What is the cause of death of a patient weighing 150 kilograms? The certificate of death reads: cardiovascular insufficiency. In fact the cause of death is obesity. – Let us cure obesity as an initial disease, and there will be less deaths caused by obesity-related complications – alarmed experts at the founding meeting of the Coalition Against Obesity held at the Ministry of Health.
Diabetes, cancers, cardiac, articular or respiratory tract diseases – these are the most popular and severe consequences of obesity. The experts warn that obesity increases the risk of developing malignant cancer by 40 per cent, and diabetes — even by 93 per cent.
Nowadays as many as 27 per cent of Poles suffer from obesity and this number is growing constantly. Preventing obesity and successful treatment of one of the most severe lifestyle-related diseases is the biggest challenge for public health in the 21st century. To suit actions to words and turn the discussion on problems related to preventing and curing obesity into complex systemic solutions, eminent Polish and foreign experts established international Coalition Against Obesity.
– As far as combating obesity in Europe is concerned, the key thing is to change the awareness among physicians – especially those who usually do not treat obesity – as well as to change social consciousness. Obesity is treated as a sign of weak will, gluttony and unhealthy lifestyle. We must become aware that obesity is a disease, just like any other condition. It is not developed in people with weak will, but it is a multifactorial disease which results from mechanisms responsible for energy intake into the body, its distribution and consumption. And when we realize that it is a disease just like any other, we will understand that we have to begin treating it. – explains Maciej Michalik, MD, PhD, academic teacher at the University of Warmia and Mazury, President of the Metabolic and Bariatric Surgery Section of the Association of Polish Surgeons.
As the experts stress, obesity is not a problem or risk factor, but a lethal condition, and we have to focus on two aspects immediately: preventing the growth of obesity and treating it as early as possible. As patients indicate, better access to the bariatric surgery procedures is needed, which is often a last hope for people with obesity. – Patients tell us that access to treating obesity in Poland is hindered. We try to intervene, where possible, to improve the situation. We hope that the Coalition will establish a framework for actual treatment of obesity in Poland – Katarzyna Latuszek–Pasternak from the Office of Commissioner for Patients’ Rights said at the meeting.
A Common Front
On 26 September 2016, in the Ministry of Health of the Republic of Poland a meeting was held aimed at establishing the Coalition Against Obesity, attended by Jarosław Pinkas, Secretary of State, and Krzysztof Łanda, Undersecretary of State, as well as MPs, medical experts and representatives of public administration institutions, including the Commissioner for Patients’ Rights, representatives of local government and international organisations (among others the World Health Organisation) and NGOs (inter alia OD-WAGA Foundation for People With Obesity Disease). The Coalition has international and inter-sectoral nature, and its goal is to take broad actions to introduce national systems of preventing and treating obesity as well as set to standards of care over obese patients in CEE countries.
During the founding meeting in the Ministry of Health, which is a member of the Coalition itself, Krzysztof Łanda stressed how important it was to involve eminent experts in the works of the Coalition and to develop guidelines for preventing and treating overweight and obesity. – The Ministry is eager to receive the strategic document, or a Road Map, to be drawn up by the Coalition – said Krzysztof Łanda Undersecretary of State in the Ministry of Health. In turn, Jarosław Pinkas, Secretary of State in the Ministry of Health, noted that the number of incidents of overweight and obesity, also among children, is growing dramatically, therefore in Poland we need a comprehensive care over people suffering from obesity. The fact that obesity is one of the priorities of WHO and UN was mentioned by Paulina Karwowska, Head of the WHO Office in Poland: – Soon, under the aegis of WHO, a report will be published on the problem of obesity in children. We expect that it will be also used in the works of the Coalition. Moreover, as far as healthy diet and preventing obesity are concerned, WHO in Poland actively collaborates with the Ministry of Health.
The meeting participants underlined the necessity of taking concurrent preventive and curative actions. The basis for preventive actions as well as relevant guidelines were included in the National Health Programme, however the effects will be visible in a few years. Therefore, at the same time, as the experts stressed, people suffering from obesity should undergo therapies, including patients with class 2 obesity (BMI 35-39.9) and class 3 obesity known as morbid or super obesity (BMI ≥ 40) which require surgical treatment. Mariusz Wyleżoł, MD, PhD, academic teacher at Military Institute of Aviation Medicine, President of the Metabolic and Bariatric Surgery Section of the Polish Society for the Study of Obesity, said: – In patients with super obesity bariatric surgery is the most successful, thus the most effective method of treatment of this severe condition from the economic perspective. According to my research, no such cost-effective method exists in any other domain of medicine. Mariusz Wyleżoł also said that bariatric procedures cause the type 2 diabetes subside and prevent its development: – After 36 month from the surgery, the demand for antidiabetic drugs is reduced by 90%. Currently in Poland three thousand surgical procedures a year are carried out, which means they are available for just under 1 per cent of people suffering from super obesity.
