Experts urge EU to deliver greater policy support for obese patients

Policymakers need to ensure that national actions to combat the growing problem of obesity address treatment as well as prevention, according to a new report.

By Colin Mackay

29 Feb 2016

Europe is facing an 'obesity epidemic' that threatens to overwhelm healthcare systems. The complications associated with chromic obesity, particularly type 2 diabetes, are increasing the strain on already overstretched resources.

A new report, entitled 'Confronting Obesity in Europe - taking action to change the default setting', by the Economist Intelligence Unit and commissioned by Ethicon, part of the Johnson and Johnson group, highlights that the proportion of obese people in Europe has doubled in less than 30 years.

On average, around half of Europe's population is now overweight or obese. The OECD estimates obesity absorbs up to three per cent of total healthcare expenditure.


Attempts to tackle Europe's growing obesity epidemic, like so many initiatives, are understandably focused on prevention, helping healthy individuals to avoid the causes of the condition in the first place.

However, this approach - targeting only the healthy in society - increasingly isolates those people with obesity, who have little support or access to treatment. This is despite the availability of effective treatments.

Zsuzsanna Jakab, the regional director for WHO Europe, has warned that, "The alarming rise of obesity across our region is a serious cause for concern. Left unaddressed, the problem will increase in many countries and disproportionately affect vulnerable groups."

Chief Scientist and WHO Representative to the EU, Roberto Bertollini, highlighted the difficulties of effective action. He pointed out that although projects such as the UK's Change4life programme, or Italy's “Let’s Go…With Fruit” scheme were valuable initiatives, the reality was that there were competing pressures. Intentions to modify lifestyle as part of the fight obesity were often balanced against support for local industry in areas where food production was a leading source of income.

Bertollini also pointed out that vested interests were able to lobby against measures known to be effective, such as increased taxes or aggressive marketing to children.

Francesco Rubino, Chair of Metabolic and Bariatric Surgery at King’s College London, urged action saying there was a pressing need to 'destigmatise' obesity.

"People with existing obesity have no champions, no voice to speak for them. People perceive obesity as a lifestyle issue, but it’s much more complex than that", said Rubino, explaining that there are situations where the obese are denied treatment until they lose weight, increasing their social isolation and sense of ostracism.

He pointed out that; "Many diseases of the liver, most cancers and many traumatic injuries are related to unhealthy lifestyles, but we do not deny treatment to patients with these diseases."

Rubino explained that bariatric surgery, a procedure that reduces the size of the stomach, is a safe and effective treatment for obesity. However, many European countries only allow this treatment in patients with a Body Mass Index (BMI) of greater than 40.

This excludes many that could benefit from the surgery. He explained that; "Restriction by BMI means that surgery is not as cost-effective as it could be, leaving patients who could die from their condition behind."

There was also growing evidence that bariatric surgery may even reverse advanced type 2 diabetes. Leading diabetes organisations including the International; Diabetes Federation, the European Association for the Study of Diabetes and the American Diabetes Association are reviewing the data on this issue, and are expected to publish their conclusions later this year.

The closing speaker, former Maltese Prime Minister and now S&D group MEP Alfred Sant, urged policymakers to recognise that obesity and the chronic conditions associated with it were a growing problem.

The EU, he said, "did not need to go as far as setting an obesity policy or agenda, but it should provide support to member states. It had a role to play in awareness raising and prevention measures."

He promised that Malta would make obesity as one of its health priorities when it takes over the EU presidency in 2017.