Time to accept that obesity is a disease – Austria is building a national system to treat it

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WHO Europe News release

Fighting obesity: treatment is just the beginning

Nina, a girl from a rural area in Austria, was diagnosed with obesity and a very heavy individual burden of comorbidities when she was 14 years old. After medication treatment and significant weight reduction, she was dismissed from hospital. But as she lived a 2.5-hour drive away from the clinic, she lost contact with her doctors 8 months after treatment.

When Nina came back, she had not only regained weight but also had type 2 diabetes.

“Cases such as Nina’s show that treatment may aid, but it can never be sufficient if doctor-patient relations are not maintained, and if there is no national system that gives clear guidelines on how obesity should be treated,” said Dr Daniel Weghuber, Head of the pediatrics department at the University Clinic of Child and Adolescent Medicine of Paracelsus Medical University in Salzburg.

Currently, there are around 240 000 children and adolescents living with overweight and obesity in Austria.

A recent report from WHO/Europe showed that, in the entire WHO European Region, around 60% of adults and 1 in 3 children are living with this condition. Halting the rise in obesity is going to require comprehensive policy approaches, both in the areas of obesity prevention, such as through creating healthy food and physical activity environments, and in the areas of obesity and overweight management.

Obesity treatment as part of general insurance

As President of the European Childhood Obesity Group, Dr Weghuber has been leading the work on a national concept on childhood obesity treatment for Austria, which is based on the idea that obesity is a serious chronic disease that is tightly connected with other noncommunicable diseases (NCDs) including cancer, diabetes and cardiovascular diseases.

The concept was prepared by professionals from primary to tertiary health care and signed by all relevant stakeholders, including representatives of the social security sector, in 2019.

WHO has been urging Member States to take further steps in halting the so-called global obesity epidemic by 2025, as no country in the Region is on track to halt or even reduce the rise of obesity by this date.

Today, Austria is ready for the next step. Leading health professionals and stakeholders launched a nation-wide initiative called Austrian Obesity Alliance. The Alliance proposes a renewed obesity management programme that acknowledges obesity as a disease and demands that the social security system includes obesity management in the universal health insurance system.

Many people don’t see obesity as a problem

There are several regions in Austria that have already created the infrastructure for the planned national obesity treatment programme. These structures can be scaled up to other regions of the country. But to roll out the programme, political commitment based on the understanding that obesity is a serious public health challenge is also crucial.

“We need to change the perception of obesity that is prevalent today,” said Dr Michael Krebs, Specialist for Internal Medicine of the Medical University of Vienna. “There are more than 3 million adults and 240 000 children with overweight and obesity in Austria representing a wide range of demographics. Yet, more than 85% of obesity patients seeking treatment in our outpatient clinic are women. That means that most men living with obesity don’t see their condition as a disease – or don’t want to treat it for whatever reason.”

In many countries in the Region, obesity is still associated with social stigma, and it multiplies the life-threatening risks of this medical condition. Health professionals need help from decision-makers to get evidence-based messages and WHO recommendations through to a wider audience.

“We need to accept that obesity is a disease”

“Countries need to adopt a comprehensive approach to obesity prevention and management,” said Dr Kremlin Wickramasinghe, Acting Head of the WHO European Office for the Prevention and Control of Noncommunicable Diseases. “We learned a lot from listening to people living with obesity and their families, and we encourage all governments to take measures to also get inputs from these important stakeholders for all stages of the obesity policy cycle.”

During the 72nd session of the WHO Regional Committee for Europe (RC72), to be held in September 2022 in Israel, high-level stakeholders and decision-makers from all 53 Member States of the Region will discuss best practices that can stop the increase of obesity levels and tackle this urgent problem.

Austria is an active participant in many of the related WHO projects including the Childhood Obesity Surveillance Initiative (COSI) and the WHO Marketing Network. These projects are helping health professionals and stakeholders to create an effective country-tailored system to fight obesity.

“We need to accept that obesity is a disease. And since it’s a chronic disease, every person with obesity has to be diagnosed, and in each case a treatment needs to be defined. This is the future,” concluded Dr Weghuber.