Europe must look to tackle obesity 'across all EU policies', says Borg

European health commissioner Tonio Borg has called for policymakers and stakeholders to pursue an "integrated approach to tackling obesity" that cuts "across all EU policies".

By Desmond Hinton-Beales

17 Oct 2014

The Maltese official was addressing a Parliament Magazine roundtable discussion co-organised with Covidien, where he highlighted that "over half of European adults are overweight or obese", adding that this has "almost become the norm".

As the event's keynote speaker on Wednesday, he stressed the problems related to obesity are "reversible", underlining that, "If we said 'nothing can be done' then the battle would be over before it began".

"If we don't act on obesity now future generations – as with tobacco and climate change – will ask 'why?'" - Tonio Borg

"The European commission has endeavoured to promote healthy living across multiple policy areas, but we do not have power to impose sanctions on member states. We can only apply soft law, by publishing statistics and reports - no one likes to be at the top of a table that is negative."

Borg pointed to the worrying fact that "obesity rates remain stubbornly high", despite the "more than 300 commitments for action that have been made". "If we don't act on obesity now future generations – as with tobacco and climate change – will ask 'why?'"

For the health commissioner, there are "multiple causes for obesity", but he issued a call for "more positive messages for children on exercise and fun", adding that there was an "EU-wide programme improving the diet of 30 million children".

The programme combines two existing plans - the school fruit scheme and the school milk scheme - and operates under the slogan of 'Eat Well – Feel Good'. Borg said the aim was also to "teach children the long and short term benefits of a healthy diet".

 

The root of the problem

The roundtable was hosted by Slovenian MEP and health campaigner Alojz Peterle, who expressed his hope that the incoming commission would share the same "attention to health" as the outgoing Barroso II executive.

"In the last few years the work of EU did not result in health indicators getting better. MEPs feel committed to doing more – get closer to the citizens and support them more from the EU level" - Alojz Peterle

"In the last few years," he stressed, "the work of EU did not result in health indicators getting better. MEPs feel committed to doing more – get closer to the citizens and support them more from the EU level."

The EPP deputy agreed with commissioner Borg on the possibility of obesity being "reversible", saying, "it is not easy but we can do something - we are not knocking on a locked door."

However, he underlined the importance of focusing "not just on symptoms, but on the root causes of our health problems. Prevention is vital."

 

Health in all policy

Also speaking was chief scientist and WHO representative to the EU Roberto Bertollini who praised the "total consistency in policy between the parliament, commission and council" in their approach.

"We must promote physical activity during daily life. We must make the healthy choices easier. We have all the knowledge and implements necessary to be effective" - Roberto Bertollini

"We have enough data and knowledge to promote healthy living and nutrition," stressed Bertollini, "who echoed commissioner Borg's comments by saying "overweight is becoming the norm".

"We must promote physical activity during daily life. We must make the healthy choices easier. We have all the knowledge and implements necessary to be effective."

However, he said, "this issue cannot be addressed only by the medical community - we need health in all policy", citing transport policies that promote activity, price reductions on healthier food and a shifting of spending towards prevention as areas of potential action.

Bertollini also highlighted the link between socioeconomic status and obesity rates, saying "this must be addressed".

 

Weight cycling

Sue Waldock, a patient who has been undergoing treatment for obesity and who recently underwent bariatric surgery to reduce the size of her stomach, focused her comments on the alternatives for people who have been fighting obesity with no success.

"I was taking weight loss pills recommended by my doctor for years, but these were amphetamines and it was unsustainable to continue taking them," she said.

Waldock stressed that she had "tried everything" in her efforts to lose weight, but had become locked in a continuing cycle of weight loss and gain. She pointed to her relationship with food, which she said "was not a logical one" which may have started when she was young, but which throughout most of her life had "no real effects".

"While it an expensive option, the cost of [bariatric] treatment must be considered against that of becoming less mobile and requiring increased healthcare" - Sue Waldock

"Once I started getting into my late 50s, however, I began to feel unwell," she said. "I had joint pain, I was tired, I was on anti-inflammatories and I had repeated trips to the doctors with no real diagnosis."

Eventually, said Waldock, her doctor suggested the possibility of bariatric surgery, but that she was initially sceptical, saying, "it is a big decision to voluntarily put yourself forward for surgery".

For Waldock, who had tried many alternatives, the surgery was "lifesaving". "While it an expensive option," she said, "the cost of treatment must be considered against that of becoming less mobile and requiring increased healthcare"

She closed with a quote from Arnold H. Glasgow, saying, "Your body is the baggage you must carry through life. The more excess baggage, the shorter the trip."

 

The tip of the iceberg

François Pattou, a surgeon at CHU Lille, warned that "extreme obesity is just the tip of the iceberg", adding that this condition is a "nightmare for the patient".

"Obese patients are prejudiced against," he said, adding that this was the case "even by healthcare professionals".

"If we can defeat severe obesity, we can defeat obesity. We have a duty to treat the obese and treat them competently" - François Pattou

Pattou was also keen to underline that treatments for obesity are a "lifelong process" and that "If we can defeat severe obesity, we can defeat obesity". "We have a duty to treat the obese and treat them competently," he added.

Euan Woodward, executive director of EASO, also pointed to obesity's status as a "lifelong condition" and said that those suffering from it need "three things: recognition, respect and support".

"We need to understand what treatments work and increase the number of treatment options available," he said, adding that it was important to raise awareness of this as "policymakers don't understand a lot about obesity".

Cristiano Franzi, president of Covidien Europe, also offered his opinion, saying that "obesity and obesity-related diseases are putting a lot of pressure on the healthcare system in general and create substantial issues for the management of the healthcare budget".

"We as Covidien play an important role in the management of this budget in the way that we control the cost respective to healthcare. We feel a responsibility for our part in this and we have been just recently recognised by the European commission as the most innovative company in the medical devices sector".

"Obesity and obesity-related diseases are putting a lot of pressure on the healthcare system in general and create substantial issues for the management of the healthcare budget" - Cristiano Franzi

Carmen Walbert, Covidien's chief medical officer, also underlined the role of industry in helping to tackle obesity as "medical devices make the fight easier".

Commissioner Borg finished by highlighting that "the four major risk factors for developing chronic diseases are all lifestyle related" - smoking, alcohol abuse, unhealthy diet and sedentary living.

"We must tackle the lack of action on these risk factors," he added.

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