Obesity: more patients and fewer services in the South, here is the map of inequalities
In Italia 160 treatment centres, more than half are in the North. Buscemi (Sio): therapy a privilege for the few with costs of 300 euros a month and no reimbursability
Key points
Obesity patients also have to contend with a map of inequalities and the obvious contradiction that the Italian regions with the highest obesity rates, those in the South, are those with the fewest facilities and, above all, the greatest barriers to accessing treatment. Of the 160 obesity centres operating in Italy, in fact, 52% are in the North, 18% in Central Italy and 30% in the South and Islands, mainly concentrated in only three regions: Sicily, Campania and Apulia. Entire regions, such as Calabria and Molise, remain grey areas in the national treatment system.
The Erice Manifesto will be presented in the Senate
The imbalance, emphasises the Italian Obesity Society (SIO), ahead of World Obesity Day on 4 March, is also reflected in the use of new drug therapies and the approval of regional PDTAs (Diagnostic Therapeutic Treatment Pathways). In the absence of a diagnosis of diabetes, the new anti-obesity drugs, so-called GLP-1 receptor agonists, are paid for by patients. Since the cost is around EUR 300 per month, access is more likely with higher incomes. While only 6 Italian regions have approved PDTAs, instruments that guarantee patients with obesity the same quality care throughout the region, and 3 are in the North, only 1 in the Centre and 2 in the South: Veneto, Piedmont, Emilia-Romagna, Latium, Campania and Sicily. It is also for this reason that Sio will present in the Senate the Erice Manifesto on Obesity, a document that aims to outline a roadmap of common and shared actions between institutions, scientific societies and patients.
Obesity affects almost 6 million Italians
"The numbers speak for themselves: the network of around 160 Italian centres is mainly concentrated in the North, an area where, paradoxically, obesity rates are lower, even if they are on the rise,' explains Silvio Buscemi, president of SIO and full professor of Clinical Nutrition at the University of Palermo. 'On the contrary, the South, where obesity is a social emergency fuelled by socio-economic determinants, suffers from a chronic shortage of centres.
In Italia, almost 6 million citizens, 11.8% of the adult population, suffer from obesity and about 34% are overweight, with a significant impact on public health and healthcare costs. The most recent data of the Italian Barometer Obesity Report 2024/2025 (based on Istat and Iss surveys) show a marked territorial gap between the North and South of the country. Among the regions with the highest rates are Molise (14.1%), Campania (12.9%) and Abruzzo (12.7%). If we include overweight, in the South and the Islands almost one person in two (about 49%) is above their ideal weight, compared to about 42% in the North. The gap is even more dramatic among minors: in the southern regions the percentage of overweight children is almost twice as high as in some areas of the north (e.g. in Campania 18.6% of minors are obese compared to 3-4% in the autonomous provinces of Trento and Bolzano).
There are also profound inequalities in access to drug therapy, particularly the new anti-obesity drugs, the so-called GLP-1 receptor agonists. 'Since these drugs are entirely paid for by the citizen ('out of pocket'), in the absence of a diagnosis of diabetes,' Buscemi emphasises, 'a social barrier is created: those who live in the south and have a lower income cannot afford treatment that costs around 300 euros a month, even though they need it the most'.
