A new report from the World Health Organisation (WHO) has revealed that overweight and obesity causes 1.2 million European deaths every year, while not a single EU country is on track to reach the target of reducing obesity rates by 2025.
Obesity is a complex multifactorial disease, which affects almost 60% of adults and 1 in 3 children, according to the WHO. It was categorised as a chronic disease by the European Commission in 2021.
Kremlin Wickramasinghe, prevention and control of non-communicable diseases (NCDs) acting head at WHO European Office, named the crisis a “tsunami of obesity,” adding that “we urgently need to pull together all that we have in order to stop this pandemic”.
During the report launch event on Tuesday (3 May), Francesco Branca, nutrition and food safety director at WHO, highlighted that obesity is not only responsible for non-communicable diseases but also raises the risk of infectious diseases. During the COVID-19 pandemic, people living with obesity had an increased risk of severe complications by up to four times.
Single policy actions
Currently, no member state is on track to reach the EU target of halting the rise in obesity by 2025, despite the efforts of several WHO policy frameworks and action plans.
“The actions we took are not adequate to turn the curve, still, it’s going up,” Wickramasinghe said. “That’s why we need to really change our business and find new ways to kind of accelerate our work to tackle obesity.”
Wickramasinghe stressed the issue of countries putting only one policy in place, while “this is multifactorial [disease], […], with lots of factors so that one policy may not lead to change in the obesity”.
Addressing the causes of obesity, Johanna Ralston, CEO of the World Obesity Federation, said that people ask her: “what is the challenge? Is it a nutrition challenge? Is it genetics? Is it clinical? Is it medical? Is it heritable? Is it, you know, a mental health problem?”
She answered: “in a way, it is yes to all of those things”.
Recognition as NCD
On 4 March, the MEP Interest Group on Obesity released a joint declaration, calling for mandatory integration of obesity as an NCD and the biology of obesity for medical education as per the EU Mutual Recognition of Professional Qualifications Directive.
The recent WHO report’s categorisation of obesity as an NCD “really further opens the door for justifying the urgent need for obesity to be implemented under the NCD framework in its own right,” said Jason Halford, president of the European Association for the Study of Obesity (EASO).
Halford emphasised the need to provide a formal framework for early diagnosis, screening, treatment and long term management. “It will reshape the professional education and activity required to provide effective treatment for people living with obesity, it will also ensure that those services are properly resourced and appropriately funded,” he said.
Jacqueline Bowman-Busato, EASO’s EU policy lead and joint head of the scientific secretariat of MEP Interest Group on Obesity, told EURACTIV that until this is done, the diagnosis of obesity will continue coming too late.
“[Body size] is a symptom of untreated, uncontrolled, unmanaged obesity. And that’s quite far down the road,” Bowman-Busato said.
“Many people think that obesity is about the size and it’s about eating less, moving more. And that’s actually been the quite erroneous and harmful narrative of policy-makers,” she added.
Pernille Weiss, Danish Christian Democrat MEP and chair of MEP Interest Group on Obesity, called for a broadening of the diagnosis toolkits on obesity, “so that we are not only focusing on body mass index, to cover also innovative early diagnosis treatment technologies, such as biomarkers and mental health screening”.
Accessing care and treatment
In the EU, the main initiatives focusing on obesity and improving nutrition are Europe’s beating cancer plan, as well as its Farm to Fork strategy. Further, in December 2021, the Commission launched the Healthier Together initiative focused on non-communicable diseases.
However, obesity rates continue to take a toll on health systems across Europe.
With cases on the rise, WHO’s regional director for Europe Hans Henri P. Kluge stressed that “it is unclear if our health systems have the capacity to respond”.
“We must strengthen capacity among our healthcare workers, integrating effective management into primary health care systems as part of universal health coverage,” he said.
Branca underlined the necessity of having primary health care services that can deliver actions on preventing and controlling obesity.
“It is unacceptable that this is considered a responsibility of the individual, and is not seen as a key element of the prime healthcare benefits package,” he said.
[Edited by Alice Taylor/Nathalie Weatherald]