National Obesity Strategy 2022–2032

Objectives

The National Obesity Strategy 2022–2032 provides a 10-year national framework to reduce the health, wellbeing and economic burden of overweight and obesity, including associated deaths, hospitalisations and disease burden. Its vision is an Australia that encourages and enables healthy weight and healthy living for all, and its overarching goal is for more people to maintain a healthy weight.[1][2]

• Achieve population targets by halting and reversing the rise in adult obesity by 2030 and reducing overweight and obesity among children and adolescents aged 2–17 years by at least 5% by 2030.[1][3]
• Improve diet by increasing average consumption of fruit and vegetables to two and five serves respectively for adults and children aged nine years and over by 2030, reducing energy intake from discretionary foods from more than 30% to less than 20%, and increasing adherence to recommended free-sugar intake.[2][3]
• Increase activity and reduce sedentary behaviour, including reducing insufficient physical activity among children, adolescents and adults, and the proportion of people aged 15 years and over undertaking no physical activity, by at least 15% by 2030.[2][4]
• Support early-life health by targeting exclusive breastfeeding for at least 50% of babies until around six months of age by 2025, and by prioritising prevention from pregnancy and the first 1,000 days through adolescence and young adulthood.[3][5]

The Strategy is organised around three ambitions: create supportive, sustainable and healthy environments; empower people with knowledge, skills and connections for healthy eating and physical activity; and ensure access to early intervention and supportive healthcare. It treats obesity as shaped by biological, psychological, social, cultural, physical, political, economic and commercial factors rather than individual responsibility alone.[1][6][7]

• Build healthier food systems by improving production, distribution, affordability and access to nutritious food; supporting reformulation; improving nutrition labelling; and reducing unhealthy food and drink marketing, promotion and sponsorship, particularly to children.[8][9][10]
• Create activity-supportive environments through connected, safe and accessible public spaces, active travel, public transport, sport, recreation and opportunities to reduce barriers related to cost, safety and access.[11][12]
• Strengthen healthy settings by supporting schools, early childhood education and care, workplaces, government institutions, community organisations and care services to improve food provision, physical activity and wellbeing.[13][14][15]
• Empower people, families and communities through health, food and physical literacy; evidence-informed social marketing; family support; culturally safe communications; and community-led initiatives.[15][16][17]
• Provide prevention, early identification, weight management and evidence-based behavioural, medical and surgical care through equitable, respectful and culturally responsive health services.[18][19][20]

Equity is a core principle. Universal measures are intended to benefit all Australians, while targeted and co-designed action should respond to avoidable inequities affecting priority populations, including Aboriginal and Torres Strait Islander peoples, culturally and linguistically diverse communities, people living with obesity, people with mental illness, LGBTIQA+ communities and people experiencing socioeconomic disadvantage. The Strategy also seeks to reduce weight stigma and discrimination, address wider determinants of health and support environmental sustainability.[5][21][22]

Implementation

Implementation is framed as a sustained, whole-of-government and cross-sector responsibility shared by Australian, state, territory and local governments, communities, community-controlled organisations, non-government organisations, businesses, researchers, professional associations, families and individuals. Delivery should combine population-wide environmental and policy change with targeted, flexible support proportionate to disadvantage, and should be developed with affected communities to promote cultural responsiveness, self-determination and avoid unintended stigma.[23][24][25][26]

• Lead through collaborative government action and enduring partnerships across health, social services, education, employment, housing, transport, infrastructure, agriculture, food, retail, trade, finance and environmental sectors.[24][27][4]
• Establish joint priorities and action agreements between Australian, state and territory governments within the first six months, while allowing jurisdictions to determine context-specific action portfolios.[28][29]
• Oversee implementation through a cross-jurisdictional mechanism linked to the National Health Reform Agreement prevention and wellbeing stream, National Federation Reform Council structures and the National Preventive Health Strategy independent governance mechanism.[29][30]
• Embed prevention, sensitive discussion of weight, early identification, routine monitoring, person-centred advice and referral pathways in primary care, maternity and child health, Aboriginal and Torres Strait Islander health, aged care, chronic disease management and other routine services.[18][31]
• Strengthen workforce capacity through pre-service education, continuing professional development, practical guidance and professional standards on obesity, culturally safe practice, shared decision-making and non-judgemental communication.[31][20][25]
• Improve access to integrated care, local and specialist services, digital health tools, telehealth, psychosocial and peer support, and proven interventions including medicines, very low-calorie diets and bariatric surgery where appropriate.[31][19][20]

Three implementation enablers are leadership, effective use of evidence and data, and sustained investment in prevention, treatment and workforce capacity. Action selection should use a balanced portfolio of policy, legislation, regulation, incentives, services, education, communications and community development, assessed for effectiveness, cost-effectiveness, equity, cost, acceptability, timing, uncertainty and sustainability.[1][4][29]

Evidence and data systems should support coordinated policy, investment and accountability. Priorities include nationally comparable surveillance of weight status, diet, food security, health literacy, physical activity, environments, food-system change and wider determinants, with appropriate coverage of priority populations and life stages. Communities, particularly Aboriginal and Torres Strait Islander peoples, should influence data collection, use and ownership through culturally appropriate research and data sovereignty approaches.[32][28]

