2023-04-26 09:00:20
Din a column published in The world of April 5, representatives of pharmacology defend the idea that obesity is first and foremost a social disease that must be treated by a preventive approach, and not by drugs. We, carers of patients suffering from obesity, researchers on the mechanisms of this disease, specialists in clinical research on obesity, patients and patient associations, wish, in response, to broaden the debate on this disease, its prevention and its treatment. .
Obesity is a chronic disease recognized by the World Health Organization (WHO) since 1997. It develops on predisposed terrain, partly genetic, in the face of an obesogenic environment which induces lifestyles that are harmful to health. Although France is one of the only countries in the world to have had a National Nutrition and Health Program (PNNS) for primary prevention for many years, its action must be continued and even strengthened by targeting the most vulnerable people in particular.
We join the authors of the forum on the alarming insufficiency of an effective prevention policy to fight against this obesogenic environment, but we also warn of the need to treat patients already in a situation of obesity. Simple injunctions “eat better and move more” are not enough… Once established, obesity is a disease that becomes chronic with a high risk of recurrence, being associated with a lasting disruption of energy storage capacities.
A graduated care pathway
France currently has more than 8.5 million obese patients, including about 1 million with particularly severe obesity with a body mass index (BMI) greater than 40. The complications of obesity are well known mechanical (osteoarthritis, sleep apnea) as well as metabolic and vascular (type 2 diabetes, hepatic steatosis, arterial hypertension, cardiovascular and thromboembolic diseases) and the risks of associated cancers. As patient associations point out, obesity is also responsible for a major alteration in self-image, depression and social isolation.
The care of children and adults in a situation of obesity has recently been the subject of recommendations from the High Authority for Health (HAS) for a graduated course of care. They are based on therapeutic changes in lifestyle, behavioural, sometimes psychological, treatment of complications and, in the event of failure and for the most severe forms of obesity, drug treatment or surgery. Reducing weight and acting on complications significantly improves patients’ quality of life and increases healthy lifespan.
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