«From the Alliance for Obesity, we request the creation of a national strategy for comprehensive care for obesity that includes an early approach, also addressing the stigma that these individuals suffer; that considers the recognition of obesity as a chronic disease in Spanish legislation; that includes coordinated care between different healthcare settings, enhancing Primary Care,» Lesmes expressed during her intervention.
Likewise, she has called for the creation and integration of multidisciplinary care units in all autonomous communities, to provide a comprehensive and effective approach and treatment, ensuring equitable access to endocrinologists, dietitians, nutritionists, psychologists, and physical activity experts; funding innovative treatments; reducing bariatric surgery waiting lists; and establishing a training plan for healthcare professionals, improving early detection and avoiding erroneous approaches within treatment.
«Obesity is one of the biggest public health challenges in Spain. Not just an aesthetic issue or individual habits, it is a chronic, recurrent, multifactorial disease, and its lack of recognition as such is severely limiting the healthcare and policy response it deserves (…) The cost of inaction is much higher than the cost of investing in effective solutions. Obesity cannot continue to be treated as an individual responsibility issue, it is a disease in itself and this requires a structural, equitable, and coordinated response,» she stated.
On the other hand, she emphasized the crucial role of coordination with Primary Care, as well as in other healthcare specialties, avoiding duplications.
The expert explained that the «first 1,000 days of life are very important» for preventing obesity in childhood, as it is a period in which metabolism will be modulated; likewise, she considered it important to have units capable of assessing the risk of people with obesity developing certain diseases like diabetes.
DIFFERENCES IN TREATMENT BY COMMUNITY
Lesmes explained that this lack of recognition creates an «associated stigma» at the social, labor, and healthcare levels, as not all autonomous communities have specialized units, there is no adequate coordination among healthcare professionals, and there are not even data on bariatric surgery waiting lists; regarding the latter, she has asked the Ministry of Health to request information from the autonomous communities.
«Today, a person with obesity in one autonomous community may receive one type of care and in another community, radically different care. This creates inequality in healthcare and perpetuates the clarification of obesity in many individuals,» she added.
The endocrinologist also criticized the fact that no pharmacological treatment for obesity is funded by the National Health System, which means that patients requiring medical treatment must bear the full cost, leaving many people unable to afford it.
Similarly, she stressed that «nobody chooses» to have obesity, as it functions like any other disease and affects multiple organs and systems, being related to over 200 pathologies such as cardiovascular diseases, type 2 diabetes, kidney diseases, liver diseases, hypertension, and even various types of cancer; obesity reduces quality and life expectancy, as these individuals live between seven and ten years less than healthy individuals.
The specialist pointed out that the economic cost of obesity is «unsustainable» and increasing, highlighting that it currently represents 9.7 percent of total healthcare expenditure, generating over 2,000 million euros in direct costs.
«From a social perspective, 479,000 working days are lost annually and it can reduce the GDP by 2.9 percent. It is estimated that if we do not act by 2030, the direct healthcare expenditure derived from obesity may increase by 58 percent,» she added.
EXISTING STIGMA
Although Lesmes believes that in recent years there has been a «reduction in stigma,» it has occurred in a «misguided way,» as there is a trend where obesity is accepted and believed to not require any intervention.
On her part, the president of the Spanish Thyroid Cancer Association and an obesity patient treated with bariatric surgery, Aránzazu Sáez Sánchez, has exposed the different stigmas that these individuals suffer in the healthcare, social, and labor spheres.
«Obesity is not just a health issue, it is a life problem. It is facing fatigue and pain, not only in the back or knees, but also in the eyes of those who judge us. It is living in fear of rejection, at work, in public transport, or even in medical consultations. It is feeling that every daily decision is conditioned by your weight, from choosing the clothes you want to wear to go out or to attend a social gathering,» she stated.
Additionally, Sánchez has pointed out that people with obesity also have to «bear a huge psychological pressure,» both from others’ comments and those they make to themselves, as they are made to feel like they «have failed when in reality, it is the system that has failed.»
«People with obesity are blamed and judged for our disease. They tell us it’s a matter of strength, of willpower, when obesity is a very complex disease with multiple factors beyond diet or exercise,» she commented.
Regarding the stigma present in healthcare, Sánchez explained that visits to the doctor often boil down to a «you need to lose weight,» without conducting tests, examinations, or following a strategic plan, in addition to offering treatments that must be paid for by the patient.
«Those of us who have undergone bariatric surgery have to pay for our vitamins for the rest of our days. This has very serious consequences because half of the patients with obesity avoid going to the doctor for fear of being judged. This means that serious illnesses are not detected on time or worsen over time,» she said, criticizing that in many cases they have to resort to private healthcare due to long waiting lists, especially for surgery.
Finally, she recalled that obesity also «closes doors» in the workplace, denouncing that they are rejected in job interviews without being given a chance, assigned less visible positions, denied promotion opportunities, and face «disrespectful or paternalistic» comments in their workplaces.
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FUENTE