New Zealand Battles Obesity Epidemic As Third Fattest Country In The World

Country ranks third behind US and Mexico for worldwide rates of obesity in its population. Health professionals are calling for increased government regulation of the food and beverage industry.

 Nearly one in three New Zealanders are now categorised as obese Photograph: Dominic Lipinski/PA

Weighing in at over 120kg Neil Coleman’s goal to retire and enjoy travelling around New Zealand was unlikely. 

The long-term foodie, school counsellor and writer was only in his early 60s but suffered from diabetes, high blood pressure, sleep apnoea and relied on a continuous positive airways pressure machine to keep breathing.

“The doctor was clear, he told me I would not be collecting my pension at 65,” he said.

Coleman decided to take drastic measures. He underwent a gastric bypass which he paid NZ$18,000 for because he didn’t qualify for state help.

Two years later, as he prepares to retire, he weighs about 77kg. He is healthy.

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 Neil Coleman, who had a stomach stapling operation in New Zealand, before and after the procedure. Photograph: Composite made from collect images.

But this is not the case for a growing proportion of his country.

A recent national health survey shows nearly one in three of the population are overweight.Figures recently released show New Zealand is suffering what has been called an obesity epidemic.

The small island nation is now in the top three fattest countries behind the US and Mexico, where 36.5% and 32% respectively of the population are obese. New Zealand’s rate is just below 29%.

Figures show one in 10 children between two and 14 years – 79,000 children – qualify for that description.

Rates of obesity are highest in the 45-65 age group and the figures among New Zealand’s Maori and Pasifika population peaked at 46% and 67% respectively.

The survey says excess weight is a leading cause of a number of health conditions, including type 2 diabetes, cardiovascular diseases and some types of cancer.

The news has shocked the nation and has led to health professionals calling for increased government regulation of the food and drinks industry and increased spending.

A New Zealand Medical Association report calls the soaring obesity rates a “public health crisis”.

The report urges new ways to tackle the problem including minimum prices on sugary drinks, restricting food advertising aimed at children and taking fast food out of schools.

It goes on to say self-regulation of the food industry is not working. “A prevailing ideology of individual responsibility and vested commercial interests have combined to thwart, dilute and undermine previous attempts at effective polities to counter the challenge of obesity,” the report says.

Those are sentiments are backed up in a report in the Lancet which says tough new controls must be introduced worldwide to stop commercial companies marketing unhealthy foods and drinks which make children overweight.

Bariatric surgeon Steven Kelly says that in his region – Canterbury – there were 350 referrals for common sleeve gastrectomies and gastric bypasses like Coleman’s but only 22 operations were performed.

He is calling on the government to provide more of these life-saving operations for the morbidly obese.

He admits the surgery is not a blanket solution for nationwide obesity but believes the surgery would pay for itself within a few years in terms of saving on treatment for related health problems.

Last year 400 bariatric surgeries were funded by the taxpayer, up from 350 in 2011. Another 400 stomach surgeries were carried out by the private sector.

The Ministry of Health figures show in 2011 $8m was allocated over four years for an additional 300 bariatric surgery procedures and last year the government directed another $10m of funding for another 480 procedures over four years.

According to Kelly this still isn’t enough, he says the funding should be at least doubled because the obesity epidemic will eventually cripple New Zealand’s health sector and have a major cost to society if it isn’t dealt with now.

He also supports a “traffic light” system on food, banning advertising unhealthy food to children and educating and promoting healthy food and taxing high-calorie foods.

“We all know the government is not going to do these things basically because they will lose voters. What it comes down to is how bad does the obesity epidemic have to get before the government will actually act?” he says.

A Ministry of Health spokesman, Kevin McCarthy, says a singular focus on stomach surgery for weight loss isn’t suitable. “Obesity is a complex problem that requires a multifaceted response,” he says.

