“Epidemic” of obesity: “Public policy is not offensive enough”

The latest WHO report, published on Tuesday, warns of an “epidemic” of overweight and obesity in Europe, especially after the health crisis. Faced with a scourge that concerns more than half of European adults, the League against Obesity in France calls on the French and European public authorities to take more offensive action on obesogenic factors. The Old Continent victim of a new contagion. The World Health Organization warned on Tuesday, May 3, of an “epidemic” of overweight and obesity in Europe, where more than 1.2 million people die from it each year. A study carried out – whose state places looks at the situation in 53 states – reveals that 59% of European adults are overweight or obese. A prevalence now higher than in any other region except the Americas. On the younger side, this concerns 1 in 3 children. Since 2016, individual data has all indicated further increases in Europe, especially since the Covid-19 pandemic. If there is no European consensus on the methodology for calculating the prevalence of obesity, screening methods are mainly based on body mass index (BMI – calculated from height and weight) and waist circumference. This is particularly the case of France, among the worst students, since it is in the upper average for the rise in obesity. A situation on which Jean-Philippe Ursulet, general manager of the League against obesity (LCO), a French non-governmental organization which brings together all the actors who help in the prevention and the fight against the disease, wishes to alert: “The France is rather at the top of the ranking, since we reach almost 50% of the population in terms of overweight and obesity”. Worsening, especially since the health crisis The latest figures collected on obesity in France date from 2020. The ObÉpi-Roche study, funded by the LCO, revealed that 30% of the adult population was overweight (BMI equal to or greater than 25), and 17% obese (BMI greater than 30). “We will have studies within the next two years to see the impact of the health crisis and confinement”, explains Jean-Philippe Ursulet. On the children’s side, the figures are alarming. The curve is only increasing, worries the director general of the association. “In 1965, there was 3% obesity among children aged 2 to 15; today, more than 15% are affected,” he says, referring to projections for 2020. In the United Kingdom, official data from the National Child Measurement Program shows that one in seven first graders is obese after three lockdowns. This figure was 1 in 10 before the pandemic, the highest increase ever. Among 6th graders, the prevalence of obesity has increased from 21% in 2019-2020 to 25.5% in 2020-2021. In France, no quantified study since confinement, but clear findings . Calls to the LCO hotline literally exploded with Covid-19. “Usually, we are between 500 and 600 annual calls. For the year 2020, we have risen to 1,700 calls”, specifies the general manager of the association. The pandemic has made the problem of obesity even more urgent, points out WHO Europe in its press release. Preliminary data suggests that people have been at higher risk for obesity risk factors, including an increase in sedentary lifestyles and consumption of unhealthy foods. “In the next studies, the curve is likely to evolve, to show a worsening of the number of the prevalence of obesity”, predicts the director general of the LCO. Moreover, recalls the WHO, patients with obesity are more likely to experience complications and die from the virus. In France, “47% of people who died from Covid-19 were obese,” adds Jean-Philippe Ursulet. “Faced with global health problems, public health, obese people are still overrepresented in mortality”. Women at greater riskIn 72% of cases, calls made to the LCO hotline during confinement concerned women, who are slightly overrepresented in the obesity figures, particularly in France. If nutritional disorder is one of the of the main causes of obesity, it is far from being the only one. Lack of sleep and psychological problems are also, not to mention the impact of endocrine disruptors (EP) on the body. Increasingly demonstrated by scientists, the hormonal disorder created by PEs may explain why women are more affected by obesity. “Women are exposed to a number of substances that disrupt hormonal balance,” says Jean -Philippe Ursulet, evoking a “cocktail of devastating endocrine disruptors”. PE present in food, plastics and paints, but also in cosmetics, used more by women, and clothing (in dyes and cadmium, a weakly radioactive element which allows clothing to be crease-resistant). “Knowing that the skin absorbs 2% of the air through the pores, imagine what it can absorb in terms of harmful products that enter the bloodstream directly…””Western European countries are also very big consumers of processed products”, develops Jean-Philippe Ursulet. But the condition of women in these countries is also to be studied, he adds, referring in particular to stress and sleep problems. “We can also correlate these figures with those of unemployment, women being more exposed to it, and precarious in terms of contracts”. So many vectors of stress, which could