New WHO report on trends in adolescent obesity

On 17 May 2017 at the 24th European Congress on Obesity in Porto, Portugal, Dr João Breda, Head of the WHO European Office for the Prevention and Control of Noncommunicable Diseases, launched the new WHO report “Adolescent obesity and related behaviours: trends and inequalities in the WHO European Region, 2002–2014”.

The report confirms that the number of obese adolescents is continuing to rise in many countries across the Region. Levels are increasing particularly in eastern European countries, are very high in the vast majority of countries, and are especially high in countries of southern Europe.

The report looks at trends regarding the risk factors for obesity, and reveals that a serious contributing factor is physical inactivity. Physical inactivity levels are higher in the southern part of Europe, where more than 70% of adolescents do not achieve the WHO daily recommendations for physical activity. At the same time, the loss of the traditional eating habits associated with the Mediterranean diet in children and adolescents seems to explain part of the problem.

The report reveals strong inequities as well: younger adolescents, boys and those living in families of lower socioeconomic position are more likely to be obese. This is the result of a combination of fewer opportunities for children and adolescents of poorer families to be physically active, and the relatively higher cost of healthy diets compared to unhealthy options richer in calories, sugar and fat.

Obesity as a chronic disease

In his keynote speech at the opening of the Congress, Dr Breda focused on obesity as a disease. “Obesity is a chronic, relapsing condition. It can be considered a disease where the toxic agent is a combination of physical inactivity and food.”

WHO defines a body mass index over 30 as obesity – a very serious condition that requires support and health care interventions. Obesity constitutes a major risk factor for other diseases as well, notably cancer and diabetes.

Dr Breda highlighted that obesity is becoming a serious problem in countries where it was not an issue some years ago. The countries experiencing this rise have recently adopted dietary patterns with more energy-dense foods, sugar and excess fat, as well as lifestyles with decreasing levels of physical activity.

Tackling the rise in obesity and its associated inequalities requires a patient-centred approach, a focus on primary care and the involvement of many sectors. Dr Breda also noted the importance of promoting communication and integration between public health and health policies: “It is not feasible for one health worker to provide every service according to a patient’s needs: he or she should be able to refer to services in other settings.”

In addition, countries should prioritize upstream interventions to stem the tide of increasing obesity in the Region. Those suffering from obesity also require follow-up, as the chronic condition is associated with comorbidities and the need for repeated care over time.

Dr Breda concluded his presentation by stressing the need for further research to fill knowledge gaps and identify linkages for innovative approaches.