New Zealand’s health Minister, Jonathan Coleman, has not made any announcements on where money would be spent by the government but says its focus would be on preventing obesity rather than trying to keep up with the demand for weight-loss surgery.

He says there is no single solution to fix obesity.

“One of my first actions as minister of health, sport and recreation has been to ask health and sport officials to summarise existing government action in this area as well as the international evidence for possible interventions,” he says.

The call for regulation of the food and beverage industry is growing as convenience food prices drop lower than healthier food items.

University of Auckland’s nutrition and global health professor, Boyd Swinburn, says wider-reaching regulation is needed.

“None of the major policies recommended by experts such as the World Health Organisation have been implemented. We’ve had a couple of terms of a government that has really done nothing about obesity,” he says.

Anne-Thea McGill, a senior lecturer in general practice and primary care at Auckland University, is leading a Ministry of Health-contracted programsupporting weight management in primary care in the Bay of Plenty.

She believes weight management through diet and exercise is still the best approach. And although stomach surgery is more of a sticking-plaster solution there is a lot of evidence that it is cost effective.

According to Swinburn: “The problem is that if we were to offer it to all the eligible people in the country then it would send our health system broke – it’s cost-effective but not affordable.

“To have stomach surgery as your major plank in your obesity response seems inappropriate so it’s a tough position for a health minister to be in,” he said.

Coleman meanwhile doesn’t believe the government has been doing enough and is emotional when he talks about his weight loss as being life saving.

“Bad food is cheap in New Zealand and poor people are obese due to a lack of food knowledge,” he said. “They don’t have a lot of choice, there’s way too much processed fast food on the market.”

Source:- http://www.theguardian.com/world/2015/feb/19/new-zealand-battles-obesity-epidemic-as-third-fattest-country-in-the-world

Getting Back In The Game After Significant Weight-Loss

Where are you in the game of life? Are you out there on the field actively participating, or do you find yourself sitting in the stands watching, wishing you could be in the game too? For many of us, our obesity has been a roadblock to living our lives to the fullest for a very long time. Now that you have lost a significant amount of weight and are experiencing this life-changing transformation, consider extending the transformation process into all areas of your life!

Could it be we were embarrassed by our weight and chose to stay in the background? Maybe, it was due to obesity- related health issues that physically prevented us from participating.

You worked very hard to get to where you are! You deserve to reward yourself with the joy and personal fulfillment. Whatever it may be that has held you back, it is now time to let go of it, and move forward.

Learning to get back in the game of life after significant weight-loss is not always easy. There are many factors that can negatively affect our ability to live fully and with satisfaction. But, we all have the choice to work through these obstacles and to enjoy the wonderful experiences that life offers.

So, What is Holding You back? 
For many of us, we continue to entertain our self limiting beliefs that we developed years ago. Our basic belief system is “programmed” by age six. These beliefs have become our way of viewing ourselves and where we belong or what we deserve in life. The problem is that many of our beliefs are inaccurate and unfair to us.

Self Image 
Self image is another big issue that can keep us from moving forward and embracing the life we truly desire. Many people, especially if they have been obese for all or most of their lives, still see themselves as that obese person, even though they may no longer be so.

Relationships 
The relationships we are in can also contribute to our inability to move forward. Some of the people that have a significant role in our lives can actually feel threatened by our weight-loss success. Spouses may fear we will want to move on to someone better, friends may feel that they are losing their connection with us as we adopt new lifestyle habits that were not a part of how we related with them in the past.

Some may be jealous of our success and resent our efforts to continue to improve our life. You may find that those who were once close to you distance themselves or try to sabotage your efforts due to the insecurity that your success creates for them. Other factors that can hold us back include self doubt, difficulty or inability to identify what we truly want in our lives and lack of direction in how to achieve these things we desire.