Uncalculated Costs of Obesity Treatment
The Coalition members emphasized that complications after obesity generate huge costs, as obesity-related diseases include inter alia: type 2 diabetes, hypertension, cardiac diseases, cancers, respiratory tract diseases, articular conditions and depression. — Therefore we have to answer the question whether we can afford failure to treat obesity, which is not only a severe condition itself, but an underlying cause of many other diseases. What is more, is it important to begin treatment at an early stage, before complications arise, and to diagnose them early, for example through regular control of blood tension, or concentration of lipids and glucose – said professor Krzysztof Paśnik, MD, PhD, Head of the Clinic of General, Oncological, Metabolic Surgery and Toracosurgery of the Central Clinical Hospital of the Ministry of National Defence, Military Institute of Medicine.
The experts noted that the actions should be taken now. – The percentage of people suffering from obesity is growing systematically, in Poland it is almost one per cent a year. The problem is that obesity is a chronic disease, without a tendency to subside spontaneously. It will not pass like a cold. It requires proper diagnosis and treatment. The key to successful treatment of obesity is diagnosing its source, e.g. compulsive eating syndrome or emotional disorders, but also many other complex factors – said professor Magdalena Olszanecka-Glinianowicz, MD, PhD, President of the Polish Association for the Study of Obesity.
Magdalena Gajda, President of OD-WAGA Foundation for People With Obesity Disease, Public Advocate for the Rights of People with Obesity Disease, stressed: — More than half Poles is overweight or obese. And in many European countries the situation is similar. Let us imagine that these data apply to e.g. cancer. Would we focus on preventing that disease, or on full treatment guaranteeing the already ill patients professional diagnosis and access to safe, reliable and effective therapies?
The Coalition members pointed out how important it is to exert broad care over people suffering from obesity. – We have to coordinate actions aimed at treatment of obesity. This condition requires comprehensive approach and introducing changes in three aspects – from legal solutions supporting reformulation of food (reducing caloric value while preserving taste) and promoting physical exercise in leisure time, through healthcare level in the form of prophylactic programmes allowing for effective education and comprehensive treatment, to the level of local governments which play a vital role in reaching the society – said Magdalena Władysiuk, MD, PhD, President of CEESTAHC. Her opinion is also supported by Dariusz Hajdukiewicz, Head of the Health Policy Office of the Municipal Office of the Capital City of Warsaw — it is important to engage also local government units in the problem of combating obesity. The Capital City of Warsaw could be a place where pilot phase of activities proposed by the Coalition will be implemented. We are ready to share our observations – both positive and negative – from the activities performed so far. Among others, this year we have tried to establish in Warsaw a complex of centres meant for comprehensive treatment of and professional care over people suffering from super obesity and morbid obesity. These centres could be provided with additional specialist diagnostic, therapeutic and patient care equipment.
Closing the meeting, Jarosław Pinkas stressed: – fighting obesity starts when a child is born. We know what to begin with and I do hope that soon we will see the effects, however we have to bear in mind that soon here means in a couple of years.
About the Coalition Against Obesity
The members of the Coalition Against Obesity are eminent experts and medical authorities operating in the area of public health and obesity, representatives of public administration institutions, scientific and local government units and representatives of patient organisations. The works of the Coalition are supported by experts from the entire Central and Eastern Europe, as well as associations for studies over obesity from CEE countries — inter alia from the Czech Republic, the Baltic States, Hungary and other countries — as well as the WHO Office in Poland and the World Bank. The Coalition members in Poland include, among others, the Ministry of Health of the Republic of Poland, the Polish Society for the Study of Obesity and OD-WAGA Foundation for People with Obesity Disease.
Within a few months to come, the Coalition will draw up the Obesity Road Map, a strategic document with recommendations and proposed solutions for creating a system of comprehensive treatment of patients with obesity. The outputs of the Coalition’s work will be presented during international conference “The obesity epidemic – challenges for Central and Eastern Europe. The patients, the professionals, the system”, to be held in Warsaw at the turn of 2016 and 2017. The honorary guest at the conference will be, among others, Vytenis Andriukaitis, the EU Commissioner for Health and Food Safety. Other guests will include the representatives of ministries of health and scientific institutions from CEE countries. Fighting obesity is also one of the priorities of Malta’s presidency in the Council of the European Union, to be commenced on 1 January 2017.
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