A third of the rural population reported psychological distress, with the highest prevalence observed in middle-aged men and women. Thus, health professionals should attend not only to physical health, but also to mental health status in this age group. It is also important to target prevention strategies at the 20% who reported moderate levels of psychological distress in order to prevent the development of more serious conditions.

Objective: To measure the prevalence of overweight, obesity and the metabolic syndrome (MetS) in rural Australia. Design, setting and participants: Cross‐sectional surveys were conducted in two rural areas in Victoria and South Australia in 2004–2005. A stratified random sample of men and women aged 25–74 years was selected from the electoral roll. Data were collected by a self‐administered questionnaire, physical measurements and laboratory tests. Main outcome measures: Prevalence of overweight and obesity, as defined by body mass index (BMI) and waist circumference; prevalence of MetS and its components. Results: Data on 806 participants (383 men and 423 women) were analysed. Based on BMI, the prevalence of overweight and obesity combined was 74.1% (95% CI, 69.7%–78.5%) in men and 64.1% (95% CI, 59.5%–68.7%) in women. Based on waist circumference, the prevalence of overweight and obesity was higher in women (72.4%; 95% CI, 68.1%–76.7%) than men (61.9%; 95% CI, 57.0%–66.8%). The overall prevalence of obesity was 30.0% (95% CI, 26.8%–33.2%) based on BMI (≥ 30.0 kg/m2) and 44.7% (95% CI, 41.2%–48.1%) based on waist circumference (≥ 102 cm [men] and ≥ 88 cm [women]). The prevalence of MetS as defined by the US National Cholesterol Education Program Adult Treatment Panel III 2005 criteria was 27.1% (95% CI, 22.7%–31.6%) in men and 28.3% (95% CI, 24.0%–32.6%) in women; based on International Diabetes Federation criteria, prevalences for men and women were 33.7% (95% CI, 29.0%–38.5%) and 30.1% (95% CI, 25.7%–34.5%), respectively. Prevalences of MetS, central (abdominal) obesity, hyperglycaemia, hypertension and hypertriglyceridaemia increased with age. Conclusions: In rural Australia, prevalences of MetS, overweight and obesity are very high. Urgent population‐wide action is required to tackle the problem.