Published 8 August 2008, doi:10.1136/bmj.a1238
Cite this as: BMJ 2008;337:a1238

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Small Australian town is model for community campaigns against obesity

¹ Melbourne

The small town of Colac in rural Australia is attracting national and international attention for its approach to fighting childhood obesity, and reducing health inequalities.

Two hours west of Melbourne, with 11 000 inhabitants, Colac is the site of a long term community-wide campaign called Be Active Eat Well, funded by the state government of Victoria.

Click on image to view video Colac, a small Australian town, is attracting national and international attention for its approach to fighting childhood obesity, and reducing health inequalities. Ray Moynihan talks to some of the architects of and participants in the programme

 
The campaign aims to build the community’s capacity to fight childhood obesity, and its action plan was designed and implemented by local organisations, including schools; parents; and local health, housing, and government services.

Key strategies include transforming canteen menus, introducing daily fruit, reducing television watching, and increasing activities after school.

In the first three years of the campaign children in Colac had significantly lower weight (about 1 kg) and smaller waist (about 3 cm) compared with children in a nearby control area. (International Journal of Obesity 2008;32:1060-7, doi: 10.1038/ijo.2008.79).

"At a population level this is very significant," said Boyd Swinburn, senior author on the evaluation, professor of population health, and founder of the World Health Organization collaborating centre for obesity prevention at Deakin University in Australia. "It wasn’t enough to reverse the increase in obesity levels that’s occurring with age and time, but it was enough to slow it down."

In what the authors describe as a world first, the community based obesity prevention campaign seemed to reduce health inequalities, not increase them. In Colac changes in weight and other measures were not related to children’s socioeconomic status, whereas in the comparison group the more disadvantaged children experienced greater unhealthy weight gain.

A recent Cochrane review of strategies for preventing obesity paints a negative picture of the current state of the literature, finding "many diet and exercise interventions . . . are not effective." However the reviewers also note that there is a positive trend for newer interventions "to involve their respective communities and to include evaluations" (Cochrane Database Syst Rev 2005;(3):CD001871, doi: 10.1002/14651858.CD001871.pub2).

Be Active Eat Well has now been introduced in five different communities in Victoria to help build the evidence base for this approach. It is also being debated as a potential model for community based interventions, as Australia develops a national prevention strategy, a priority of the incoming federal government of prime minister Kevin Rudd.

Cite this as: BMJ 2008;337:a1238

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