Cape Town - Tax on hamburgers, chips, chocolates, sodas and other unhealthy foods should be introduced to help overcome South Africa's ever-growing obesity problem.
And if junk food adverts were not banned, they should carry health warnings and should only be shown on TV at certain times of the day.
The revenue raised from this should go to fund educational programmes that teach young people the benefits of healthy eating as well as towards a concerted media campaign.
That is the opinion of South Africa's foremost authority on obesity: Professor Tessa van der Merwe from the International Society for the Study of Obesity and head of the country's first specialised centre for obesity in Pretoria.
When France imposed a similar tax on the sale of sweet alcoholic drinks, consumption dropped off by 40% in the first year.
"Just as they did with cigarettes"
"When the government was worried about cigarettes, it banned smoking in public places," she said.
"Obesity is a major problem with 45% of South Africans carrying too much weight.
"We need the government to legislate against unhealthy fast foods and sugary soft drinks - just as they did with cigarettes. Marketing to children should also be limited. I am continually amazed at how advertisers are allowed to advertise foods laden with fats and kilojoules - foods that are killing us!
"Let the government show its commitment to us through legislation and by imposing higher taxes on unhealthy fast foods. They should also tighten nutritional labelling on foods.
Van der Merwe was addressing 500 doctors, specialists, surgeons and physicians at the SA Gastroenterology Congress in Port Elizabeth last week. The experts gathered to focus on the causes, treatment as well as on the scientific and public awareness of obesity, classified as a disease since 1997.
"Can't let the matter slide"
"Ten years ago, HIV/Aids was in the same position as obesity is today," she said.
"For the sake of the country's future, we can't let the matter of obesity slide like we did with Aids. Already nearly half of us over the age of 15 are overweight. The government might soon have to move in to manage the epidemic and its most important consequence, namely diabetes."
She aims to make the public aware that morbidly obese people need medical help to lose weight and keep it off.
Better control at school level
Van der Merwe also feels that the government should take control of the obesity situation at school level. She feels that advice on correct eating and physical training should form part of the curriculum.
"With our childhood obesity problem, it is hard to believe that schools allow vending machines with crisps, chocolates and fizzy drinks and a tuck shop with other unhealthy choices."
She said she understood the motive of the school was to make a profit - and that unhealthy hamburgers and hotdogs brought in money - but that it was at the expense of the nation's health.
The country's obesity rate has exploded, because many rural people have drifted to the cities and have adopted western eating habits. Fast-food outlets have sprung up and people are eating more energy-dense food and drinking liquid-based sugar, while decreasing their exercise levels to watch TV or work on computers.
"We need the government to intervene as it did with the anti-smoking campaign. The soft-drink and fast-food companies are doing exactly what the tobacco industry did - targeting the developing world."
In the United States, the average person ingests 80kg of sugar per year, while in Kenya the figure is just 4kg. In developing countries sweet soft drinks are directly driving the obesity epidemic.
"Huge cost to the country"
"Obesity, with its related diseases, is a huge cost to the country," Van der Merwe said. "If the government invests in youth education about healthy eating, it will not only be improving the quality of life for many, but it will be saving on health bills. Prevention is better than cure."
Van der Merwe, an endocrinologist, is head of South Africa's first Bariatric Centre of Excellence, the country's leading facility for the treatment of obesity by a team of professionals.
Under her leadership, a similar centre has opened in Cape Town and this will be followed by centres in Johannesburg, Bloemfontein and Pietermaritzburg. The aim is to establish 12 centres across the country.
Van der Merwe is also head of the SA Society for the Study of Obesity. The Society's helpline is 086 110 2011
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