Teens forgotten in obesity prevention, as a virtual world poses increasing risk

Obesity prevention strategies that target adolescence – a crucial period for developing healthy behaviours – are disjointed, piecemeal and underfunded, and are failing to respond to the added challenges posed by today’s technology-fixated culture, leading adolescent obesity experts warn.

In a paper published today in Public Health Research & Practice, a peer-reviewed journal of the Sax Institute, experts from the University of Sydney, Royal Prince Alfred Hospital and The Children’s Hospital at Westmead say young people have been historically ‘forgotten’ in our health system, and adolescent overweight and obesity largely goes untreated, despite the fact it has major health consequences in later life.

Around one-quarter of 5 to 17-year-olds and nearly half of 18 to 24-year-olds in Australia are affected by overweight and obesity. Poor dietary, physical activity, sedentary behaviour and sleep habits often form in adolescence and are hard to shift in later life, the paper states.

The authors say their unique developmental needs underline the importance of obesity prevention in adolescents: changes to appetite and how the body lays down fat and muscle in this period can lead to excess weight gain if coupled with physical inactivity and sedentary behaviours. Extensive brain development also occurs during adolescence, with the prefrontal cortex region responsible for self-control being the last to mature, likely contributing to the overconsumption of palatable, fat- and sugar-rich foods.

The authors, including dietitian and researcher Dr Helen Cheng, say Australia is lagging on national legislation to combat obesity in young people. They note that sugar-sweetened beverage taxes are now in place in 50 countries, while Australia relies on an industry pledge for a 20% sugar reduction in beverages by 2025. Junk food advertising is also largely left to the food industry to self-regulate in Australia.

“Mounting evidence suggests fiscal and regulatory measures are essential for managing population-level obesity,” the authors write.

They welcome the inclusion of a goal to reduce overweight and obesity in children and adolescents in the National Obesity Strategy 2022–2032, launched earlier this year. But while the Strategy emphasises the need for engagement with adolescents and young adults, the authors note that initial consultation only included 21 to 26-year-olds.

In their own consultation research with teens, the authors identified three key health concerns that provide clear directions for action: the toxic social media environment; manipulative junk food marketing strategies; and inaccessibility of sport and recreation venues.

They also warn that the digitalisation of society is one of the greatest challenges for obesity prevention because it creates new marketing opportunities for fat- and sugar-rich junk foods. Online food delivery services have already shifted how young people access junk food, they note, and online advertising regulations have not kept pace with evolving technology.

“Coordinated action is needed to support young people to lead healthy lifestyles through personal empowerment and environments that promote healthy decision-making,” the authors write.

The paper is published in a special issue of Public Health Research & Practice exploring actions needed to address obesity through the life course. It was produced in partnership with the Health and Social Care Unit at Monash University, with support of VicHealth, and is published in the lead up to the International Congress on Obesity being held in Melbourne next week.

In an accompanying editorial, Dr Michelle Gooey of Monash University and colleagues argue that effective responses to the obesity challenge require “moving away from a narrative of blame and individual responsibility, which promotes stigma, and focusing on treatment and prevention”. We must acknowledge that the solutions lie across our society, they add, and that we need to focus on treatment and prevention “with an equity and systems lens”.

Other papers in the new edition look at:

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