• Establish nationally agreed indicators and measures for overweight and obesity, including wider social and environmental determinants, through National Preventive Health Strategy implementation.[4][3][33]
• Monitor progress using the Australian Institute of Health and Welfare framework, nationally agreed indicators and 2017–18 population data as the baseline for children aged 2–17 years and adults aged 18 years and over.[30]
• Evaluate innovative actions to address evidence gaps, assess implementation, outcomes, scalability and economic impacts, and share lessons across sectors and jurisdictions.[4][32][28]
• Publish independent mid-term and end-point reviews to assess implementation, collective impact and lessons for future action.[29]

Financing is recognised as necessary but is not presented as a dedicated costed programme budget. The Strategy calls for appropriate and sustained investment, explores new prevention funding mechanisms with an ambition to reach 5% of total health expenditure for preventive health, and proposes consideration of health-system payment models, including Medicare Benefits Schedule rebates and alternatives under the National Health Reform Agreement.[4][28]

Monitoring & Evaluation

The Strategy sets national outcome targets to halt and reverse the rise in adult obesity by 2030 and reduce overweight and obesity among children and adolescents aged 2–17 years by at least 5% by 2030.[1][2]It also frames these targets as aspirational and dependent on sustained action across society.[1]

• Monitor dietary targets, including average consumption of two serves of fruit and five serves of vegetables daily for adults and children aged nine years and over by 2030; reduce discretionary foods from more than 30% to less than 20% of energy intake; and increase compliance with recommended free-sugar intake.[3]
• Track exclusive breastfeeding, with a target for at least 50% of babies to be exclusively breastfed until around six months by 2025.[3]
• Reduce insufficient physical activity among children, adolescents and adults by at least 15% by 2030, and reduce the proportion of people aged 15 years and over undertaking no physical activity by at least 15%.[2][4]
• Use the Australian Institute of Health and Welfare framework for monitoring overweight and obesity and relevant National Preventive Health Strategy indicators to track obesity prevalence, diet, physical activity, sedentary behaviour, breastfeeding, environmental influences, health-care access, inequalities and social determinants.[2][30][3]
• Establish nationally agreed indicators, definitions and measures for the wider social and environmental determinants of overweight and obesity, alongside standard approaches to data creation, access and sharing across Australian governments.[4][30][33]

Monitoring is intended to use reliable, timely and comparable surveillance data across priority population groups and critical life stages, including child growth monitoring and adult weight-status measurement.[32]Relevant sources include the Australian Bureau of Statistics National Health Survey, planned approximately every three years, and the National Nutrition and Physical Activity Survey, anticipated to be completed again in 2023 through the Intergenerational Health and Mental Health Study.[32]The Australian Institute of Health and Welfare is expected to report regularly against targets using available and newly agreed indicators, with 2017–18 national data for children aged 2–17 years and adults aged 18 years and over serving as the baseline.[30]

Evaluation should assess implementation, outcomes, scalability and economic impacts, particularly for innovative actions intended to address Australian evidence gaps.[4][32]Community-led action is expected to include local leadership in planning, design, implementation and evaluation, particularly for Aboriginal and Torres Strait Islander communities.[17]Evaluation and communications testing should also consider equity, weight stigma and discrimination, wider determinants, sustainability and potential unintended effects.[21][22]

Accountability is shared between Australian, state and territory governments, with supporting roles for local government, non-government organisations, businesses and community organisations.[29]Implementation oversight is to operate through a cross-jurisdictional governance mechanism linked to the National Health Reform Agreement prevention and wellbeing stream, National Federation Reform Council structures and the National Preventive Health Strategy independent governance mechanism.[29][30]National reporting is to align with the proposed National Health Reform Agreement prevention monitoring and reporting framework.[29]An independent mid-term review and independent end-point review are planned, with both to be publicly available.[29]

Costing & Financing

The Strategy identifies sustained and appropriate investment in prevention, treatment, workforce capacity, evidence and data systems as a core delivery enabler, but the supplied material does not set an overall programme budget, funding allocation, funding gap or detailed costed implementation plan.[4][34][28]

• Recognise the estimated 2018 cost of obesity in Australia as 11.8 billion Australian dollars, including 6.4 billion Australian dollars in indirect community costs and 5.4 billion Australian dollars in direct health costs.[6]
• Note the estimate that obesity could cost 87.7 billion Australian dollars over 10 years without action, and that each Australian pays an additional 678 Australian dollars annually in taxes to cover obesity-related costs.[6]
• Use the reported estimate of up to 6 returned for every 1 invested in obesity prevention as the stated economic case for prevention investment.[24]
• Explore sustainable prevention funding through National Preventive Health Strategy processes, aiming for preventive health to reach 5% of total health expenditure.[28]
• Explore funding and payment mechanisms for primary and public health services to identify and manage overweight and obesity, including Medicare Benefits Schedule rebates and alternative models under the National Health Reform Agreement.[28]
• Consider cost and cost-effectiveness, alongside equity, acceptability, timing, uncertainty and sustainability, when selecting jurisdictional action portfolios.[29]

The financing approach also identifies potential economic-policy levers, including subsidies, incentives, taxation, food-pricing measures and investment changes that may support healthy eating, active living and prevention.[35][28]The source does not specify whether these measures will be adopted, their fiscal scale, financing source, implementation timetable or expected revenue.[35][28]

Reported economic context includes higher prices for healthier foods in regional, rural and remote areas, substantial household spending on unhealthy food and drinks, and financial barriers to sport and physical activity.[35][12]Lower-income households may spend up to 40% of income on food, compared with 12% in the general population, while 22% of Aboriginal and Torres Strait Islander households report food insecurity.[36]These figures describe the economic context rather than allocated Strategy funding.[35][36]