also explain the overexposure of women to obesogenic risks. But how can these risks be reduced? If structural factors cannot be the subject of legislation with immediate effect, doctors are, on the other hand, asking the public authorities to take action directly on certain products. “An action that is not offensive enough on targeted products””Obesity knows no borders. In Europe and Central Asia, not a single country will meet the goal of halting the spread of obesity, which is one of the global targets of the non-communicable diseases (NCDs),” said Dr Hans Henri P. Kluge, Regional Director of WHO Europe, in the report. “There is huge diversity among countries in our region, but they all face some degree of challenge. By creating more enabling environments, promoting health investment and innovation, and putting effective and resilient systems in place, we can change the trajectory of obesity in the region.” draw consumers’ attention to the quality of the dishes they select. The principle has also been taken up by several of our European neighbours, such as Belgium, Germany and the Netherlands. However, nutritionists mostly dispute it because it only measures the nutritional value of the product concerned. “We calculate the nutritional value and put a letter for an isolated dish, but if you combine this dish with another product, this will necessarily change the value of the total Nutri-score of what you have consumed”, explains Jean- Philip Ursulet. According to doctors, it would therefore be better to indicate on each product its caloric and nutritional value, but also to specify the foods that should not be eaten with this processed dish. “Similarly, anything with the letter C, D or E ( indicating the presence of added sugars, and often different types of added sugars, editor’s note) should be prohibited”, pleads the director general of the League against obesity. To go further, the LCO asked the public authorities to overtax the products harmful (and prohibit very harmful products), and on the contrary, to reduce VAT on healthy products to which the consumer should have easier access.” If everyone takes refuge in products that are a priori inexpensive, it is before everything linked to a problem of precariousness”, underlines Jean-Philippe Ursulet. “Legislators have a duty to perform to reorient the consumption of the population.” “We have learned over time that a one-size-fits-all policy will not work. To be successful as a country or region, we need a whole full range of interventions,” said Dr. Kremlin Wickramasinghe acting head of the WHO European office for the prevention and control of NCDs, which produced the European regional report, in the press release. However, to date, no country has was able to put all these policies in place at the same time. “It is important to prioritize 2 or 3 policies to implement now and have a workable plan to introduce the rest of the interventions,” he continues. Among the recommendations, the restriction of the marketing of unhealthy foods to children, the taxation of sugary drinks and the improvement of the response of the health system for the management of obesity. In France, “the policy of the public authorities n is not offensive enough on products which have nevertheless been well targeted”, estimates the general manager of the League against obesity. The latter again points to endocrine disruptors, but also fast food particularly appreciated by young people. The “aggressive marketing” of brands towards children is also in the sights of the association. “Children are the target of this marketing, especially at the checkout counters where ultra-sweet candies and chocolates are displayed, with very attractive visual marketing that seems benevolent for products that are extremely harmful”. disparities (partly cultural) pre-exist, the finding is the same in all European countries. In Finland, for example, concern for healthy eating is widely conveyed through television cooking shows (such as Top Chef). However, specifies Jean-Philippe Ursulet, “The Finns do not really tackle the problem by legislating on products, because these decisions must be taken at European level”. No hunting for harmful and endocrine disrupting products in Finland either , so. On the other hand, the country has succeeded in establishing a time of physical activity on working time for employees, and Finnish employers spend an average of 200 euros per employee for physical activity (against tax relief). The same dynamic in Sweden, named the most sporting nation in Europe in 2018 by the European Commission as part of its fight against inactivity. In 2017, the Eurobarometer dedicated to sport and physical activity revealed that only 15% of Swedes never practiced physical activity, compared to 46% of French people. In France, this line of thought was submitted by the LCO to the Senate, at the beginning of April, indicates Jean-Philippe Ursulet. “Sport allows the proper functioning of the organs, but also to eliminate endocrine disruptors”. Thus, one hour of sport per day would make it possible to obtain quite encouraging results, he says. “It is this track that we must follow. In parallel, of course, with the prohibition of certain products.”