You Have the Power to Overcome Your Challenges 
You truly do have the power and ability to break through your barriers and embrace the life you have always wanted! You have already proven this to yourself. Look at how far you have come in your weight-loss. No, it wasn’t always easy to do what you had to do to achieve this, but YOU did it! You can do this too. Your decision to get back in the game of life can be put into action today.

As you begin to move forward and learn to embrace life and all it has to offer, you will find that some of the obstacles will take time, effort and sheer determination to overcome. Some will be easier to break through. As you progress, you will experience an awesome sense of personal empowerment. This empowerment will help you work through the more difficult challenges with more confidence and success.

Breaking through the Barriers 
The first and most critical aspect of learning to live life fully is being able to identify the barriers and challenges standing between you and how you want to experience life. Without having a clear idea of what it is that keeps you back, it will be impossible to make the changes that must be made to facilitate the achievement of your desires and goals.

To successfully identify what holds you back, you need to do some deep soul searching. You need to ask yourself what it truly is you want to experience and achieve. This may not be easy to do, as our self limiting beliefs can cause us to dismiss many of our goals and desires as being impossible to achieve, farfetched or even unrealistic. But the truth is they are likely very achievable and realistic, we just may not believe they can happen for us.

So, when you begin to explore what it is you truly want to experience, do not allow yourself to dismiss anything that comes to mind. Once you have completed your list of goals or things you would like to experience or achieve, it is time to take the next step.

Consider each goal with an open mind. Next to each goal, define what it is that you feel holds you back from attaining it. Every roadblock or barrier to your desired outcome, no matter how big or small it seems, should be included. Remember, identifying the obstacles is the primary key to enable you to begin the process of breaking through them.

The next step is to begin to identify ways in which you can conquer these barriers. Even if you begin with very small but positive actions and mindsets, write down everything for each challenge that you can do to begin moving toward successfully breaking through each barrier. As you begin to identify ways to accomplish this, it may be helpful to ask others that you trust for ideas they may have as well. It is important to allow yourself to think “outside the box” and be creative in this process.

Make it Work 
Once you have your basic list in place, it is time to begin to implement some of these new actions and mindsets. Do not try to tackle them all at once. It will be far too overwhelming. Start small and move forward as you feel ready. The process of incorporating these new thoughts and actions into your life may not feel comfortable at first. But as you continue to practice them, they will become easier to do. Eventually, they will become a new habit for you, and it will seem almost effortless.

If you find you are struggling with this process, there are places you can get support to assist you in successfully executing this process. You may consider:

• Seeking advice or suggestions from a support group you are involved with
• Seeking counseling if needed
• Asking trusted loved ones or friends to encourage and assist you
• Considering hiring a life coach that is knowledgeable and personally experienced in the issue of obesity and significant weight-loss

Key Actions for Getting back in the Game

Be Spontaneous!
When you are presented with an opportunity to enjoy yourself and experience the fun things in life, just do it. Do not evaluate it or try to think of all the reasons you should not or could not participate. Allow yourself to engage in it. Live fully in the moment. Give yourself permission to experience it. You ARE deserving of it!

Do Not Allow Others to Hold You back
There comes a time in our lives  when we must be true to ourselves. That time is now. If you have relationships with people that foster negativity and self doubt within you, you must not allow this to continue. This is not to say that you have to break off these relationships, but it may be time to set new ground rules and boundaries within these relationships.

It can be quite possible that some of these people that foster the negativity in us are not even aware they are doing so. So, now is the time to be open and honest with them. Make them aware of your position. Let them know what you need and expect from them and what you cannot accept. Those who truly care for you would want nothing less for you and will want to honor your request.

Recognize How Far You Have Come
Give yourself credit for all that you have achieved. Know that you are strong and worthy and have the power to continue to achieve all that you desire. Sure, you may have had some slip ups along the way, but who hasn’t? When you do slip up, don’t beat yourself up over it. Simply acknowledge it, accept responsibility for it and move forward, knowing that next time you have more awareness and have the opportunity to choose to do it differently.

