‘Government policy is not offensive enough’

The latest WHO report, published Tuesday, warns of an “epidemic” of overweight and obesity in Europe, especially after the health crisis. Faced with a plague that affects more than half of European adults, the League Against Obesity in France is calling on French and European governments to take more offensive measures against obesogenic factors.

The old continent is the victim of a new contagion. The World Health Organization warned Tuesday, May 3, of an “epidemic” of overweight and obesity in Europe, killing more than 1.2 million people every year.

A study conducted – the inventory of which covers the situation in 53 states – shows that 59% of European adults are overweight or obese. A prevalence now higher than in any other region except America. The youngest is 1 in 3 children.

Since 2016, individual data all point to further increases in Europe, especially since the Covid-19 pandemic.

Although there is no European consensus on the methodology for calculating obesity prevalence, screening methods are mainly based on body mass index (BMI – calculated from height and weight) and waist circumference. This is especially the case in France, one of the worst students, as it is in the top average for the increase in obesity. A situation about which Jean-Philippe Ursulet, General Director of the League Against Obesity (LCO), a French non-governmental organization uniting all the actors helping to prevent and fight the disease, wants to warn: “The France is more on the the top of the ranking as we reach almost 50% of the population in terms of overweight and obesity.

Deterioration, especially since the health crisis

The latest obesity figures in France date from 2020. ObÉpi-Roche’s study, funded by the LCO, revealed that 30% of the adult population was overweight (BMI equal to or greater than 25), and 17% were obese (BMI higher than than 30). “We will have studies in the next two years to examine the impact of the health crisis and the incarceration,” explains Jean-Philippe Ursulet.

For children, the numbers are alarming. The curve is only widening, the director-general of the association is concerned. “In 1965, there was 3% obesity in children ages 2 to 15; today, more than 15% is affected,” he says, citing forecasts for 2020.

In the UK, 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 the students of 6andthe prevalence of obesity has increased from 21% in 2019-2020 to 25.5% in 2020-2021.

In France, no quantified study since incarceration, but clear findings. Calls to the LCO hotline literally exploded with Covid-19. “Usually we are between 500 and 600 calls per year. For the year 2020 we have increased to 1,700 calls,” specifies the director general of the association.

The pandemic has made the problem of obesity even more urgent, the WHO Europe said in its press release. Preliminary data suggest that people are at higher risk for obesity risk factors, including an increase in a sedentary lifestyle and consumption of unhealthy foods. “In subsequent studies, the curve is likely to evolve, to demonstrate a worsening rate of obesity prevalence,” predicts the LCO’s director general.

In addition, the WHO recalls, obese patients are more likely to have 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 more exposed

In 72% of cases, calls to the LCO hotline during labor involved women, who are somewhat over-represented in the obesity rate, especially in France.

If nutritional disorder is one of the leading causes of obesity, it is certainly not the only one. Sleep deprivation and psychological issues are too, not to mention the impact of endocrine disruptors (EP) on the body. Increasingly shown by scientists, the hormonal disorder caused by PE may explain why women are more prone to obesity.

“Women are exposed to a number of substances that disrupt hormonal balance,” says Jean-Philippe Ursulet, referring to a “cocktail of devastating endocrine disruptors.” PE present in food, plastics and paint, but also in cosmetics, which are used more by women, and clothing (in dyes and cadmium, a weakly radioactive element that makes clothes wrinkle-free). “Knowing that the skin takes in 2% of air through the pores, imagine what it can absorb in terms of harmful products that go straight into the bloodstream…”

“Western European countries are also very large consumers of processed products”, Jean-Philippe Ursulet develops. But the condition of women in these countries also needs to be examined, he adds, referring mainly to stress and sleeping problems. “We can also relate these figures to those of unemployment, women who are more exposed to it and insecure in contracts.” So many vectors of stress, which could also explain women’s overexposure to obesogenic risks.

But how can these risks be reduced? On the other hand, if structural factors cannot be legislated with immediate effect, doctors ask the government to take direct action on certain products.

“An action that isn’t offensive enough to target products anyway”

“Obesity knows no borders. In Europe and Central Asia, no country will achieve the goal of halting the increase in obesity, which is one of the WHO’s global targets for non-communicable diseases (NCDs),” said Dr. Hans Henri P. Kluge, Regional Director of WHO Europe, in the report. “There is enormous diversity among countries in our region, but all of them face a certain challenge. By creating more stimulating environments, fostering investment and innovation in healthcare, and by putting in place high-performing and resilient systems, we can track the obesity trajectory in the region.”

In France, since 2016, the nutrition label “Nutri-score”, intended to promote a balanced diet, draws the attention of consumers to the quality of the dishes they select. The principle has also been adopted by some of our European neighbours, such as Belgium, Germany and the Netherlands. However, nutritionists usually dispute it because it only measures the nutritional value of the product in question. “We calculate the nutritional value and put a letter in front of an isolated dish, but if you combine this dish with another product, it necessarily changes 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 the caloric and nutritional value on each product, but also to specify the foods that should not be eaten with this processed dish.

“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 also be banned,” the director general of the League argues against obesity.

To go further, the LCO asked the government to over-tax harmful products (and ban very harmful products), and vice versa, to lower VAT on healthy products that consumers should have easier access to.

“If everyone resorts to products that are a priori cheap, it is mainly linked to a precarious problem,” emphasizes Jean-Philippe Ursulet. “The legislator has a job to redirect the consumption of the population.”

“We have learned over time that a one-size-fits-all policy will not work. To succeed as a country or region, we need a comprehensive array of interventions,” Acting Head Dr Kremlin Wickramasinghe said in the WHO statement. European Office for the Prevention and Control of NCDs, which prepared the European Regional Report.

To date, however, no country has been able to implement all these policies simultaneously. “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. Recommendations include limiting the marketing of unhealthy foods to children, taxing sugary drinks and improving the health system’s response to obesity treatment.

In France, “government policy is not insulting enough for products that are nevertheless well targeted,” says the director-general of the League against obesity. The latter points again to endocrine disruptors, but also to fast food that is especially 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 cash registers where ultra-sweet candies and chocolates are displayed, with very attractive visual marketing that appears to be benevolent to products that are extremely harmful.”

The importance of sports

If there are (partly cultural) differences, the observation is the same in all European countries. In Finland, for example, concern for healthy eating is widely conveyed through television cooking programs (such as Top Chef). However, Jean-Philippe Ursulet states: “The Finns do not really address the problem by enacting legislation on products, because these decisions have to be made at European level”.

So no hunting for harmful products and endocrine disruptors in Finland either. On the other hand, the country has managed to set a time of physical activity for employees on working time, and Finnish employers spend an average of 200 euros per employee on physical activity (against tax relief). The same dynamism in Sweden, voted Europe’s most sporting country in 2018 by the European Commission as part of its fight against inactivity. In 2017, the Eurobarometer devoted to sport and physical activity revealed that only 15% of Swedes have never exercised, compared to 46% of French.

In France, this line of thought was presented by the LCO to the Senate at the beginning of April, says Jean-Philippe Ursulet. “Sport ensures proper functioning of the organs, but also for the elimination of endocrine disruptors”. For example, an hour of exercise a day would yield very encouraging results, he says. “It is this track that we must follow. Parallel of course with the ban on certain products.”

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