Obesity: a pandemic affecting Italy and Spain, but the weapons to fight it are still blunted
The risk of obesity increases in Europe, new drugs and strategies could change the way we tackle this crisis
by Marzio Bartoloni (Il Sole 24 Ore), Andrea Muñoz and Fran Sánchez Becerril (El Confidencial)
8' min read
Key points
8' min read
There are those who call it a new 'pandemic', for sure obesity is already a 'global epidemic' as the WHO has renamed it: 1.9 billion people are overweight, 650 million are obese with 4 million deaths a year as a consequence of this condition that triggers chronic diseases such as diabetes, cardiovascular diseases and even cancer. And Italy, the first country in the world that is preparing to pass a law recognising obesity as a disease, is among the hardest hit, with one in three Italians overweight and one in ten obese, and a near future that points to the worst, given that the country that was once the standard-bearer of the Mediterranean diet - a model in the world and the first 'vaccine' against extra kilos - is second in Europe for the number of obese or overweight children.
In Spain, as many as one in two people are overweight and almost 20% are obese. But how to stop this obesity pandemic? The strategies and problems vary from country to country, even in Europe, and range from the shortage of qualified personnel in hospitals, as in Spain for example, to the number one problem of resources to pay for treatment and especially the promising new anti-obesity drugs that are flooding the market and that Italy would like to offer.
In Italy the first law recognising obesity as a disease
Italy is preparing to become the first country in the world to pass a law recognising obesity as a real 'progressive and relapsing' disease, and those who suffer from it will be entitled to receive free treatment that will be provided for by the essential levels of care, i.e. those services that the National Health Service must guarantee to all citizens. The law, approved at the beginning of last May, could be finally passed by the summer. But the road to care for millions of patients is still a long and bumpy one: the measure consists of just a few articles, allocating modest resources needed just to set up an Observatory to study obesity and launch information and communication campaigns on the importance of prevention: this chronic disease is in fact the result of multiple factors closely linked to one another, including sedentary lifestyles and reduced physical activity, poor diet, socioeconomic determinants, psychological aspects and stress, in addition to genetic factors. And being able to intervene in time also means saving money, since it is estimated that between direct and indirect costs (related pathologies to be treated) the cost impact on the National Health Service exceeds 13 billion each year. In short, betting and investing on anti-obesity treatments could eventually pay off for everyone.
The resource node for free care
.The problem, however, is to really follow up on Article 2 of the law, which states that 'people suffering from obesity' will be able to benefit from 'the services contained in the essential levels of care (the so-called Lea) provided by the National Health Service', . This means that with the updating of the LEAs, all those anti-obesity services such as examinations and analyses, the new drugs that have been gaining ground in recent years, up to bariatric surgery and medical indications on lifestyles such as the medical prescription of sporting activity, will have to be included among the free treatments (or against payment of the ticket).
"After the passing of this law, there is no going back. It is like when the treatment of diabetes became part of the essential levels of care. Now the resources must be found, centres identified, and therapies defined. And it must be done because the cost of obesity is such that any intelligent state had better get it treated before it becomes a problem,' Andrea Lenzi, an endocrinologist and one of the leading experts on the subject in Italy, explained to Il Sole 24 Ore, to the extent that he collaborated in drafting the law. 'Treatment,' Lenzi goes on to explain, 'will not concern those who are overweight, nor all six million obese people in Italy. There will be specific guidelines and indicators to identify who is entitled to it with precise paths: an obese person will first go to the family doctor who, in the event of complications, will refer him or her to a specialised outpatient clinic on the territory, which in turn can send him or her to the regional specialised centre that will produce a complete diagnosis and a treatment plan that may last several months'.
