Evaluating Australian health literacy on obesity in Australian adults


The obesity epidemic is recognised as a global phenomenon and serious public health issue (WHO, 2021). Further, it is a complex, multifactorial and fundamentally preventable condition affecting approximately a third of the world’s population (Hruby & Hu 2015). Obesity is defined as abnormal or excessive fat accumulation in adipose tissue, to the extent that health is impaired and is often a major predisposing factor to the development of non-communicable diseases, significant disability and premature death (Ofei, 2005). Within Australian society, obesity is more common in older age demographics, particularly adults (Australian Institute of Health and Welfare (AIHW), 2020b). In 2017-2018, 31% of Australian adults were obese; a substantial increase from a previously recorded 19% in 1995 (AIHW, 2020b). This rising prevalence of adult obesity forbodes a staggering burden of disease in individuals and healthcare systems; where in 2015, 8.4% of the disease burden was attributed to obesity, denoting it the second leading risk factor contributing to disease burden (Hruby & Hu 2015; AIHW, 2020b). Contemporary literacy has also highlighted societal factors that promote sedentary lifestyles and the consumption of high-fat, energy-dense diets as primary potentiating factors of obesity (Ofei, 2005). Additionally, while genetic origins are recognised factors, obesity, by and large, transpires when energy intake exceeds energy expenditure over a protracted period (Ofei, 2005). Moreover, this essay aims to evaluate Australian health literacy on obesity with particular emphasis on the adult demographic, in addition to the collaborative initiatives taking action to curb the epidemic and improve overall quality of life outcomes through prevention and management strategies.

Obesity Prevention in Australian Adults

Majority of the causative factors of obesity onset are modifiable and generally occur over prolonged and sustained periods while involving underlying biological, social and behavioural factors (Östman, Britton & Jonsson, 2004); therefore, it is preventable. Additionally, contemporary society’s ceaseless nutritional transition and increased reliance on processed foods and high caloric diets have displayed positive correlations with elevated prevalence of obesity (Hruby & Hu 2015). Dually, evidence of increasing sedentary lifestyles in Australian adults have also been independently associated with increased weight gain; where in 2021, AIHW (2020a) declared approximately 55% of adults did not adhere to the physical activity (PA) guidelines. Combined with diet, these elements have synergistic and potentially cumulative effects on weight management.

Rudimentary Guidelines to Support Obesity Prevention

Obesity can be prevented by adopting individualised long-term strategies and rudimentary dietary habits (Östman, Britton & Jonsson, 2004). In accordance with Australian PA guidelines, the AIHW identified several recommendations for obesity risk prevention through apt levels of physical activity (per week) in adults; engagement in at least 2.5 hours of moderate PA; or minimum 1.25 hours of vigorous PA (AIHW, 2020a). Furthermore, obesity risk can be lowered through reducing calories ingested from fats and sugars and rather supplementing it with larger portions of fruit/vegetables, legumes, whole grains and nuts (WHO, 2021). However, independently, these prevention strategies will subside, therefore, synergy between both will promote a coherent and motivated lifestyle, engendering optimal health outcomes.

Contemporary Initiatives Promoting Obesity Prevention

According to the Australian Bureau of Statistics (2016), more than 58% of Australians spend their ‘food dollar’ on discretionary foods high in fat, salt and sugar; accounting for 35% of kilojoule intake for adults. This is reflective of a contemporary lack of health literacy and relative awareness, with only 7% of Australians adhering to dietary recommendations (Obesity Policy Coalition (OPC), 2017). Combatting this issue are preventative strategies such as The Healthy Food Partnership which aims to reformulate packaged and processed foods distributed by food manufacturers to reduce nutrient-poor and calorie-dense items whilst facilitating a positive shift in the food environment and population-wide improvement in diet (OPC, 2017). Additionally, public education campaigns addressing poor health literacy including the ‘LiveLighter’ campaign, established in Western Australia, underlines the antagonistic health consequences associated with weight gain, the implications of poor diet alongside recommending alternatives to obesogenic behaviours (Morely et al., 2016; OPC, 2017). Moreover, with a majority of Australian adults espousing sedentary lifestyles, national active travel strategies such as the Heart Foundation’s ‘Blueprint for an Active Australia’ encourages ‘active transport’ as means of sustainably increasing PA levels through a combination of interventions promoting walking and cycling as alternative modes of transport to motorised vehicles (Mizdrak et al., 2019; OPC, 2017).

