The day March 4th is reserved on the world calendar to talk about obesity. The World Health Organization (WHO) established the date with the aim of disseminate knowledge about the disease and combat social stigma regarding the subject.
O Brazil and the world are experiencing a rise in obesity cases. A report released by The Lancet magazine at the end of February shows that the disease more than doubled among adults and quadrupled among children and adolescents aged 5 to 19in the period between 1990 and 2022.
In partnership with WHO, the analysis reveals that 879 million adults were living with obesity in 2022. In 1990, the number of obese adults was 195 million.
If the world scenario is seen with concern, here in Brazil it is no different. According to the World Obesity Atlas 2024, which brings together data from 186 nationalities, published earlier this month by the World Obesity Federation (WOF), the Brazil had 34% (15.58 million) of the public aged 5 to 19 living with excess weight in 2020.
Endocrinologist Lívia Lugarinho, director of the Obesity Department at the Brazilian Society of Endocrinology and Metabology (SBEM) and member of the Childhood Obesity Department at Abeso, look at the numbers carefully. She states that if nothing is done, more cases of the disease could be recorded in the coming years.
According to Lívia, the exponential increase recorded between 1990 and 2022 may have several factors. The expert explains that the sedentary lifestyle and the pandemicwith people using screens for longer, are important factors that must be taken into consideration.
“The pandemic caused a lot of harm, the values are also reflections of a pandemic context. People were confined, without physical activity, more anxious, and this reflected in a worse diet. And many of these habits persisted. Obesity in adults is complex, because talso involves socioeconomic issues”, he points out.
In addition to the reasons already mentioned, the endocrinologist cites another factor of attention, which is the growth in consumption of ultra-processed foods. A The culture of ‘faster’, fattier and sugary foods has a direct impact on cases of childhood obesity.
WHO data showed that 159 million children and adolescents were living with obesity in 2022, while in 1990 the number was 31 million.
“One of the biggest villains in the growth of childhood obesity are sugary drinks, such as ready-made juices. There is a campaign for higher taxation of these products, they are cheap and guarantee a very large caloric supply for this population that is already more sedentary”, assesses Lívia Lugarinho
For the specialist, the reasons for the increase in obesity are already evident, however, It is difficult to get around the numbers in a society with sedentary behavior. Furthermore, she highlights that the stigmatization of people makes it difficult to advance the debate.
“When people arrive with obesity, they often hear ‘shut up and exercise’. As if it were that, as if it were a very simple thing. No one would say this to a person with cancer or another disease, but with obesity there is this stigma. It’s not easy, because if it were such a simplistic solution, we wouldn’t be living through this epidemic,” he says.
Treatment
Today, Brazil has few treatments for obesityand, the most common is bariatric surgery, which is not indicated for all cases. The country still has five approved medicines that patients can use, but none of them are available in the Unified Health System (SUS).
In this scenario, the endocrinologist states that the country lack of public policies for the treatment of obesity. Today, according to her, most actions are focused on prevention, which is not enough to stop the number of cases and face the epidemic.
“We lack public policies, higher taxes on certain foods and the need to incorporate drug treatment. The incorporation of drug treatment for this group is extremely important, I think this will be a watershed in terms of public policies. The only issue is dietary guidelines and the physical part, in the vast majority of cases, is not enough to sustain the person’s weight loss,” he explains.
A reference in the treatment of obesity, according to Lívia Lugarinho, is the United Kingdom. The place distributes medicines in the public health system, including those who cannot pay for treatment.
Growth until 2035
If Brazil does not make progress in combating obesitythe Atlas suggests that there will be an annual increase of 1.9% in the numbers of Brazilian adults with obesity and overweight between 2020 and 2035. Furthermore, the value could jump to 50% (around 20 million) of young people in the same period.
At a global level, the document says that, if current trends continue until 2035, 770 million children and adolescents are expected to live with overweight and obesity — an increase from 22% (in 2020) to more than 39% by 2035.
“I really believe that with the incorporation of treatment, combined with lifestyle changes, we can reduce these numbers a little. And when we reduce the numbers of obesity, we also reduce the numbers of more than 200 diseases, such as breast, intestinal and endometrial cancer. We have a reduction in other diseases that also generate a high cost. Therefore, there needs to be a confrontation that does not only involve prevention”, assesses the specialist.
The Atlas projects that nearly 3.3 billion adults will be affected by obesity in 2035, up from 2.2 billion in 2020 — an increase from 42% to more than 54%.
“The estimated annual growth of people with a higher BMI will be 1.9% per year. This implies that, from less than 100 million people with overweight or obesity in 2020, in 15 years we will have almost 140 millions of Brazilians with health problems related to being overweight”, says the report.
