'Obesity is a disease to be cured': yes to the law, the first step towards free treatment and drugs

The Chamber of Deputies, with 155 votes in favour and 103 abstentions, has approved the bill with the 'Provisions for the prevention and treatment of obesity': a text of only six articles that may, however, represent a sort of manifesto for a condition that today affects about 6 million Italians and is still experienced as a stigma to be blamed. What is now missing is the Senate's go-ahead for its final approval, which opens the door to the entry of anti-obesity treatments - from check-ups to diagnostic examinations to bariatric surgery and new anti-obesity drugs - among the essential levels of care (the Lea), that is, among those services that the National Health Service must provide free of charge to all citizens. However, in order to define exactly which treatments will be paid for by the SSN, it will be necessary to formally define them within the Lea and, above all, to find the necessary resources to guarantee them to everyone.

"With the approval of my bill containing provisions for the prevention and treatment of obesity, of which I am the first signatory, we become the first country in the world to recognise obesity as a disease. Starting in 2019, I pledged to involve the scientific and university world, the medical world, and patient and citizens' associations, writing a motion together and bringing it to this House for unanimous approval. Today that motion and that commitment become law'. Thus Roberto Pella, Forza Italia's group leader in the Budget Committee, speaking during the explanation of vote on the pdl for the prevention and treatment of obesity. Although there were no votes against the bill, there was no shortage of criticism from the opposition: 'Obesity is, according to this government, a progressive and relapsing disease, so the bill is a placebo, with no real consequences on the country's needs, obese people are left without concrete support from the State, which will merely organise a few more information campaigns,' said the leader of the Avs group in the Chamber Luana Zanella.

But what does the law, which should be passed and enter into force before next summer, provide for? First of all, as mentioned, the recognition of obesity as a pathology, with 'persons suffering from obesity' being able to take advantage of 'the services contained in the essential levels of care provided by the National Health Service', Article 2 of the law states. This means that with the updating of the LEAs - a step that will have to provide ad hoc funds - all those anti-obesity services such as examinations and analyses, the new drugs that have been affirming themselves in recent years, up to bariatric surgery and medical indications on lifestyles will have to be included among the free treatments (or against payment of the ticket). On the latter front, the bill also aims to finance a 'national programme for the prevention and treatment of obesity' that will promote initiatives ranging from breast-feeding to the promotion of sports activities and knowledge of the main dietary rules in schools and among parents, and to support training and refresher courses on obesity and overweight among university students, family doctors, paediatricians and NHS personnel. Lastly, the establishment of the Observatory for the Study of Obesity at the Ministry of Health is envisaged, with the task of monitoring, studying and disseminating lifestyles among Italians.

Obesity is a chronic disease that is the result of multiple factors closely linked to one another, including, for example, sedentary lifestyles and reduced physical activity, poor diet, socioeconomic determinants, psychological aspects and stress, in addition to genetic factors, and 'today it represents a major public health problem and expenditure for the national health services, also by virtue of its complications,' stressed Pella, who in the last budget manoeuvre 'thanks also to Minister Schillaci's commitment' also found the first resources to finance, among other things, communication and awareness campaigns right into schools, where prevention is already needed. Intervening in time also means saving money, given that it is estimated that between direct and indirect costs (related pathologies to be treated) the impact on the health service exceeds 13 billion a year, affecting children from a very young age, given that, according to ISTAT, around 19% of children aged 8-9 years are overweight and 9.8% suffer from obesity, with very large territorial inequalities that see the South take the lead and with differences between large and small municipalities.