An Australian initiative established in Victoria denoted ‘Health-Promoting Communities: Being Active Eating Well’ employed a multi-faceted, community-based approach to a range of settings across a variety of demographics with aims to improve individual health outcomes and spearhead obesity prevention at a community level (Bolton et al, 2017). In such manner the needs of the community were recognised, therefore allowing them to be addressed; one such avenue was positive exercise and modulating dietary behaviours. Moreover, evidence of improved quality of life outcomes were observed in ‘community 5’ which comprised of working Australian adults; where health-promoting strategies employed resultingly enhanced healthy dietary behaviours along with minimised sedentary behaviours and increased PA (Bolton et al., 2017).

Managing & Treating Obesity in Australian Adults

The treatment of the obesity crisis in Australia has been recognised as a national and economic priority and the nation’s response to it has been commensurate with the breadth of its prevalence, speed of growth and its individual and societal implications (AMA, 2016). However, given the highly complex aetiology of obesity, respective interventions and treatments for the condition are highly individualised (Bolton et al., 2017). Previous research has denoted that the factors contributing to obesity are multi-faceted, thus the treatment of this condition needs to be addressed in a similar manner; extending beyond model diets (Grima & Dixon, 2013). Nevertheless, as stated by the National Health and Medical Research Council (NHRMC) (2013), treatments that resultingly procure an energy deficit, where energy expended is greater than energy intake, will engender weight loss. Moreover, lifestyle interventions promoting healthy dietary behaviours, increased PA and awareness of obesogenic health-related issues constitute the cornerstone for treating obesity in Australian adults (NHRMC, 2013).

Reducing Energy Intake

Initial diagnostic assessments and management interventions for obesity are undertaken by general practitioners; as the first line of intervention and trusted conduits for health literacy (Grima & Dixon, 2013). Additionally, individualised person-centred that is culturally appropriate and utilises contemporary literacy in accordance with a direct focus on issue severity serves as the premise for effective evidence-based treatment (Grima & Dixon, 2013; NHRMC, 2013). Evidence-based treatment, outlined by the NHRMC (2013), suggests for the purpose of weight loss obese patients should ingest below 2500 kJ/day (~597 kcal); equating to an energy deficit. This can be achieved through forgoing energy-dense food and drinks whilst reducing snacking. Comparingly, adults requiring additional intensive intervention due to extremely high degrees of obesity undergo medically supervised very low-energy diets; as they are effective in supporting weight loss in extreme circumstances (NHRMC, 2013). In this regard, adhering to a lower, assigned number of calories equating between 1675 – 3350 kJ/day that is low in carbohydrates, predominantly protein-based and comprised of essential nutrients has positively correlated with prompt weight loss (Sumithran & Proietto, 2008).

Promotion of Physical Activity

The NHRMC (2013) defines PA as bodily movement generated by skeletal muscles that expend energy. A variety of PA domains including occupational, organised activity (sports, exercise) and transport (walking, cycling) exist within the sphere of relative PA intensities; which can be performed at levels ranging from light to vigorous activity (NHRMC, 2013). Recent data depicts that PA guidelines, outlined in (AIHW, 2020a), denote optimal health benefits. However, more frequent exercise routines are favoured in comparison to periodical activity. This is attributed to physiological and metabolic adaptations which serve to boost weight loss (Bauman, 2011). Moreover, a direct correlation between PA and lowered obesity has been outlined; additionally, this subserves the purpose of reducing colon cancer, accentuating musculoskeletal health, and improving functional mobility (Bauman, 2011).


Australian health literacy on the obesity health concern in adults since 1995 has highlighted an array of contemporary prevention and management strategies that have incrementally lowered associated rates; however, it continues to be a significant threat to health burden. Further, research has consolidated associations between obesity and social behaviours; coupling low PA rates and poor diet. Notably connotations of obesity have shown to result from a multitude of factors; therefore, the interventions implemented must similarly be multi-faceted. Intervention strategies need to adhere to a person-centred scaffold, hence creating an environment conducive to optimal health outcomes.

Whilst current evidence pertaining to obesity determinants is relatively comprehensive, gaps in contemporary literacy have been highlighted. Despite the wealth of health literacy accompanied by the array of interventions and strategies targeting adult obesity, the dissemination and extrapolation of the above fails to occur cohesively; this is reflected in tentative and transitory measures. A secondary aspect which current research fails to adequately address is the importance of community-centred approaches in targeting obesity. The avoidance of individualised interventions and adoption of community-orientated approaches should facilitate the development of resources, educational frameworks and heighten awareness surrounding obesity; these are requisite to implement a coordinated agenda of action to potentially lower adult obesity rates.

References (APA 7)

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