March 4th is celebrated World Obesity Day (World Obesity Day)a pathology that constitutes one of the major health problems, not only in industrialized countries, but also in developing ones. Local Health Authority e Ferrara University Hospital are engaged in various aspects regarding this very important social problem. There are many services that operate in the area and within the Cona Hospital.
THE FOOD HYGIENE AND NUTRITION OPERATIONAL UNIT OF THE USL COMPANY OF FERRARA (Director Dr. Cristina Saletti) operates in the field of food safety and preventive nutrition – and, in collaboration with the other Services of the Department of Public Health and in line with the objectives dictated by the Regional Prevention Plan – carries out interventions aimed at combating overweight and obesity in the Ferrara population with a particular commitment to the promotion of healthy lifestyles. Preventive nutrition interventions are guaranteed by a team of doctors, biologists and dieticians who operate mainly in the Health Centers of the province of Ferrara.
The professionals actively participate in all interventions to evaluate the nutritional status, eating habits and adherence to healthy lifestyles coordinated by the Ministry and the Emilia-Romagna Region, guaranteeing the evaluation and verification of the menus proposed in school and social catering. welfare, promote training and information initiatives on healthy, safe and sustainable nutrition in schools and in all contexts that can contribute to supporting changes and guarantee group and individual nutritional counseling activities throughout the province.
I am 7 preventive nutrition clinics located throughout the Ferrara area (Ferrara, Portomaggiore, Argenta, Copparo, Codigoro, Comacchio and Cento); these clinics, which can be accessed at the request of the general practitioner or specialist doctors, offer consultancy aimed at the prevention and control of overweight, obesity and related chronic degenerative diseases, historically guaranteeing around 10,000 services per year.
The counseling activity, also aimed at children and adolescents with overweight and obesity problems, instead adheres to the regional project “Fit kids” which, with the involvement of Free Choice Paediatricians, sees a multidisciplinary team made up of a dietician, sports doctor and graduate in physical education, with the aim of encouraging the adoption of a healthier eating and physical lifestyle .
“Overweight and obesity – highlights Dr. Saletti as Director of the Service – continues to be a health emergency that requires us to implement more and more actions that allow us to combat and prevent this condition. Given the relevance of the problem, we are working in alliance with all health professionals (general practitioners, paediatricians, specialist doctors, dentists, nurses, physiotherapists, dental hygienists etc.), but also with the world of schools, of the catering and food sector, of sport, with associations and local authorities, to systematise all those scientifically accredited good practices in the field of nutrition and physical activity, which can help citizens stay healthy” .
THE CENTER FOR THE STUDY AND TREATMENT OF METABOLISM, ATHEROSCLEROSIS AND CLINICAL NUTRITION DISEASES, HOSPITAL – UNIVERSITY OF FERRARA (Head Prof. Angelina Passaro). For over a decade the clinic dedicated to the study and treatment of obesity and its complications has been operating within the company. The University Hospital of Ferrara offers a multidisciplinary approach to guide patients along a path to weight loss. body weight, together with all the available therapeutic options, starting from diet therapy up to drugs or sending patients to a Bariatric Surgery center. The clinic provides an average of 800 services per year and access can take place upon proposal of the General Practitioner or Specialist Doctors.
Despite advances in knowledge of the mechanisms underlying obesity and its complications, the profound clinical and social stigma surrounding this condition continues to be a significant challenge.
The prof. Angelina Passaro, Head of the Clinic, together with Dr. Edoardo Dalla Nora, Medical Director of the S. Anna University Internal Medicine Unitthey point out “the importance of recognizing obesity as a chronic disease. Too often, in fact, obese patients receive only generic advice on reducing calorie intake and/or moving more, which overlooks the complexity of the condition and implies that the patient is solely responsible for his or her weight. Clinical stigma, combined with the social stigma experienced by obese individuals since school age, contributes to widespread discrimination that negatively affects quality of life and access to care.”
