Obesity: Italy’s pioneering legislation should serve as a model for Europe

The real challenge begins now. Italian Law 149/2025 – the first in the world to officially recognise obesity as a chronic, progressive and relapsing disease – has marked a historic milestone, but its value will not be measured by its symbolic significance. It will be judged by its ability to transform a legal principle into real change. Because this pioneering achievement is merely the first step. The success of this reform will depend on how effectively we can translate it into a reduction in the risk of heart attacks, strokes, heart failure and all the complications that still accompany this condition today.

This is precisely the conclusion that emerges from our paper “Italy passes obesity law: an opportunity to prevent cardiovascular disease across Europe”, which has just been published in the European Heart Journal – Quality of Care and Clinical Outcomes. The study by the IRCCS Policlinico San Donato does not merely describe an unprecedented legislative development, but analyses how this decision could serve as a model for the evolution of European health policies, finally placing cardiovascular prevention and the treatment of obesity within the same public health strategy.

Italia is the first country in the world to have taken this path. This leadership role represents both an opportunity and a responsibility. An opportunity, because we now have the scientific knowledge needed to tackle obesity as a genuine medical condition; a responsibility, because legislative recognition would risk remaining incomplete if it were not accompanied by a profound paradigm shift.

The law, in fact, provides the tools to bring about this change. It lays the foundations for the gradual inclusion of obesity-specific services within the Essential Levels of Care, for the integration of the condition into the National Chronic Disease Plan, for the implementation of multidisciplinary diagnostic, therapeutic and care pathways, and for the development of a national epidemiological monitoring system. These are not merely administrative formalities, but necessary conditions to ensure that every patient can access a continuous and appropriate care pathway.

The reasons why this transformation is necessary are now clear even to our legislators. Cardiovascular diseases continue to be the leading cause of death on our continent and account for around 282 billion euros annually in the European Union, of which 42 billion is borne by the Italian healthcare system. A significant proportion of this healthcare, economic and social burden is linked to obesity, one of the main modifiable risk factors for cardiovascular disease. Taking early action therefore means safeguarding the future sustainability of healthcare systems. And, even more importantly, people’s health.