Obesity is one of the main contemporary global challenges concerning public health: its impact and growth rates, in fact, are so alarming that they led the World Health Organization to coin the term “Globesity”.
Obesity is often associated with individuals who adopt incorrect lifestyles and unhealthy diets when it is scientifically proven that it is a complex and multifactorial disease. But obesity is not only a disease, but also a risk factor for widespread chronic diseases, including cardiovascular diseases, tumors, chronic kidney diseases, gastrointestinal tract diseases, respiratory diseases and depression. Obesity is constantly increasing throughout the world, both in industrialized and low-income countries. And Italy is no different.
Obesity in Italy: costs and impacts on quality of life
According to data from the European Health Interview Survey, included in a study also carried out in collaboration with Eli Lilly, obese people in Italy represent 11.2% of the population, while overweight individuals are equal to 33%.
In our country, obesity is mainly recorded among the segments of the population with lower income, with a gap of almost 3% between the richest and poorest portion of the population, and the less educated with the higher incidence of obese people and overweight recorded in Southern Italy.
Obesity not only has a significant cost on national health spending, but also negatively affects the quality of life with effects on the economic and productive stability of the country. The data, in fact, demonstrate how obesity produces incremental fatigue in carrying out ordinary daily activities, such as carrying out housework or walking 500 metres. Movement difficulties, in fact, increase the likelihood of carrying out work activities due to difficulty concentrating, tiredness or sleep problems.
The costs of obesity in Italy amount to 13.34 billion euros in 2020, equal to 0.8% of GDP, with direct healthcare costs representing 59% of total costs. These costs are mainly attributable to cardiovascular disease (84% of total healthcare spending), diabetes (8%), cancer (4%) and bariatric surgery (3%).
Perception and knowledge of obesity
In the perception of Italians, obesity is still a little-known universe even if, in recent years, people’s awareness has increased: according to IPSOS research, in fact, 49% of Italians consider obesity a chronic disease and a factor of risk for other pathologies. The data shows that those who recognize obesity as a chronic disease have a greater awareness of the damage it can cause to health compared to those who dismiss it as bad eating habits. However, there is broad consensus (85%) on the fact that, at the basis of obesity, there are multiple causes and it is not just “eating a lot”.
Furthermore, 85% of Italians are in favor of recognizing obesity as a pathology and the consequent need to guarantee Italian patients adequate medical care and support through the National Health Service.
A public health challenge
The real challenge for the future is to combat the phenomenon: it is estimated, in fact, that reducing the obesity rate by 5% could lead to an annual reduction of 5.2% in global economic costs between 2020 and 2060. Despite the growing threat, however, obesity still today struggles to be recognized as a priority chronic pathology in public health agendas, on a par with equally challenging pathologies such as diabetes, tumors or cardiovascular diseases. This is why, as the World Health Organization underlines, it is necessary to develop a courageous and integrated national strategy between social, food and health components.
At an international level, obesity began to take on growing importance in the first decade of this century, leading international and European bodies to repeatedly call on Governments to take concrete actions: however, in Italy, the approach was more timid. Overweight and obesity were included for the first time in 2007 among national policies with the “Earning Health” Program which aims to combat the main risk factors for chronic diseases in the country, such as poor nutrition, physical inactivity, excessive consumption of alcohol and smoking. However, obesity is still not included in the LEAs, leading to the preclusion of the benefits and services associated with the management of the pathology among those that the NHS is required to provide free of charge to all citizens. The study proposes some fundamental points to ensure that many obese patients in the future have greater guarantees and treatment opportunities compared to patients with other chronic diseases.
The first is that relating to the effective recognition of obesity as a chronic disease with social impact, through the inclusion in the updated list of chronic and disabling diseases which give the right to exemption from participation in the cost from which the benefits to be guaranteed to the subject with severe obesity by the National Health Service.
And again: inclusion of obesity in the National Chronicity Plan, development of national guidelines for the development of diagnostic therapeutic assistance plans (PDTA), definition of standard territorial governance, organization and planning of awareness and education campaigns with the aim of strengthen the recognition of obesity as a pathology, inclusion of obesity screening among the services offered by service pharmacies to strengthen the proximity and timeliness of the diagnosis capacity and prevent the onset of the pathology and the establishment of an ad hoc fund for the care of the person with obesity aimed at guaranteeing full access to prevention, diagnostic procedures for co-morbidities, dietary treatments and, in the most serious cases, access to second level centers to evaluate psychological, pharmacological and surgical approaches.
The research then invites institutions to address the issue of obesity during the Italian G7 Health Presidency with a dedicated session and to strengthen Italy’s leading role in Europe by committing to keeping the fight against obesity at the top of political debates healthcare.
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