Silence that Internal Naysayer
Just as with our relationships with others, we may need to set new boundaries and guidelines in our relationship with ourselves. Many who struggle with or have struggled with obesity have learned to view themselves in a negative light. Self doubt, poor self image and fear have become strong saboteurs in our ability to grow and incorporate new and positive changes into our lives. It is time to slay those demons. They no longer have a place in our lives.

Conclusion
As you begin this new leg of your journey, know that you must go outside of your comfort zone to reach new destinations. To experience what you never have, you must do what you have never done. Even the smallest steps into new and unexplored actions and opportunities will result in very powerful and positive results.

Source:- http://www.obesityaction.org/educational-resources/resource-articles-2/general-articles/getting-back-in-the-game-after-significant-weight-loss

Life After Extreme Weight Loss

Julia Kozerski lost half her weight in a year, but coming to terms with her new body was the real battle, as her self-portraits reveal

 Julia Kozerski: ‘I hate the skin. I don’t want to fill it back up.' Photograph: Julia Kozerski

The opening photo in Half, Julia Kozerski's series of naked self-portraits, is actually the bookend to a sequence of earlier photos. In those, she appeared unhappily in her wedding dress in a changing room cubicle, more than 300lb (21 stone) and mortified. Here, she appears in the dress again, standing sideways on to the camera, to show how much of the dress is unoccupied. Over the course of a year, Kozerski lost half her body weight, and you might expect the resulting photos to conform to the glib narrative of before and after. Instead, the 28-year-old took pains to show "what real is, what raw is" – in this case stretchmarks, skin folds, contours like sand dunes. Raw is Kozerski naked, and frequently crying.

Nudity is an overused gesture in photography, particularly when it purports to "celebrate" the "ordinary". You can't turn on the TV (Lena Dunham), go to a gallery (Spencer Tunick) or, if you're in San Francisco, enter a civic building these days without tripping over someone getting their kit off in the name of corporeal democracy. That Kozerski still manages to be shocking and interesting is testament to her ideas and her courage. The question most people ask on seeing the photos – after "Why don't you get surgery to remove the extra skin?" – is "How did you get the weight off?" which she thinks misses the point. Losing the weight was tough, she says: "I had no idea who I was, and while I went through all that I was lost." But what came after was tougher. Contrary to media everywhere, being thin isn't enough of an identity to go on. "This is it!" she thought, when she finally got her weight down, and then: "Now what do I do?"

We are in a coffee shop in Milwaukee, where Kozerski grew up and where, after finishing her degree in fine arts, she works in marketing. The photos, taken when she was at her most vulnerable, don't prepare one for how she is now. Kozerski could advertise the midwest: she is fresh-faced, ruddy-cheeked, brimming with enthusiasm. "Nothing fancy, I'm from Milwaukee!" she says cheerfully. She is a regular weight, she points out. Not model-thin, but the size that, after a lot of trial and error, she worked out she needed to be. When she decided to lose weight, she signed on instantly to the cult of perfectionism. She thought, "I'm going to be this amazing person, I'm going to be a model! And that's not what happened. It was a transition into something new; into learning to love myself as I turned out, as I was and as I am now."

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"Loving who she was" sounds like a dictum from therapy, which Kozerski didn't have. She didn't hire a personal trainer, or join a gym. The most remarkable thing about her year-long journey is that it wasn't assisted by exorbitant lifestyle aids. When I ask to whom did she outsource her motivation, she laughs and says, "No, no, no, no one." At least, no one beyond her husband, Tim, a mechanic who cheerled his wife from day one and was hugely understanding, even though "he can eat whatever he wants and nothing ever happens to his tiny little body".

Instead of paying someone to shout at her in her lunch hour, Kozerski walked the dogs. She exercised "portion control". She cut back on fizzy drinks. "I feel like it's a disappointment to people, they want some magic remedy and I don't have one." When things got really tough, she looked at those photos of herself trying on her wedding dress at the one shop in Milwaukee that carried her size. "It's humongous," she says. "And I still put it on. But these days my husband can fit into it with me."

