results.
State tables. 2007-08. Cat. no. 4362.0. ABS: Canberra; 2009.
8. Australian Bureau of Statistics. National Aboriginal and Torres Strait Islander
Health Survey, 2004-05. Cat. no. 4715.0. ABS: Canberra; 2006.
9. Organisation for Economic Co-operation and Development. Health at a Glance
2009: OECD Indicators. DOI: 10.1787/health_glance-2009-en. OECD: Paris;
2009.
10. Chuang H-T, Lee Y-C. Analysis of factors found to affect self-perceived weight
status in Australia. Journal of Nursing Research 2010;18:227-237.
11. Abbott RA, Lee AJ , Stubbs CO, Davies PSW. Accuracy of weight status
perception in contemporary Australian children and adolescents. Journal of
Paediatrics and Child Health 2010;46:343-348.
12. Norton K, Dollman J , Martin M, Harten N. Descriptive epidemiology of
childhood overweight and obesity in Australia: 1901-2003. International Journal
of Pediatric Obesity 2006;1:232-238.
13. Libbey HP, Story MT, Neumark-Sztainer DR, Boutelle KN. Teasing, disordered
eating behaviors, and psychological morbidities among overweight
adolescents. Obesity 2008;16.


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Prepared by: Population Epidemiology Unit, Strategic Partnerships and Epidemiology Branch, Preventative Health Directorate, Division of the Chief Health Officer, Queensland Health
Suggested citation: Queensland Health: Overweight and Obesity 2011 Fact sheet. Division of the Chief Health Officer, Queensland Health, Brisbane, 2011.