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Obesity: blind to the problem that lies before our eyes

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Obesity: blind to the problem that lies before our eyes

In our country, people with obesity make up 11.4 percent of the population and over 21 million Italians lead a sedentary lifestyle. The habits of some regions, at the basis of the territorial inequalities shown in the graphs below, cause the country to fall significantly behind in international statistics: for example, 44% of children in Campania, the country’s black flag, are overweight and 55% are sedentary . The phenomenon has undergone rapid growth over the last three decades and today one billion people in the world – one in eight – are obese and of these 159 million are children and young people, among whom global obesity rates have more than quadrupled in the period between 1990 and 2020, as highlighted by the report from the School of Public Health of Imperial College London just published in the Lancet, close to the world obesity day, which is celebrated on March 4th around the world. At the same time, from 1990 to 2020 the portion of the underweight population decreased. For the authors, “it is very worrying that the obesity epidemic that was evident among adults in much of the world in 1990 is now reflected in school-age children and adolescents.”

There is no excess of non-harmful fat

What is very worrying is the future projection based on overweight and obesity in children and adolescents, also because the excess kilos in this phase of life will tend to remain, will weigh heavily on future health and will reduce life expectancy by many years and the time spent in good health by at least twenty years. Excessive body weight during pregnancy influences the development of the fetus and also its predisposition to develop diseases later in life.

An economic burden too

In addition to the human costs, there are economic ones which burden and will burden the national healthcare system and everyone’s pockets, as we told you in detail in the second chapter of Vita Magazine of December 2023/January 2024, where it also clearly emerges that there is no excess of fat that, in the long run, is not harmful to the body. On that occasion, we also talked about one of the solutions – the sugar tax– adopted in some countries, to protect especially the little ones from added sugars, and from the results obtained. A Perspective on the New England Journal of Medicine by title “Prevention of childhood obesity: focus on interventions and equity at population level” reiterates that “cost-effectiveness analyzes have highlighted that such fees may result in cost savings», through the reduction of cases of obesity and overweight.

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Multi-level responsibility

Adopting a healthy lifestyle and maintaining a normal body weight therefore acquires a completely different meaning. However, these economic and health emergencies must also be addressed at an institutional level. «Obesity is not an individual disease, there are many obesogenic factors that surround us, from pollution to the structures of our cities, not least those of a psychological and social nature which they tend to prevent us from recognizing being overweight as a health problem” he said Andrea Lenzi, president of the Italian arm of the Obesity Policy Engagement Network organisation Open Italy during the meeting organized in Rome. «It follows that no actor alone can solve the problem, we need a radical rethink of business models, food systems, the involvement of civil society and national and international governance». The slogan of this edition of the world day refers precisely to the need for interaction between different sectors “Let’s talk about obesity and…” (Let’s Talk About Obesity and…)

Alarming data

To live together with obesity they will be 1.9 billion in 2035, or 1 in four people. The estimated increase in obesity among children from 2020 to 2035 is 100 percent. THEn Italy, in 2022 the percentage of adults with overweight and obesity, equal to 46.3 percent, has returned to pre-pandemic levels, during which the peak of 47.6 percent was reached. However, the number of people with obesity went from 10.9 percent in 2019 to 11.4 percent in 2022with a peak of 12 percent in 2021.

Territorial inequalities – North South Islands Territorial inequalities Children and adolescents – North South Islands

Over 21 million people, or 37.2 percent of the population aged three years and older, say they do not practice sport or physical activity in their free timewith marked gender differences: 40.6 percent of women are sedentary compared to 33.6 percent of men.

Don’t “see” the extra pounds

An obstacle to the adoption of healthy lifestyles is constituted by lack of awareness among obese and overweight people of their problematic condition and, in the case of the little ones, by the distorted perception of parents unable to see the problem in their children. In 40% of cases, mothers of children with weight problems perceive them as normal weight, so much so that 70% of mothers consider the amount of food consumed by their overweight child to be adequate. 59.1 percent of mothers of physically inactive children believe that their child does adequate physical activity. All this undermines prevention and is stronger than ongoing expert recommendations on the importance of epigenetic mechanisms and habits in the first years of life. It has been known for some time that underestimation of offspring body weight is one of the main causes of the spread of the problem.

Altered perceptions of mothers with overweight and obese children

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«Perception is precisely one of the priority points identified by the white paper White Paper “The Need for a Strategic, System-wide Approach to Obesity Care”» Paolo Sbraccia, Vice President of the Indo Foundation. Furthermore, approximately 40% of doctors and decision makers believe that patients with obesity must solve their problem on their own as it is linked to lifestyle decisions. Finally, other dangerous misunderstandings concern the so-called body positivy: the appeal launched a few years ago by cardiologists who denounced the attempt to include obesity and overweight in the messages of inclusion and diversity against discrimination, which are the objectives of the body positivity: «Under no circumstances should we convey the message that obesity should be considered as a ‘normal’ condition, even an alternative to excessive thinness or normal weight. In this field ‘one does not equal one’. Obesity is a chronic disease. Obesity and overweight must be addressed and treated already in children and adolescents, without wasting time.”

From condition to disease: a legislative proposal

«Recognizing obesity as a real disease and addressing it as a national priority is the main content of the bill, first signed by me, which we are currently discussing in Commission XII and I hope will soon be able to arrive in the Chamber for its approval» he said Roberto Pella, president of the parliamentary intergroup Obesity, diabetes and NCDs, during the Roman event. “Obesity is a gateway to many chronic, metabolic diseases, neoplasms and disabilities,” he said. Luca Busetto, vice-presidente for the Southern Region della European Association for the Study of Obesity Easo, highlighting the fact that «obesity is a complex condition, not a simple choice of the individual. This changes the perspective in terms of prevention and treatment.” We’ll talk about it next time Easo congresswhich will be held next May in Venice.

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A costly underestimation

Having underestimated the extra kilos has already had consequences on the perception of citizens and on the possibilities for intervention. According to Rocco Barazzoni, president of the Italian obesity society Sio, «obesity, in terms of clinical impact and medical expenditure for the treatment of the diseases resulting from it, constitutes a challenge which, if not adequately addressed, will end up influencing future generations with important negative consequences on the healthcare system and our society as a whole.” Also because “obesity is a chronic relapsing disease” he said Frida Leonetti of the Italian Society of Diabetology Sid and is at the origin of many cases of diabetes and must be treated, even in diabetics, like blood sugar. A now consolidated literature indicates that a 5 percent reduction in weight decreases the risk of diabetes by 40 percent, with a significant clinical improvement in glycated hemoglobin and blood pressure. Even moderate weight losses can improve not only the most common risk factors, but also disease outcomes such as fatty liver disease and sleep apnea in people with type 2 diabetes.

The poster

On March 4th in Rome a document signed by over twenty associations representing the medical-scientific world, institutions and patients will be presented (the live broadcast is Who). Il “Manifesto to combat obesity, as a chronic disease to be addressed in a multidisciplinary and holistic synergistic manner, free from prejudice, stigma and discrimination” indicates to the government the priorities to follow, which are to be recognised obesity as a non-communicable diseasethat is, to obtain governmental, parliamentary and health system inclusion of obesity as a chronic non-communicable disease in its own right; build health literacythat is, building public and political awareness of the complexities of obesity throughout a person’s life; optimize prevention strategiesthat is, ensuring that governments prioritize the collection of data, generation of evidence and resources necessary to provide actions that effectively contribute to preventing or reducing key risk factors for obesity; improve services for people with obesity.

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