When you realise what is happening, the implications are quite alarming. Between 1985 and 1997 the number of children and adolescents who were overweight or obese doubled.

But what about between 1997 and 2004? It is too early to know for sure as the figures are not yet in, but it is probably around 30-33% overweight or obese. Unless something changes it is likely to be around 50% of 2-17 year olds by 2020 according to Dr Michael Booth, co-director of the NSW Centre for Overweight and Obesity, University of Sydney. He was addressing the Preventing Obesity in Children and Youth planning day run by the Northern Rivers Area Health Service in Byron Bay in May (2004).

So does it really matter if being overweight becomes the norm for children and adolescents? Unfortunately from a health perspective it certainly does. Not only are there psychosocial implications of being overweight, there are breathing problems including sleep apnoea and asthma, orthopoedic problems such as flat feet and gait abnormalities, as well as type 2 diabetes and heart disease.

This is a serious epidemic that won't be solved easily and it will take many years and a concerted effort by government, health and town planning authorities as well as individuals to make a difference. Commercial forces and progress have made our world increasingly obesogenic. Societal and environmental changes will be needed to entice us to move more, eat less food and change certain behaviours. This is not just an issue for health workers, it is an issue for everyone.

Examples of what needs to change are"

• less hours in front of TV and computers,
• no TV junk food advertising during children's viewing hours,
• better controls of food sold through school canteens,
• removal of soft drink vending machines from schools,
• banning of junk food company sponsorship in schools,
• more encouragement of participation in sport at grassroots rather than at elite levels (including addressing the cost barrier for families particularly in the light of escalating sports club public liability insurance premiums),
• more involvement of families in proper meal times at the table versus in front of TV,
• more outdoor activities and use of public transport, footpaths and bicycles rather than cars by everyone,
• better nutrition in pregnancy, and
• encouragement of longer term breast feeding for infants.