Fighting the obesity battle early

Adolescence is a crucial 'window of opportunity' for the development of healthy habits and obesity prevention.

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Adolescents and young adults are a “forgotten” demographic when it comes to the prevention of chronic health conditions, experts say. 

According to a recent study in a special issue of Public Health Research & Practice, several major risk factors are left unaddressed in this age group, elevating the burden of disease and associated costs later in life.  

Obesity was noted as particularly prevalent in Australian teenagers and young adults. The Australian Bureau of Statistics found a quarter of 5-17-year-olds are overweight or obese, with this figure rising to almost 50% among 18-24-year-olds. 

But GPs can play an important role in helping to address these issues, says the study’s corresponding author and clinical research fellow at the University of Sydney, Dr Helen Cheng. 

“Overweight and obesity in young people, and importantly, the health implications of this, is somewhat under-recognised in the community,” the adolescent health expert told The Medical Republic.  

“There’s a real push to encourage routine growth tracking when a young person presents to a medical practice regardless of what they’re presenting for. However, practitioners need to tread carefully as the idea is to plant the seed in their head but not push the issue to the point that the young person disengages.” 

Increasing independence and autonomy surrounding lifestyle choices, together with a lack of strategies and interventions targeting this age group, were identified as key contributors to the severity of this health concern. 

“Effective obesity prevention requires a combination of interventions that empower adolescents and young adults to make healthy lifestyle choices and create environments that support healthy decision-making,” the authors wrote. 

“Coordinated action is required across multiple sectors to address nutrition and health literacy, improve the food and built environment and provide societal protection to disadvantaged adolescents and young adults via affordable, nutritious food, recreational activities and health services.” 

The National Obesity Strategy 2022–2032, launched earlier this year, was developed by the Australian government with the objective of “reducing overweight and obesity in children and adolescents aged 2–17 years by at least 5% by 2030”.  

A primary aim of the framework is to overcome the disjointed nature of current measures in place across different jurisdictions of government. 

“Current state-based interventions show modest effects on improving weight-related behaviours,” the paper stated. 

“Major fiscal and regulatory measures have yet to be implemented despite demonstrable public health benefits and public support.” 

The initiative emphasises the need to engage with youth as a priority group, although initial consultations only included individuals between the ages of 21 and 26.  

Dr Cheng provided some further helpful suggestions as to how GPs might broach the topic with the sometimes-difficult demographic and approaches they could take to address the issue. 

“Practically speaking, if overweight/obesity is flagged as an issue in a routine check, then using the BMI chart to introduce the concept is a good foray into the conversation,” she said. 

She highlighted the importance of involving the adolescent in the decision-making process and implementing family-wide changes.  

“Engaging with the adolescent and finding out what they want to get out of weight management is also essential. Find out what their goals are and why they may want to lose weight. 

Small changes at a time tend to be more acceptable. 

Focussing on sleep and ways to improve pre-bed routine and pushing bedtime earlier is a good non-stigmatising/non-weight-fixated approach to addressing the issue,” she said. 

“This can have a positive knock-on effect.” 

Public Health Research & Practice 2022, online 12 October