Current Status and Response to the Global Obesity Pandemic Proceedings of a Workshop (2019) / Chapter Skim
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3 Global Obesity Prevention and Treatment Efforts
3 Global Obesity Prevention and Treatment Efforts
Pages 27-40
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From page 27... ...
The World Health Or ganization produced a global action plan on physical activity for 2018–2030 to accelerate the implementation of policies to create active societies, active environments, active people, and active systems. (Fiona Bull)
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The findings will be used to create a Health Systems for Obesity Index, she said, which will be added to the Federation's Global Obesity Observatory, a repository of obesity prevalence and incidence data. Barata Cavalcanti explained that the World Obesity Federation decided to focus on health systems because obesity is being tackled with multifactorial solutions.
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From page 29... ...
Additional barriers identified are shown in Figure 3-1. Barata Cavalcanti also shared data on the availability of specialized obesity training in 30 countries: approximately one-quarter of the countries have no such specialist training available; in another quarter, the availability of such training is unknown; and the remaining half of the countries reported specialist training for bariatric surgery, nutrition, counseling, or other broad-ranging specialist training.
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SOURCE: Presented by Olivia Barata Cavalcanti, October 9, 2018. lower availability of qualified obesity treatment professionals was reported in rural compared with urban areas.
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Do obesity treatment financing mechanisms facilitate equitable access to care? (e.g., is obesity treatment largely covered by out of pocket expense, insurance, or government health provision?
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She added that talking about specific ways, such as playing, dancing, cycling, or walking, resonates with nonhealth sectors that may be less accustomed to the term "physical activity." She explained that the updated plan maintains the 2013 plan's global target of a 10 percent relative reduction in the prevalence of insufficient physical activity by 2025, and also targets a 15 percent reduction by 2030. To achieve these goals, she suggested that all people have access to safe and enabling environments, as well as
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Presented by Fiona Bull on October 9, 2018. Reprinted with permission from Elsevier.
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Create active societies. Create a paradigm shift in all of society by enhancing knowledge and understanding of, and appreciation for, the multiple benefits of regular physical activity, according to abil ity and at all ages, by changing social norms and attitudes around physical activity.
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She elaborated that countries need resources and "how to" guides for developing or updating their national action plans for physical activity, conducting communication and social marketing campaigns, integrating physical activity into the guidance patients receive from health and social care services, and promoting physical activity in schools. She stressed that countries also need help with capacity building for multisector collaboration, and noted the challenges of bringing government departments together to build a "whole-of-system" approach.
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Pointing out that eating ultraprocessed foods1 is associated with poorer dietary quality and higher obesity prevalence, da Silva Gomes emphasized that "there is no population that eats more ultraprocessed products and eats better." He displayed a series of graphs showing that in various countries, a greater proportion of energy intake from ultraprocessed products is correlated with a higher intake of sugars and saturated fat and lower intake of fiber (Cediel et al., 2018; Cornwell et al., 2018; Costa Louzada et al., 2015; Julia et al., 2018; Juul and Hemmingsson, 2015; Martinez-Steel et al., 2016; Monteiro et al., 2018)
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. Stressing that the relative affordability of ultraprocessed products contributes to their displacement of "real foods," da Silva Gomes advocated for correcting the distortion of prices so that real foods are more affordable, and ultraprocessed products are less affordable.
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It is a major priority for the health system." Another participant observed that obesity treatment is often over shadowed by a focus on prevention, and wondered whether this is because treatment is generally not as available. She asked Barata Cavalcanti what types of treatment countries offer and whether the World Obesity Federation recommends specific offerings for different health systems based on their capacities and resources.
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But according to MAPPS key informants, she reported, "the waiting list is so long that you would have to wait around 100 years to get your surgery." She added that the World Obesity Federation will try to clarify what treatments are actually available in practice, and noted that while it is not yet making recommendations to health care systems, any guidance would feature a multidisciplinary team approach. Bull responded to a participant's question about whether an association has been observed between physical inactivity and obesity across countries.
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