Busetto, helping people with obesity

«Obesity can be controlled and cured, as we have even more ways to help our patients lose fat and keep their healthy weight over time»

Luca Busetto, associated professor of Internal Medicine at the University of Padova, president of the SIO (Italian Obesity Society) and coordinator of the Obesity Management Task Force

Obesity is a complex chronic disease. People suffering from it often feel stigmatized by a patronizing society, sometimes even brutal, that doesn’t know that it is a medical, psychological and social condition.

Luca Busetto, associate professor of Internal Medicine at the University of Padova, president of the SIO (Italian Obesity Society) and coordinator of the Obesity Management Task Force, has been fighting for people with obesity’s rights to have access to reliable information and professional treatment.

Obesity, a chronic pathology hard to keep in check

While some scientific communities still debate whether obesity is a condition or a disease, for Busetto the answer is clear. «Obesity is a complex disease», he explains, «and it requires a multidisciplinary treatment, especially in the more severe cases. It has to comprehend a clinical point of view, especially whenever complications arise; correct nutritional education; and information about the benefits of physical activity». What’s difficult about obesity and its definition resides in its complexity.

What are the causes of obesity, and why is it finally time to debunk some myths about the disease? «In the majority of cases, “common” obesity has a genetic root, it has strong ties to family history» Busetto starts, and explains that there are rare cases where the condition is purely genetic. «But there are also environmental factors, which are not only tied to nutrition and excess calories» he says. «There are sleep disorders that facilitate the onset of obesity, certain kinds of foods that may cause obesity or facilitate it. And then medical science is also debating about environmental endocrine pollution, namely substances that are present in the environment and that may alter the functioning of our body’s regulatory mechanisms.»  

All these factors contribute to the “epidemic of obesity” that society is facing. «We live in an “obesogenic” world, where food is always available and we receive constant pressure that pushes us to eat». Furthermore, obesity is a disease which cannot be cured just by dieting, as people commonly think. «Obesity can be controlled and cured, as we have even more ways to help our patients lose fat and keep their healthy weight over time. But it still is a chronic disease, and so treatment must be thought of as long-lasting both by the patient and the doctor» Busetto insists, clarifying that longer-term treatment is necessary to avoid relapse.

The hope of new drugs and of modern innovative practices

“Obesity is a gateway” is a definition used by the European Community and by EASO (European Association for the Study of Obesity). In fact, the condition acts as a door to a series of other problems ever more severe, in a “domino effect” kind of event that endangers the patient. «Without doubt it leads to metabolic diseases such as type II diabetes, hypertension, dyslipidemia, an increased risk of blood clotting and consequently cardiovascular diseases such as heart failure. However people with obesity also have an increased risk to get diseases tied to the accumulation of fat tissue and its distribution, such as respiratory problems up to respiratory failure, together with mechanical and fertility issues and an increased risk of contracting cancer» professor Busetto observes. 

Luckily, scientific research in the field of obesity is working to offer new solutions to people with obesity, such as innovative drugs previously used to treat diabetes. «We already have medications against obesity, but they have a bland effect on weight. There are, however, new molecules that are very near to being distributed in Italy and Europe which are way more promising» Busetto claims. According to the professor, these new innovative drugs will be extremely useful to cure obesity and keep it in check. Pharmacological treatment will be more indicated for patients who do not reach the most severe obesity levels; on the other hand, bariatric surgery is more than up to the task to treat the most serious cases. «I think that in the coming years we will see a great deal of changes in pharmacological treatment of obesity» he says with optimism.

However, no treatment can deal with a generalized lack of information surrounding the disease. Talking about obesity and educating the patients and their families may help people overcome the social stigma surrounding the condition. Moreover, it would send a message to the scientific community, not yet fully convinced that it is a pathology. This slows research and prevents patients from accessing the benefits given by the Italian National Health Service. «The big problem will be to make these medications available to people, as they will be innovative but also costly» the professor clarifies.

The role of SIO and of the clinics against obesity

«SIO fights obesity in different fields: scientific, clinic, educational and political» Busetto says. The Italian Obesity Society, founded in Bologna in 2000, has always tried to promote correct information about obesity and those who suffer from it. To facilitate access to treatment and to guarantee people are helped by professionals, the association has put together a list with affiliated clinics that have to comply with a set of standards. «The continuous feeling of being seen as inferior human beings has serious effects on people with obesity and on their willingness to seek and commit to their treatment» the doctor explains, saying that it is important to raise awareness to the disease even to people who do not suffer from it.

Busetto also highlights that SIO-affiliated clinics have to offer psychological help to patients, as the disease has a strong mental strain that cannot be ignored. «”Eat a bit less” or “try to be physically active”: these sentences may be said with good intentions, but you cannot just will people to heal from a disease. Patients with obesity suffer from this, as they have probably been living with the stigma since they were kids» he says, and underlines the psychological burden that someone not having a physique in line with societal standard has to suffer.

Busetto concludes saying that SIO wants to have some political power to bring real change to those who suffer from obesity. «Isn’t it strange that a molecule that is already distributed by the Italian NHS is free for patients with diabetes, but must be paid in full by those who suffer from obesity?» he asks. Even if it is a wide conversation, which falls outside of pure scientific medicine, Busetto still insists on it. «If there are effective therapies which are safe and help my patients’ health, then I will do everything in my power as the president of the SIO to help people have access to them» he ends.