Policy responses to obesity failing, EU experts admit

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Europe needs to find new ways of tackling obesity as traditional prevention measures clearly appear to be failing, according to EU policymakers and health experts. In just a few decades, obesity is expected to weigh heavily on Europe's healthcare systems and become the cause of many other illnesses.

Obesity is today a global phenomenon that affects all countries and all layers of society regardless of age, sex and income, with some health experts now referring to the pandemic as "globesity".

As a risk factor behind chronic non-communicable diseases like diabetes type 2, obesity is expected to increase the pressure on already stressed healthcare systems, experts told a conference in the European Parliament organised on Tuesday (18 June) by the European Centre for International Political Economy (ECIPE), a think tank.

While healthcare expenditures are currently being slashed in many European countries, the prospect of reducing future costs by investing now in weight-management programmes, for instance, is being neglected.

Speaking at the Parliament debate, ECIPE director Fredrik Erixon said obesity was now just "as certain as death and taxes".

"We can use this expression about obesity," Erixon told the conference. "When you look at type 2 diabetes in Europe, it's the principle cause of roughly 80% of type 2 diabetes and diabetes is related to premature death," he said.

The ECIPE director added that growing levels of obesity led to higher taxes and higher expenditures in the healthcare systems.

"So far we haven't seen the big pushes in healthcare costs from obesity, but they are very likely to come in the future. Part of this because we see a growth in obesity, but also because people tend to live longer and when they live longer, the demand for healthcare related to unhealthy lifestyles gets much higher," Erixon stated.

"Left unchecked, we are going to see a very profound effect on healthcare expenditures in the next couple of decades coming from growing levels of obesity," he added.

Philippe Roux from the European Commission's health directorate (DG Sanco), said that the EU needed to continue to push forward the thinking around obesity.

"I can confirm that despite many efforts both at European and international level, the statistics continue to prove that we are far from having achieved what we want," said Roux, who works at DG Sanco's unit for health determinants.

"Obesity rates continue to remain very high," Roux said, adding that finding tools that would allow EU institutions to make valid data comparisons on obesity remains an issue.

Lack of action

The numbers of overweight and obese people has grown globally since the 1980s.

In Europe, it is estimated that 50% of all men and women were overweight in 2008, and on average around 23% of all women and 20% of men were obese, according to the World Health Organization.

Obesity often results from physical inactivity and unhealthy diets, as well as from tobacco and alcohol use. These are the main risk factors for the development of non-communicable diseases, notably cancer, diabetes and cardiovascular and lung diseases.

It is estimated that non-communicable diseases are the main causes behind almost 86% of deaths in Europe, and 77% of the disease burden.

Erixon mentioned that even if most governments acknowledge the problem, policy responses tend to be weak. He also highlighted that prevention seems to be the key word for governments.

"Everyone talks about prevention and with prevention they typically mean education and finding ways to get people to do more physical exercise and live more healthy lifestyles, but behind that you can also see that they are talking about prevention because they believe it's cheap and an economically way to address obesity."

"But when you raise the point with them; 'Is it effective?', very few can give an answer at all," Erixon said.

New methods and technology needed

Analyses suggesting prevention methods are effective are hard to come by, Erixon continued, for the simple reason that obesity rates have continued to grow at the same time as these were being put in place.

"That of course does not mean that all prevention methods are bad, but it simply means that it's difficult to find out which prevention measures work and which do not work at all."

When governments talk about weight management, they use 19th-century technology and approach instead of a 21st-century approach; they teach people how they should eat, and then just think that would solve the problem, the director said.

"This is something we have to think about when we go forward. Modern technologies are a great contrast to what is going on in many healthcare systems."

Gema Frühbeck, president of the European Association for the study of Obesity, backed Erixon's views by saying that it's not enough to tell people they have to change their diets and be more physically active.

"This message is not that powerful and has not translated into decreasing rates of the epidemic. We really need to look into why this isn't working, how we can get the message across, especially to vulnerable, disadvantaged groups," Frühbeck said.

She stated that obesity is frequent, serious, complex and a chronic disease.

"We need a combined approach not only from the biomedical area, but also with the social sciences and humanities. We need to develop a new paradigm, seeing obesity as a complex system."

Erixon said new and cheap technologies could already be used now, citing mobile apps as an example. By taking a photo of a meal, some apps can calculate and memorise the nutrition intake, giving the user a better picture of its nutrition status.

Automatic phone calls before people take foods with instructions on what different meals would mean in terms of nutrition could also be a way forward, he added.

Obesity is a medical condition in which excess body fat has accumulated to the extent that it may have an adverse effect on health, leading to reduced life expectancy and/or increased health problems.

People are considered obese when their body mass index (BMI), a measurement obtained by dividing a person's weight in kilos by the square of the person's height in metres, exceeds 30 kg/m2.

Obesity increases the likelihood of various diseases, particularly heart disease, type 2 diabetes, obstructive sleep apnea, certain types of cancer, and osteoarthritis.

Obesity is most commonly caused by a combination of excessive food energy intake, lack of physical activity, and genetic susceptibility, although a few cases are caused primarily by genes, endocrine disorders, medications or psychiatric illness.

NGOs and think tanks

  • European Centre for International Political Economy (ECI): Website
  • The European Association for the Study of Obesity (EASO): Website

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