In our health region (South West Sydney), we have the second highest childhood overweight and obesity rate in the state, almost six percent above the state average of 22.4 percent.

The NSW government has nominated our health service as a priority focus area from July 2016. The service has launched Growing Healthy Kids in South Western Sydney action plan.

Twenty percent of Australian adults are obese with a BMI of 30 or higher. There has been tenfold increase in obesity in four decades. We live in an obesogenic environment with ready availability of cheap, high calorie foods and drinks, lack of walking, cycling and recreational infrastructure and the overuse of the motor car for each and every trip.

 A recent definitive article by Dr Seema Mihrshahi recommended the following strategies:

1. Integrated action to prevent obesity

"In terms of obesity prevention, there needs to be integrated action from preconception, through pregnancy and early childhood, and across the age and developmental spectrum."

2. Fiscal policies to reduce consumption of sugar-sweetened beverages, including a 20 percent tax on sugar-sweetened beverages to reduce purchasing and consumption.

3. Regulate unhealthy food marketing to children

"Limiting the exposure of children to the marketing of energy-dense, nutrient-poor foods has been identified as a highly cost-effective strategy, potentially saving an estimated $38 for every $1 invested."

4. Public transport policies that promote active transport.

The lack of cycle and walking paths in the Southern Highlands mean that most schoolchildren are unable to ride or walk to school safely.

More than two in three Australian children and teenagers are being driven to school.

More than 50 per cent of parents believed it was important that children be able to walk to school without an adult, but fewer than one-third believed it was safe for them to do so.

5. Urban planning approaches to support active communities

We need more neighbourhood park and playground access and availability and active commuting. More skate parks, indoor recreation facilities, indoor cricket, basketball, netball and soccer facilities would make a difference especially in the colder winter months.

6. Treat children and adolescents with established obesity more effectively.

Southwest Sydney health services are tackling this problem with an integrated multitiered response.

Locally the the BDCU Children's Foundation have very generously funded a part-time position of a weight management nurse working in close collaboration with Bowral Hospital paediatricians to provide integrated management for children and adolescents identified as seriously overweight.

7. Coordinate health care pathways in each health region

"We need to link primary care through to tertiary care services, including bariatric surgery for older adolescents with more severe obesity,"

Weight loss is achieved 80 percent by diet and 20 percent by exercise. It's never too early to deal and look at weight management of any age.

The grim reality is this - with no intervention, children who are overweight or obese are likely to remain that way into adulthood and more likely to develop chronic diseases.

All layers of government from local councils to state to federal need to take this massive problem very seriously. If our population continues to gain weight at this rate Australia will be faced with a huge future burden of obesity-related illnesses in the adult population including type two diabetes, heart disease, strokes and joint problems.