“THE DIETARY CLINIC OF THE UNIVERSITY HOSPITAL OF FERRARAwithin which 3 dietitians work – explains the Dr. Melissa Teodorini of the Directorate of Health Professions, responsible for Logistic-Hotel Comfort – guarantees users personalized consultancy aimed at promoting correct nutritional and behavioral habits, through an accurate dietary survey and using specific instruments for measuring anthropometric values and body composition. Hospitalized users, however, in addition to dietary advice, if requested, are offered a menu suited to the patient’s needs, aware that there is no ideal diet for everyone; each individual should follow a diet suited to their age, gender and general health conditions. Nutrition, in fact, is one of the factors that contributes most to the promotion and maintenance of good health. To safeguard the humanization, functionality and hotel comfort of obese people hospitalized at the S. Anna University Hospital, I am available, if necessary, electric bariatric beds. These devices are designed to integrate into patient rooms, with the furnishings and other beds used in the healthcare environment, contributing to respect for dignity while providing all the functions necessary even for operators who deal with obese patients. This is dedicated equipment for patient recovery but, at the same time, helps reduce the risk of injury to patients and operators”.
“Obesity is a largely preventable condition. The Body Mass Index or Body Mass Index – explains the Dr. Annachiara Piva, Dietitian – it is the measurement system that allows us to identify overweight and obesity conditions by relating the weight and height of an individual. BMI or BMI, as an indicator of population studies, does not provide information on body composition (distinction between fat mass and lean mass, distribution of body fat), but is nevertheless, in the medical field, the most used index for correlation with the state of health“.
“Nutrition – continues Dr. Piva – it is one of the factors that contributes most to the promotion, achievement and maintenance of an optimal state of health. In consultations carried out in dietetic clinics the percentage of overweight or obesity found represents approximately 60% of the total number of patients: a significant percentage considering that in the Ferrara area the prevalence rate of obesity in adults has been found to be, even in the year 2023, around 12%”.
THE PATHOLOGY. “Obesity – puts in the doctor. Marcello Monesi, Director of the Territorial Diabetology Operating Unit of the Local Health Authority of Ferrara – represents a constantly increasing global health problem. Recent data indicate that in Europe 15% of the male population and more than 20% of the female population are affected. In addition to the direct consequences on physical and mental health, obesity is recognized as one of the main factors predisposing to diabetes mellitus. More than 40% of people suffering from type 2 diabetes are also obese: data from the Annals of the AMD (Association of Diabetes Doctors) register show how Emilia Romagna is one of the regions in our country in which the percentage of people is highest with diabetes mellitus who also have obesity.
The relationship between obesity and diabetes is complex and multifactorial, involving different pathophysiological mechanisms of our metabolism.
One of the main pathways through which obesity contributes to the development of diabetes is insulin resistance. As fat tissue accumulates, especially in the abdominal area, the body may become less sensitive to insulin, the hormone that regulates blood sugar levels. This insulin resistance makes it harder for cells to absorb glucose, leading to increased blood sugar levels and, consequently, the risk of developing type 2 diabetes.
Furthermore, obesity is often associated with a chronic inflammatory state, characterized by increased production and release of inflammatory substances in the body. This inflammatory state can negatively affect the function of the beta cells of the pancreas, which are responsible for the production of insulin. Beta cell dysfunction may further contribute to the onset of diabetes.
Tackling the obesity epidemic – continues Monesi – therefore becomes crucial in the prevention of diabetes and its complications. Interventions that promote a healthy lifestyle, including a balanced diet and regular exercise, can significantly reduce the risk of obesity and, consequently, the risk of developing diabetes. Furthermore, educational programs and awareness campaigns can play a key role in promoting awareness and prevention. In addition to this, there are innovative therapies, some already available, others imminently arriving, which have demonstrated in clinical studies a significant impact on reducing body weight, comparable to the results obtainable with bariatric surgery. In this regard, however, it is necessary to remember that there are no miracle pills or injections, that all therapies must be prescribed and managed by the doctor, without which the risk of side or unwanted effects multiplies; finally, in the absence of substantial lifestyle changes even the most effective drugs are doomed to failure.
In conclusion, obesity emerges as a significant risk factor for the development of diabetes, underscoring the importance of integrated approaches to address both of these public health challenges. The commitment of the diabetes teams (doctors, nurses, dieticians as well as physical activity experts) is focused on a multidisciplinary approach tailored to the needs of the individual patient and focused on the strategies necessary to neutralize the fearful consequences of obesity and metabolic diseases” .