“OBESITY in our country is not included in the list of chronic diseases, the services are not included in the essential levels of assistance (Lea), there is no national care network and not even a National Plan: it is time to change in the fight againstobesity! “. This is the conclusion of an editorial – signed by Renato Lauro, IBDO Foundation President, Andrea Lenzi, Open Italia Coordinator, and Paolo Sbraccia, IBDO Foundation Vice President – important food for thought for the debate of the experts gathered on the occasion of the third Italian Obesity Barometer Summit : “Consider obesity a priority in the health care system“. The event is organized by the Italian Barometer Diabetes Observatory (IBDO) Foundation with the parliamentary intergroup “Obesity and Diabetes”, OPEN Italia – Obesity Policy Engagement Network and IO-NET – Italian Obesity Network, with the contribution of Novo Nordisk as part of the project Changing Obesity International.
The obesity epidemic
According to Istat estimates, in Italy the number of people in overweight and with obesity grows with age, so much so that if the excess weight concerns 1 minor in 4, the share almost doubles among adults, reaching 46.1 percent among people aged 18 and over, reaching the peak in the class 65-74 years, with a prevalence of 61.1 percent. “Our country’s obesity rates will impact the future of many people and our national health system. Obesity is the fifth most frequent cause of death in the world, associated with serious diseases such as type 2 diabetes, cardiovascular disease, hypertension, at least 12 types of cancer, liver and respiratory diseases. In the past year it has also emerged that people who are overweight or living with obesity and who contract the coronavirus are more likely to be hospitalized, in a ‘intensive care unit and, unfortunately, dying of COVID-19 compared to normal weight people “, explains Paolo Sbraccia, vice president of the IBDO Foundation and professor of Internal Medicine at the University of Rome Tor Vergata “.
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A problem for health
“Because of pandemic in progress, obesity has become an immediate concern for our health and welfare services, so much so that people with obesity have been included among priority categories to be vaccinated as they are ‘highly frail’ in correlation with the lethality rate associated with Covid-19 for pre-existing organ damage or impaired immune response capacity to SARS-CoV-2. This is certainly an important milestone for people with obesity, but we should reflect on the fact that in the Government’s list of the 14 “extremely fragile” diseases, obesity is the only one that is not a recognized chronic disease, still lacking of a complete path of assistance and care by our health system “, he adds Andrea Lenzi, Italy coordinator of the Obesity Policy Engagement Network (OPEN) and president of the National Committee for Biosafety, Biotechnologies and Life Sciences (CNBBSV) of the Presidency of the Council of Ministers.
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Fragile in the pandemic
The ongoing pandemic has highlighted the fragility of people with obesity and priority access to vaccination is the first real official recognition for what is currently not considered a disease, but a personal responsibility of the individual. “Among all the terrible aspects of this pandemic, the hope is that it has at least served to get people with obesity the right protection rights and that this highly disabling disease continues to be a concern for our national health service even after this. emergency phase », he explains Giuseppe Fatati, president of Italian Obesity Network – IO NET.
The social stigma
Obesity is also a strong disease social implications because it is often associated with a stigma, which leads people affected to be discriminated against in social relationships, in school and working life and even bullied and ridiculed because of their body weight, with important physical and psychological repercussions in people with obesity. “Using the term” disease “in addition to leading to important implications for obesity cures and treatments and for the development of new policy guidelines, could also help reduce social disapproval and discrimination against those affected. It could also represent an important weapon against what is called the ‘internalized stigma’, that is the stigma linked to the weight of people with obesity that can lead them to attribute negative connotations to themselves triggered by social stigma and / or to be afraid of being rated negatively by others on the basis of weight, he explains Iris Zani, president of Amici Obesi.
If the doctor does not understand
“Besides the social stigma it is necessary not to underestimate the presence of one clinical stigma. Many doctors are unaware of the fact that obesity is a chronic disease and consequently are reluctant to address the problem with their patients, deeming them unmotivated or disinterested. On the other hand, people who feel discriminated against because of their obesity tend to avoid further contacts and visits, reducing their access to treatment and putting their health further at risk. For this reason, health professionals must be adequately trained on this disease, so that they do not underestimate its causes or consequences, and are able to offer the person with obesity an adequate treatment path “, he explains. Ferruccio Santini, president of the Italian Obesity Society (Sio).
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According to experts, it is therefore necessary for obesity to become a national priority at the health, political, clinical and social levels. “Government and Parliament must take legal action to ensure that a definition of obesity as a chronic disease, characterized by high economic and social costs, a definition of the role of specialists dealing with this pathology and a definition of care services and methods for reimbursing them, to ensure full access to care and treatment for people with obesity, and by a national media campaign against social stigma involving the world of information, sport, school, of the municipalities “, he adds Roberto Pella, intergroup president or parliamentarian Obesity and diabetes.
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