The most fundamental and perhaps important task in addressing the epidemic of obesity is prevention. Unfortunately, strategies that have been employed to date in an effort to prevent the development of obesity have been disappointing, and the problem of obesity is worsening.
While obesity has dual origins relating to both genetics and the environment, these factors are inextricably linked. The genes provide the gun and the environment pulls the trigger. There is no doubt that the problem we face today is related to our modern western environment. We live in a world of plentiful and attractive energy dense foods, and a working and leisure environment that encourages sedentary behaviour.
Solutions will require involvement within our communities at many levels. Solutions need to range from legislation to protect our children from the bombardment of advertising from processed food manufacturers, and provision of achievable physical activity guidelines for our kindergartens and schools as an essential part of the daily activities, to local town planning of our living environments to provide attractive, safe, user friendly areas for active leisure and physical activity. It is important to establish an advocacy for the range of initiatives required to combat the obesity epidemic.
CORE has been established to provide such advocacy, and to lead the way in promoting and supporting the changes necessary to make a difference.
Interventions to prevent or control disease are usually most effective, and perhaps most cost effective, if delivered to a high-risk population. Diabetes prevention studies have clearly demonstrated the value of such targeting. Modest weight loss, achieved through lifestyle change, has reduced the number of people with impaired fasting glucose which leads to the development of type-2 diabetes.
The challenge is to identify the individuals of high-risk groups to which scarce resources need to be focused. CORE has a major interest in both identifying those at risk of obesity related diseases, and in studying the effects of weight loss on conditions such as type-2 diabetes, non-alcoholic fatty liver disease, obstructive sleep apnoea and polycystic ovary syndrome.
A major role of CORE is to provide education to the health profession at large regarding the identification of those at risk in our community, and in providing management strategies for the prevention and treatment of obesity related diseases.