Abstract
Introduction
The prevalence of obesity is soaring all over the world, and Italy is reaching the same pace. Similar to other countries, the Italian healthcare system counts on a three-tier model for obesity care, and each region has freedom in the implementation of guidelines. No national record is currently available to monitor the actual situation throughout the country.
Purpose
To provide a report of the current status on the availability of specialized public obesity care services in Italy.
Methods
Regional prevalence of obesity was extrapolated from publicly available data. Data on facilities for the management of obesity were retrieved from records provided by national scientific societies. Whenever possible, data was verified through online research and direct contact.
Results
We report a north–south and east–west gradient regarding the presence of obesity focused facilities, with an inverse correlation with the regional prevalence of obesity (R = 0.25, p = 0.03). Medical-oriented centers appear homogeneous in the multidisciplinary approach, the presence of a bariatric surgery division, the availability of support materials and groups, with no major difference on follow-up frequency. Surgery-oriented centers have a more capillary territorial distribution than the medically oriented, but not enough data was retrieved to provide a thorough description of their characteristics.
Conclusion
Obtaining a clear picture of the situation and providing consistent care across the country is a challenging task due to the decentralized organization of regions. We provide a first sketch, reporting that the model is applied unevenly, and we suggest feasible actions to improve the situation in our country and elsewhere.
Level of evidence
Level V, narrative review.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
Availability of data and material
All data other than SIO records is publicly available. SIO records will be made available upon reasonable request.
References
Noncommunicable Diseases Progress Monitor (2017) World Health Organization, Geneva
Prospective Studies C, Whitlock G, Lewington S, Sherliker P, Clarke R, Emberson J, Halsey J, Qizilbash N, Collins R, Peto R (2009) Body-mass index and cause-specific mortality in 900 000 adults: collaborative analyses of 57 prospective studies. Lancet 373(9669):1083–1096. https://doi.org/10.1016/S0140-6736(09)60318-4
Lauro R, Sbraccia P, Lenzi A (2019) 1st Italian Obesity Barometer Report. Obesity Monitor, vol 1. IBDO Foundation, Rome
Italian National Institute of Health. OKkio alla Salute: i dati nazionali 2016. (National data 2016). (2017). http://www.epicentro.iss.it/okkioallasalute/dati2016. Accessed 2020
World Health Organization, Mean body mass index trends among adults, crude (kg/m2). Estimates by country. http://apps.who.int/gho/data/view.main.BMIMEANADULT. Accessed 2020
OECD (2019) The Heavy Burden of Obesity. doi: https://doi.org/10.1787/67450d67-en
McAllister EJ, Dhurandhar NV, Keith SW, Aronne LJ, Barger J, Baskin M, Benca RM, Biggio J, Boggiano MM, Eisenmann JC, Elobeid M, Fontaine KR, Gluckman P, Hanlon EC, Katzmarzyk P, Pietrobelli A, Redden DT, Ruden DM, Wang C, Waterland RA, Wright SM, Allison DB (2009) Ten putative contributors to the obesity epidemic. Crit Rev Food Sci Nutr 49(10):868–913. https://doi.org/10.1080/10408390903372599
Watanabe M, Masieri S, Costantini D, Tozzi R, De Giorgi F, Gangitano E, Tuccinardi D, Poggiogalle E, Mariani S, Basciani S, Petrangeli E, Gnessi L, Lubrano C (2018) Overweight and obese patients with nickel allergy have a worse metabolic profile compared to weight matched non-allergic individuals. PLoS One 13(8):e0202683. https://doi.org/10.1371/journal.pone.0202683
Bluher M (2019) Obesity: global epidemiology and pathogenesis. Nat Rev Endocrinol 15(5):288–298. https://doi.org/10.1038/s41574-019-0176-8
