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- Title
Perché stiamo perdendo la guerra contro l'obesità e le malattie metaboliche.
- Authors
DI CIAULA, AGOSTINO; PORTINCASA, PIERO
- Abstract
Overweight and obesity are progressively increasing at all ages and worldwide, as also related mortality, morbidity (mainly cardio-metabolic risk and cancer) and health costs. In recent decades, the fight against obesity has been solely aimed at obtaining weight loss by changing lifestyle, by pharmacological treatments and/or bariatric surgery or endoscopy. Epidemiological evidence certifies the failure of this approach, which however remains the major recommendation in current clinical guidelines. Lifestyle changes produce poor and frustrating effects in the long-term. The most innovative anti-obesity drugs (GLP1 agonists, double GIP/GLP-1 agonists, triple GLP-1, GIP and glucagon receptor agonists) generate up to 20% weight loss. However, emerging limitations (i.e., high cost of therapy, weight gain after interruption of treatment, adverse events) and socio-economic risks (economic sustainability, inequity in the access to therapies) are generating concerns about their adequacy as the preferential answer to the obesity epidemic. Obesity derives from inadequate individual behavior but also from living in an unhealthy environment, able to disrupt the metabolic homeostasis. The available guidelines appear inadequate and ineffective, since they are merely oriented towards individual behavior and therapy, largely neglecting primary prevention measures to counteract an inadequate food production system, an unsustainable food market and the progressive rise of environmental obesogens. Specific and effective strategies should also target food production and marketing, as also the unsustainable production and release of toxic chemicals into the environment, to improve food safety and public health.
- Publication
Il Cesalpino, 2024, Issue 61, p22
- ISSN
0394-6231
- Publication type
Article