Growing up, no one in Kozerski's household was thin. She is one of three girls and their parents worked hard, her father in sales, her mother as a librarian and teacher in the public school system. "There was a lot of frozen food after work, real quick. We drank a lot of soda. We didn't have specific meal times, so I'd be eating throughout the day. It catches up with you."

There is almost no period in her memory when Kozerski can't recall being sensitive about size. When she was in junior school, she avoided the girls and hung out with the boys. "The boys would accept me for who I was. I'd play sports with them, they didn't care what I looked like. But the girls were always into fashion, and I knew I couldn't do that."

Things got worse as she got older. Shopping was a nightmare, particularly for big events. For her prom, as for her wedding, she shopped alone, as quickly as possible, and bought the first thing that fitted. "I got the bare essentials and got out."

Kozerski's mother died in 2011 of diabetes. Her father has had a triple bypass. There are long-standing weight-related health issues in her family. Before her mother's death, Kozerski asked her why, when she saw her three daughters getting unhealthily large, she didn't say anything. "And she said, 'I never wanted you to be unhappy; I never wanted you to think that you had to be thin.' And I said, 'You know, I was unhealthy, I could have died, you should have said something.' And she said, 'I would rather us have a good relationship than have it strained by me telling you to diet.'"

Kozerski sighs. "It's not their fault; they didn't do it out of ill will. They were unhealthy, we were unhealthy, it was just our lifestyle."

It wasn't the wedding that triggered Kozerski's desire to change, although she anticipated the day with a certain amount of grim humour. She and Tim met when they were 15, in high school, and although the actual day of the wedding was wonderful, "I knew I was going to be the big girl bride with the skinny groom. And I knew what the pictures were going to look like. Reliving that is tough."

It was six months later, as she and Tim sat idly on the sofa eating cookies, that Kozerski suddenly had the urge to weigh herself. She got up and went to the bathroom. "And I saw 338lb. And I thought, 'Oh my gosh; if you think that a model is 100lb, all of a sudden I'm three people!' So I started freaking out. I thought I could die. I thought, 'What does it mean if I have children?' So I said, 'OK, I'm going to carry on eating cookies tonight and then tomorrow, I'll start.'"

 ‘I felt safe, with a little community of artists, that they would see it isn’t pornography.' Photograph: Julia Kozerski

A thousand resolutions like this are made every day, but Kozerski meant it. So alien was the concept of nutrition that the next day she sat at her computer and typed, "How to eat healthily" into Google. She devised methods of incentivisation, cleverly realising that small goals would be more effective than huge, unattainable ones. Instead of focusing on an end weight, she worked in increments of 10lb and no more. With each 10lb she knocked off, she gave herself tiny rewards; a CD she wanted, a movie.

The only weight-loss gadget she bought was an armband that measures how many calories you're burning against what you're eating. She rolls up her sleeve and shows me; Kozerski has burned 1,300 calories today. "I don't think you need this," she says, guiltily. "You can work it out for free on the internet. But I love it."

Having, for most of her life, treated her body as an enemy and tried to ignore it, she started to be sensitive to small fluctuations. "Like when it gets cold out, I don't lose weight as quickly. There are hormonal fluctuations. I just became very attuned to how I functioned. There were weeks when I gained, then lost, then stayed the same. I was beginning to understand my body."

She was also beginning, slowly, to understand that losing weight wouldn't automatically fix all her problems. Kozerski had always taken photos; her degree at the Milwaukee Institute of Art & Design had a photography component. As she documented her weight loss, starting with that horrifying moment on the scales, she realised that as her size went down, she still looked unhappy.

