Slovakia needs urgent new obesity management interventions [Advocacy Lab Content]

Slovakian obesity rates have been rising steadily for a decade, mirroring global and European trends. Approximately 60% of Slovaks are either overweight or obese, highlighting the need for effective new public health interventions.

Obesity is a serious public health problem increasing the risks of poor health outcomes, shorter life expectancy, and reduced quality of life. In Europe, one in six lives with obesity, and more than 50% of EU citizens are overweight.

According to the OECD, individuals with lower incomes are more likely to be obese, exacerbating health inequalities. Increased consumption of energy-dense foods, trans-fats, and saturated fats, coupled with sedentary lifestyles, lack of physical activity, and health illiteracy, have contributed to the growing obesity trends.

“Knowledge about nutrition and physical activity is very general and superficial. People often do not realise that they can significantly influence their health and reduce the risk of many non-communicable diseases, including cancer, Alzheimer’s diseases, and type 2 diabetes,” said Professor Barbara Ukropcová of the Biomedical Research Centre at the Slovak Academy of Sciences (BMC SAS).

The World Health Organisation (WHO) warns that more than one billion people in the world are living with obesity. Among adults, obesity has more than doubled since 1990 and quadrupled among children aged 5 to 19.  More than 80% of people with type 2 diabetes have obesity or are overweight. The WHO estimates that overweight and obesity cause more than 1.2 million deaths in the WHO European region every year, representing more than 13% of total deaths. 

Intersectoral and multidisciplinary approach needed

Obesity is a complex issue without a single solution, and according to Professor Ukropcová, educating about prevention, risks, and management of obesity in schools, workplaces, healthcare, and media is one of the key solutions.

“Many people have no idea about the caloric content of the food they eat, how much exercise they need to burn off excess calories, or the effects associated with lack of movement or a diet rich in saturated fats or simple carbohydrates,” she told Euractiv.

Ukropcová adds that a comprehensive and coordinated management of patients with obesity is needed. This includes healthcare personnel, physiotherapists, nutrition specialists, and psychologists trained in obesity management, involving health insurers, implementing legislative measures focusing on food, and improving access to active transportation.

Slovakia has only one facility accredited by the European Association for the Study of Obesity – the Centre for Obesity Management at Biomedical Research Centre SAS.

“Patients can undergo individual dietary counselling, a three-month training programme, and cognitive-behavioural coaching to build healthier dietary habits and to increase physical activity. In indicated cases, the treatment can be supplemented by pharmacotherapy or bariatric surgery,” Ukropcová added.

According to some clinical studies, only around 11% of patients maintain a 5% weight reduction after a year. The ‘yo-yo effect’ commonly discourages people from persevering.

“Returning to the original weight is not a failure, and there is no need to feel ashamed or apologise for it. It is important to come and seek solutions together,” she continued.

More initiatives to improve obesity rates

On 4 March, World Obesity Day, a month-long ‘Slovakia Against Obesity’ initiative commenced, organised by the multidisciplinary Slovak Obesity Association. The initiative united different specialists focused on obesity management. During this time, citizens can get a test for BMI, blood pressure, cholesterol, glycemia, and a basic liver disease screening in selected pharmacies across the country.

The goal of this project is to support the protection of public health, bring important testing and diagnosis of pre-obesity and obesity closer to people, and improve health literacy on the topic of obesity as a disease.

Since October, a hotline has been set up with the aim of removing barriers that prevent people from addressing obesity. It is intended for those who lack the determination to go to a doctor or do not have access to obesity management in their region.

In 2022, the Health Ministry adopted health standards for the management and prevention of overweight and obesity. The framework is aligned with the latest WHO guidelines on physical activity and sedentary behaviour. Incorporated are also interventions in physical activity, nutrition, counselling, and psychotherapy.

Despite the positive action, there is still room for improvements in health literacy and capacity-building.

Apart from the Centre for Obesity Management at BMC SAS, outpatient clinics and private clinics are available, but the capacities are not sufficient: “There is still a need for more clinics and specialists dedicated to comprehensive obesity management,” Ukropcová concluded.

[By Filip Áč, Edited by Vasiliki Angouridi, Brian Maguire | Euractiv’s Advocacy Lab]

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