Obesity is the primary cause of heart diseases and Type 2 diabetes. More than 4500 people die every year from heart diseases, the second largest cause of death in New Zealand.
Type 2 Diabetes causes 900 deaths a year and 1000 amputations.
We have an epidemic; over 30 per cent of us are obese and a further 35 per cent overweight; the third highest rate of obesity in the OECD.
Life in New Zealand was sedate until the mid-1980s, one that shut down for leisurely weekends.
We exported a lot but imported little. We were meat and three veg people. Beef or lamb with potatoes and carrot, cauliflower or cabbages. Our only indulgences were cheese and beer, perhaps ice cream. Cooking at home was the norm.
From the mid-1980s, it was a perfect storm for obesity. The economy opened up, and imports flooded in. GST of 10 per cent and removal of farm subsidies made healthy local food more expensive.
Massive layoffs increased poverty, which worsened when welfare benefits were slashed in 1991.
As lifestyles got hectic, we turned to convenience. The number of takeaways, fast food outlets, and restaurants increased dramatically. The food industry discovered higher profit margins in mass-produced processed food, which were cheaper but less healthy.
Changes in diets and lifestyles showed up in our waistlines and weighing scales. Obesity rose from 10 per cent in the late 1970s to 31 per cent today, a rate almost three times that of Italy and Switzerland.
Our health spending on obesity is approximately $1.6 billion a year. And the total economic cost, including lost income, taxes etc, is twice that. The cost is projected to increase exponentially due to an ageing population, increase among younger people, rising prevalence of diabetes, etc.
Poverty and the closely linked food insecurity are key drivers of obesity.
People on low incomes turn to cheaper, unhealthy food out of necessity. Obesity is two times higher in the most deprived areas compared to the most affluent. It is passed down the generations; 40 per cent of children are likely to inherit obesity, it's as high as 70 per cent for low-income families.
Adult obesity is higher among Māori and Pasifika; 63 per cent of Pasifika and 48 per cent of Maori are obese. Disparities in child obesity are even starker – the rate for Pasifika children is four times that of Pākehā.
A survey in 2016 found nearly 20 per cent of children lived in households with moderate to severe food insecurity; an estimated 7 per cent lived with severe food security - missing meals and going without food for a day. Parents often go without food to feed their children.
This is in an affluent country where we produce sufficient food for 40 million people.
The situation is probably worse now due to Covid-19 and rising rents. Food insecurity is caused by not just a lack of money. It's also a lack of time (working long hours, two jobs), lack of knowledge, storage, etc.
Ultra-processed food - confectioneries, pastries, ice cream, ready to eat meals, pizza, sausages, burgers, all carbonated drinks, etc - have rocketed in volume over the past 40 years. They now comprise 50 per cent of the dietary calories in the developed world, probably the most significant cause of rising obesity.
A diet heavy with processed food costs about a third less than nutritious food.
Takeaways, fast food and restaurant meals are the other main reason for the rise in obesity. We tend to eat larger quantities at a sitting than home-cooked food; these are typically less healthy. The more deprived areas have more fast-food outlets.
The move to start providing meals in low-decile schools is a step in the right direction. A Green Prescription programme helps people with obesity shift to healthier food and an active lifestyle.
This is a public health issue, not to be blamed just on our choices or, worse, lack of willpower. The environment and genetics play a significant role.
We are exposed to advertising with high frequency on multiple platforms for unhealthy food and drinks. It is worse when children are targeted.
We lag behind many countries. The UK, for example, has a National Obesity
Strategy and legislation in progress on issues like banning advertising before 9pm and a
"Better Health" campaign with significant media spending. A sugar tax on soft drinks since 2018 has reduced sugar levels in standard soft drinks by 11 per cent and shifted consumption to low-sugar drinks.
In New Zealand, the government has been reluctant to legislate and tax due to optics and politics, relying on voluntary guidelines instead. It's not working.
A Food Industry Taskforce convened in 2018 made a suite of recommendations. Since then, the task force has been disbanded; the ministry is not tracking its progress currently.
It is high time for individuals, families and the government to take this issue seriously; it's causing human suffering and loss of lives, costing billions.
The longer we wait, the worse it gets.
• Kushlan Sugathapala is a researcher and writer on social justice issues.