There was a lot of shame in her system. Part of the reason she wouldn't go to exercise classes or ask for help was that she didn't want to involve other people: "Because I felt like it was such a burden. And I also felt I did this to myself." She didn't want to be complimented either because, at that stage, she didn't feel she deserved it. "So people are saying, 'You look great!' And you don't feel great. You are in transition. You think, 'No, no, not yet.' It was never good enough."

At one stage, she went into overdrive and began over-exercising.

"There were times when I walked 20 miles a day and I would come back and say, 'OK, I just spent six hours walking. That's too much.' When you start counting calories, you want to push yourself, just 20,000 more steps, and it becomes addictive. And I stopped when I realised that. There was a picture I took in the changing room in a store and I look very unhappy. I was skinny, and I didn't feel well. My blood pressure was high and my face super-red." (She doesn't like the word skinny, particularly when her husband uses it. "Sometimes he'll say, 'You look skinny' and it really freaks me out. I don't mind the word fat – I wouldn't use it towards other people, but I do say it to myself. But the word skinny bothers me." It raises the spectre of comparison. "Like, are you comparing me to the old me, or to a model? It doesn't mean anything.")

The photo of Kozerski looking thin and unhappy is one she keeps on her phone as a useful reminder not to get any smaller. The naked photos act as its counterweight; a decisive gesture towards embracing "imperfection" and a desire not to eradicate all signs of her struggle. She's not so sentimental as to "love" the folds of skin. "I hate the skin." But it's a good visual reminder of how she once was and the choice she made not to be that way any more. When she looks at the skin, she thinks, "I don't want to fill it back up." With some effort, she says, "This is where I came from, it's the baggage to show I'm not trying to be a model. This is a real person. And I like having conversations about it. People say, 'Oh, I have stretchmarks after having a child.' It's not just about weight, it's about everyone."

She calls the photos "grotesquely beautiful", and they are. They are alienating in the best way, acting against the industrialised uniformity of most high-profile women. But, given that Kozerski is on the shy side, how on Earth did she get to the point of putting the images on the internet?

She laughs. As with the weight loss, she took baby steps. First, she took them into college and showed them to classmates. "I felt safe, with a little community of artists, that they would see it isn't pornography or exploitation. So I had that buffer."

Then she submitted the work to a gallery show in Colorado. The theme was food, and she sent a photo of herself naked and demoralised in front of the fridge. "And it won. And it got publicised all over. And then I thought, 'OK, this is it.' I didn't have a choice. It was out there."

For the first time, in Colorado, she started to talk to strangers about the psychology of size and her search for a happier way to be. "I just had the most wonderful conversations with people about the work and my experiences."

Since then, Kozerski has had a lot of exposure. There have been negative reactions, mostly from abusive male posters on websites. What do they write? "Superficial stuff, like 'She's still ugly.'" Kozerski shrugs. "People are brutal. It's out there."

Where does she think the anger comes from? "People are insecure about nudity. And it's not the nude people want to hang over their fireplace."

Mostly, however, she has encountered a huge wave of positive interest from people. (Her dad, she says, would prefer it if she was still taking photos of flowers like she did in high school. "But I think he's very proud of what I've done, especially with the health concerns. I'm improving my life.")

In one photo in the collection, Lovers' Embrace, she lies alongside Tim, her defender and champion. "I thought it might be too personal, and relate too much to me. But he's a symbol for all the people who have been supportive throughout."

She has, at the end of it all, come up with something like a theory of happiness. It rests on two things: to allow for the possibility of failure and "to disconnect from comparing yourself to other people. To figure out who you are."

How do you do that when the entire world turns on comparisons?

"Well," Kozerski says, "when I look at a picture of a model, I go, 'OK, she's pretty. But she's not me, she's not working my job, she's not married to my husband, she's not living in my house.' So," she smiles at her luck, "it doesn't matter."

Source:- http://www.theguardian.com/lifeandstyle/2012/dec/07/life-after-extreme-weight-loss