To date, 40 percent of adults are overweight in Italy and about 10 percent are obese. A phenomenon that also affects the youngest by affecting 20 percent of children between 6 and 10 years of age, but which concerns all the countries of the world. According to a new study published in The Lancet, if governments do not adopt effective strategies as soon as possible to curb this epidemic, over half of adults and almost a third of children and adolescents in the world will be overweight or obese. A trend that will mainly threaten the new generations, who will have to deal with the physical and psychological problems related to this pathology, but also with a dizzying increase in health costs.
One of the novelties put in place in recent years in the fight against obesity are Glp-1 competitive drugs, born as anti-diabetics but which are also used today to treat obesity. Mimenting the action of a natural hormone, the “glucagon-like peptide-1” (GLP-1), help overweight patients/obese to lose between 15 percent and 20 percent of their body weight. Although they are connected to serious adverse events, and despite the lack of long -term data on their security, they have become extremely popular. In addition, they should be taken throughout their lives to maintain the results earned, although the treatment is often interrupted after a couple of years, with consequences on health in the medium and long term still to be clarified. We talked about it with Luca Elli, head of the Nutrition and Life Styles Commission of Aigo (Italian Association of Gastroenterologists and Digestive Hospital Endoscopists).
Doctor Elli, when it comes to obesity it is essential to clarify an important aspect: it is not a condition attributable to an incorrect lifestyle, but of a real pathology. What are the risk factors?
“Obesity is a multifactorial pathology. Risk factors to include genetic and family aspects. Age and gender can influence risk as well as an unbalanced diet and poor physical activity. Furthermore, some drugs can contribute and medical conditions can increase risk. But also a sedentary lifestyle helps, those who are already prepared, to develop a real obesity”.
By 2050, more than half of the adult population and about a third of children and adolescents in the world will be overweight or obese. This is what emerges from an analysis conducted by Global Burden of Disease (GBD) Study 2021, published in The Lancet, which examined the trends from 1990 to today in 204 countries. What are the causes of this increase?
“The global increase in obesity and overweight is probably linked to changes in lifestyle. The transition towards less balanced diets with a lower fiber content, with more ultra -reprocessive foods, is a key factor. The poor physical activity and the increase in the past time in front of screens are other factors. Globalization has finally led to a greater availability of high calorie foods. These changes have influenced public health at a level. world “.
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The most disturbing aspect concerns young people between 5 and 14 years of age: in this age group the growth of obesity is exceeding that of overweight. What impact can infantile obesity on long -term health?
“Infant and youth obesity can have serious consequences on long -term health. Obesi children have a greater risk of developing type 2 diabetes and other metabolic disorders. Cardiovascular problems and orthopedic disorders are common in these cases. Furthermore, childhood obesity can also influence psychological and social development. As for many other pathologies, prevention is crucial: it is necessary to intervene in the prevent complications “.
The increase in obesity rates will have a significant impact not only on individual health, but also on society and global economy. What strategies can be implemented to reverse this trend? And above all, how to sensitize the youngest?
“To reverse the trend of obesity, it is necessary to change the lifestyle in general. Promoting a balanced diet and regular physical activity is fundamental. The awareness campaigns by scientific societies can help change food habits. Also interventions of environmental urban planning, such as parks and cyclopedonal paths, encourage physical activity. Sensitizing young people through schools and families is crucial for long -term success.”
Is it possible to heal from obesity? How does a obese patient take care of? What are the therapeutic options?
“Obesity therapy is very complex given the clinical characteristics of the obese patient and possible comorbidity. The cure of obesity requires a multidisciplinary approach. Lifestyle changes, such as diet and physical activity, are the first step. Pharmacological therapy can be useful for some patients. Bariatric surgery and endoscopic therapies are instead options for more serious cases. Finally, psychological is important to maintain the results over time “.
The new anti-obesity drugs are revolutionizing the treatment of obesity. What are those available in Italy and how do they reduce body weight?
“The agonist drugs of GLP-1 and GIP are new therapeutic options for obesity. They usually act by reducing hunger and improving glycemic control. These through different mechanisms help to lose weight and therefore can be important tools, together with the change of lifestyle and psychological and dietary support, for the obese patient. They are particularly effective also in reducing the risk of metabolic complications. Italy for the treatment of obesity and overweight in adults are three: Orristat, Liraglutide, bupropione/naltrexone “.
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What are the advantages of their hiring?
“Anti-obesity drugs offer several advantages, including a significant weight loss, an improvement in glycemic control and a reduction in cardiovascular risk. They can therefore improve the quality of life of patients. Long-term efficacy depends on the combination with lifestyle changes. They are particularly useful for patients with severe obesity or metabolic complications”.
However, these drugs also have limits. First of all, to maintain the results, they should be hired potentially for life. What can the suspension of the treatment lead to?
“Anti-obesity drugs have an important limit, namely the need for continuous intake. The suspension of the treatment can lead to the total recovery of the lost weight, for this reason they can help in some phases of the treatment, premising that the education in lifestyles remains at the basis of long-term treatment. Among the causes of abandonment there are side effects as a persistent feeling of nausea sometimes accompanied by alance, and diarrhea requires a prolonged use. Constant monitoring to avoid complications for these reasons.
Studies have shown health benefits as well as weight loss. But nevertheless it is important that they are assumed only when the conditions are such as to make them necessary. What are the risks related to abuse?
“The improper use of these drugs can cause serious side effects and dependence. It is crucial to use these drugs only under medical supervision. The lack of adherence to the prescriptions can reduce the effectiveness and increase risks. Risk sensitization is essential to prevent abuse and guarantee safe use. The most common side effects of the Glp-1 and investigating drugs of nausea, vomiting and diarrhea, which are mainly at the beginning. treatment and tend to decrease over time “.