Childhood obesity in Rotorua has been called an "epidemic", as a study reveals more than a quarter of 4-year-olds in the area are overweight or obese.
But one expert says while decreasing obesity is an easy goal to have, it's a hard one to achieve.
The just-released results of the study showed that in the Rotorua area 4.8 per cent of 4-year-olds were extremely obese, 5.8 per cent were obese and 16 per cent were classed as overweight.
Only 1 per cent were underweight and 72 per cent were classed as normal.
Medical officer of health Dr Neil de Wet conducted the study, in 2014, with Toi Te Ora Public Health.
"I think this is a really important issue. There's no doubt that this is an epidemic.
"It's been emerging over the last 30 years around the world and New Zealand is no different.
"The data from the report shows it's definitely an issue in Rotorua. The really important thing is it's not just affecting a few individuals, it's affecting the whole nation."
He said the key issues were sugary drinks and hidden sugar.
"It's very difficult as a parent to avoid the consumption of sugar when it's in everything.
"There has been a big rise in awareness. Schools are becoming water only, and Healthy Families Rotorua are doing a great job.
"They have been working with the Rotorua Lakes Council to remove vending machines which is showing great leadership.
"I think there are some things that need to happen, it's good to see the food industry using less sugar, but it's going to take more than that.
"It concerns me, the extent in which children are exposed to marketing, childhood should be free of commercial advertising," Dr de Wet said.
Healthy Families Rotorua manager Leanne Morehu said the organisation was trying bring community leadership together.
"It's the best way to go because it's more sustainable. It's not going to happen overnight, what we are aiming to do is change the environment our kids are in.
"We are working with the existing services in the community. Our goal is to decrease obesity, which is an easy goal to have, but a hard one to achieve.
"Sometimes it can be really hard to change policies and systems. The Ministry of Health has taken a really proactive approach towards the obesity issue that we have.
"I think it's something that we aren't going to see a change in for a little while, but we are building awareness and if we have that awareness across the community then things will change.
"It's an epidemic, but it's the culture in our community that has to change.
"We have managed to remove one of the vending machines at the Aquatic Centre and change what is in the other two. We are hoping to do this in other places throughout the community as well.
"We are working with schools to bring in water only policies. And we have been working on a local food network which will encourage the community to grow their own fresh vegies and fruit.
"It's about working with the community to make the changes sustainable."
Rotorua Lakes Council chief operating officer Dave Foster said the three vending machines at Rotorua Aquatic Centre had been the best producing Coke machines in the Bay of Plenty.
"The Rotorua Aquatic Centre now has two vending machines which stock zero/diet beverages and water.
"In removing one vending machine and changing the products of the remaining two, the centre has taken the opportunity to offer healthier alternatives to their customers and have received good feedback about the changes.
"Rotorua Lakes Council's Sustainable Living Strategy advocates for healthy food environments with a plan to develop a healthy food, and sugar-sweetened-beverage free policy for council venues, events and activities," Mr Foster said.
Sport Bay of Plenty's Catherine McCulloch said childhood obesity was a significant problem in the Rotorua region, as it was across all of New Zealand.
"As a community, we need a multi-levelled approach that works across all sectors to support individual, community and environmental needs.
"Interventions focusing on healthy eating and physical activity are extremely important to encourage healthier lifestyles."
She said Sport BOP was disappointed to have lost the funding for its Family Lifestyle Coach programme, which worked with referred children who were overweight and their families.
"Sport BOP think the conclusion of this service has left a gap in available interventions for those children identified as morbidly obese who require intensive regular sessions together with their whanau to ensure they adopt healthier lifestyles.
"Sport BOP are working with a group of health professionals from the Lakes DHB region to consider and address the future needs," she said.
Western Heights Primary School principal Brent Griffin said he thought the figures sounded accurate.
"It's a real issue and I don't know how we change it. I think the schools are doing a good job, but I don't believe it's enough for the overall issue. Families can only afford what they can afford.
"We are a bronze medallist in the Health Promoting School programme which is about being sun smart and being healthy.
"All children have three sessions with a specialist P.E teacher every week. Once a week we have a thing called 'let's get moving' which they do on top of P.E.
"We also have a fruit in schools programme where we have a delivery of really good fruit on a Monday and a Wednesday.
"We have a mother who comes in to make homemade meals for the kids during the day, this means we can get rid of pies and hot dogs and sugary drinks."
But Lynmore Primary School principal Lorraine Taylor said her school was in a fortunate position and didn't have many obese children.
"Our parents are very educated in what they should be giving their kids.
"We have a really strong fitness programme going. It's about keeping the kids active.
"We are investigating a water only policy at the moment, which will help, that will hopefully come into play next year."
• Sugary drink-free policies and healthy food initiatives led by schools, early childhood education centres, councils and workplaces.
• Food product reformulation that progressively reduces sugar content.
• Policies that increase availability and affordability of fresh and whole foods.
• Council planning to reduce children's exposure to unhealthy food (such as the high density of fast-food outlets and dairies that often seem to surround schools).
• Regulation of the marketing of unhealthy food and drink products so children can experience childhood free from the commercial interests of the food and beverage industry.
• A focus on investment in healthy pregnancies, the first nutritional environment that children experience.
Source: Medical officer of health Dr Neil de Wet