Obesity: burden of disease and management in public health

Today we are talking about obesity, a topic already addressed in this web series, but we are talking about it from the point of view of Public Health, since it is a condition that is increasing significantly, especially in Western countries so much so that it has tripled in the last 50 years. Most of the world's population lives in countries where obesity kills more than underweight. Almost three and a half million adults die from obesity-related consequences (ischemic heart disease, diabetes and malignant tumors). About one billion people in the world are overweight. At the European level, 30% of the population is overweight or obese. If we also look at the data of children, it is no longer comforting.

If this is the epidemiological picture, what are the causes that have led to an increase in the prevalence of obesity? Certainly the change in lifestyles and an increase in sedentary lifestyle and reduction in physical activity, but also hormonal, endocrine and drug-related problems, such as steroids or antidepressants.

There is a relationship between fertility and obesity, which is the subject of studies and research. Obesity in women implies a series of disorders of the endocrine and metabolic axis, which lead to pathologies that affect the rate of live births from obese mothers in the sense of a reduction.

What are the public health strategies to be pursued? Certainly prevention, which is a path that must be followed with a multilevel and integrated approach. We need to implement services and interventions and involve the population, including children and young people.  At the European level, action has been taken with regard to schools with school programmes, interventions in canteens and the creation of cycle paths to increase physical activity.

In summary, to combat obesity it is necessary to act on different environmental, social and cultural behaviors and on different levels, in order to have a synergistic effect of the various actions and – therefore – multiplicative, for a real effectiveness of interventions and programs.