More young adults are getting fat than other age groups, according to a study that has tracked 11,000 Australians for 12 years.
But the AusDiab study shows Australians in general are failing to make the lifestyle changes necessary to beat obesity, heart disease and diabetes. And women are putting on more centimetres than men.
Radical action similar to the anti-smoking drive is needed, says joint chief investigator Professor Jonathan Shaw of the Baker IDI Heart and Diabetes Institute.
"The health and wellbeing of a whole generation of young Australians is being compromised by a lifestyle rich in energy-dense foods and low on physical activity," he says.
The study shows people aged 25 to 34 have gained more weight and waist circumference during the 12 years than other age groups and about 270 people aged over 25 develop type 2 diabetes every day.
"We have a big problem. If we want to be serious about it we have to recognise it is not something that can be solved only through telling individuals what they need to do," Prof Shaw says.
"It's complicated, but we need to find ways to make healthy food options the cheap options."
Possible approaches include taxation of junk food and subsidies of healthy food, he says.
The study shows that living in the most socially disadvantaged areas doubles the risk of diabetes.
"Education and income are major determinants of health," says Baker IDI Associate Professor Anna Peeters.
"The AusDiab data highlights the extent to which a person's environment makes a contribution to their wellbeing."
She says disadvantaged areas generally have higher concentrations of junk food outlets and fewer recreational opportunities.
The study shows obese people aged 60 and over are about twice as likely than their peers to have cognitive impairment and physical disability.
"One of the biggest contradictions is that people are living longer but they're being diagnosed with more disease. So their quality of life is being compromised," says Prof Shaw.
"As a community, we need to be prepared to take some tough decisions.
"It's not impossible. Look at what we've achieved with gun control, smoking and water restrictions."