GU Serie Generale n.360 del 28-12-1978 - Suppl. Ordinario (1978)
Art.32 Costituzione italiana, Parte I, titolo II (1947)
Generale n.4 del 07-01-1994 - Suppl. Ordinario n. 3 (1994)
Dong Z, Xu L, Liu H, Lv Y, Zheng Q, Li L (2017) Comparative efficacy of five long-term weight loss drugs: quantitative information for medication guidelines. Obes Rev 18(12):1377–1385. https://doi.org/10.1111/obr.12606
Santini F, Busetto L, Cresci B, Sbraccia P (2016) SIO management algorithm for patients with overweight or obesity: consensus statement of the Italian Society for Obesity (SIO). Eat Weight Disord 21(2):305–307. https://doi.org/10.1007/s40519-016-0279-3
Sbraccia P, Busetto L, Santini F, Mancuso M, Nicoziani P, Nicolucci A (2020) Misperceptions and barriers to obesity management: Italian data from the ACTION-IO study. Eat Weight Disord. https://doi.org/10.1007/s40519-020-00907-6
Mariani S, Watanabe M, Lubrano C, Basciani S, Migliaccio S, Gnessi L (2015) Interdisciplinary approach to obesity. In: Multidisciplinary approach to obesity: from assessment to treatment, pp 337–342. https://doi.org/10.1007/978-3-319-09045-0_28
Lenzi A, Jannini EA (2017) Endocrinologia 2.0 - Libro Bianco sullo stato dell’endocrinologia Italiana. Milan, Italy
Società Italiana dell’Obesità. https://sio-obesita.org/. Accessed 2020
Società Italiana di Chirurgia dell’Obesità e delle malattie metaboliche. https://www.sicob.org/sicob2/default.aspx. Accessed 2020
The European Association for the Study of Obesity. https://easo.org/. Accessed 2020
Tsigos C, Hainer V, Basdevant A, Finer N, Mathus-Vliegen E, Micic D, Maislos M, Roman G, Schutz Y, Toplak H, Yumuk V, Zahorska-Markiewicz B, Obesity Management Task Force of the European Association for the Study of O (2011) Criteria for EASO-collaborating centres for obesity management. Obes Facts 4(4):329–333. https://doi.org/10.1159/000331236
EASO. Obesity: perception and policy – multi-country review and survey of policymakers. London: European Association for the Study of Obesity; 2014. European Association for the Study of Obesity. Policymaker Survey 2014. http://easo.org/wp-content/uploads/2014/05/C3_EASO_Survey_A4_Web-FINAL.pdf. Accessed 2020
Caterson ID, Alfadda AA, Auerbach P, Coutinho W, Cuevas A, Dicker D, Hughes C, Iwabu M, Kang JH, Nawar R, Reynoso R, Rhee N, Rigas G, Salvador J, Sbraccia P, Vazquez-Velazquez V, Halford JCG (2019) Gaps to bridge: misalignment between perception, reality and actions in obesity. Diabetes Obes Metab 21(8):1914–1924. https://doi.org/10.1111/dom.13752
Camera dei Deputati, Legislatura 18, Mozione n. 1/00082. https://www.camera.it/temiap/2019/11/15/OCD177-4202.pdf. Accessed 2020
Capehorn MS, Haslam DW, Welbourn R (2016) Obesity treatment in the UK health system. Curr Obes Rep 5(3):320–326. https://doi.org/10.1007/s13679-016-0221-z
Istat Conti Economici territoriali 2017. https://www.istat.it/it/files/2018/12/Report_Conti-regionali_2017.pdf. Accessed 2020
Acknowledgements
We would like to thank the Italian Society for Obesity (SIO) for providing records of their affiliated centers.
Funding
This research received no external funding.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors declare that they have no conflict of interest.
Ethical approval
Not applicable.
Informed consent
Not applicable.
Consent for publication
Not applicable.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
This article is part of the Topical Collection Italian Society of Obesity (SIO) Reviews.
Rights and permissions
About this article
Cite this article
Watanabe, M., Risi, R., De Giorgi, F. et al. Obesity treatment within the Italian national healthcare system tertiary care centers: what can we learn?. Eat Weight Disord 26, 771–778 (2021). https://doi.org/10.1007/s40519-020-00936-1
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s40519-020-00936-1