Expert: Doctors must be vigilant against obesity, just like they are against cancer

Doctors in Poland do not use the basic tool in diagnosing obesity, which is measuring the patient's weight and height, assessed Małgorzata Gałązka-Sobotka, Ph.D. from Lazarski University in Warsaw. In her opinion, medical workers must start showing vigilance for obesity disease.

"Obesity has not existed in the dictionary of medical practice in Poland for many, many years, although it is included in the international classification of diseases, where it has the code E66. For years, it was also not visible in the healthcare system in Poland," said Małgorzata Gałązka-Sobotka, PhD, director of the Institute of Management in Health Care at Lazarski University in Warsaw. According to the specialist, this is evidenced by the statistics of the National Health Fund, which show that obesity (code E66) was diagnosed in about 200,000 people. Meanwhile, the Central Statistical Office estimates that the population of obese people in Poland is about 9 million people.

At a press conference organised by the Stop Obesity Partnership on World Obesity Day (March 4), Dr Gałązka-Sobotka pointed out that in the Polish healthcare system we have not developed a habit among medical workers of taking basic measurements that could provide insight into whether a patient is at risk of obesity, whether the disease has developed or whether it has been cured.

The specialist pointed out that in many countries of the world - even before the patient enters for a medical visit - nurses check their body weight and height, and sometimes also waist circumference (to determine the risk of abdominal obesity - PAP). This is treated as one of the basic activities in collecting medical history about the patient.

“The regulation has only been in force for five years, imposing on all service providers operating in primary health care (POZ) the obligation to weigh and measure the patient and to submit information on the body weight and height of the beneficiary to the National Health Fund reporting system at least once a year,” explained Dr. Gałązka-Sobotka. She added that the National Health Fund should have this data, because these are very important parameters that determine the health condition of the population and are used to assess the effectiveness of many interventions that we undertake.

"Such a legal obligation exists, it functions on paper, but in practice it has never been enforced, so it has not been fulfilled by healthcare providers," said the specialist. As she emphasized, doctors should be vigilant for the appearance of the first symptoms of obesity, and the first symptom indicating the risk of its development is overweight.

Dr. Gałązka-Sobotka also pointed out that currently family doctors do not have the systemic tools to help patients at earlier stages of obesity development. "Today in Poland, most patients with obesity do not receive help within the framework of guaranteed benefits, even though we have effective therapies that can help them," she said. She added that only patients with the most severe form of obesity, i.e. morbid obesity, have access to innovative treatment under public health insurance; this is bariatric surgery.

"In this matter, we can boast of many achievements, including the most innovative model of comprehensive treatment for patients requiring surgery. But this is only a certain percentage, a group of 5.5 thousand patients who have benefited from the program from the beginning of its launch until March 2024. For a patient who does not require surgery, the system actually has partially closed doors," she noted.

She added that in order for Poland to achieve success on the path to reducing obesity, it is necessary not only for the Minister of Health to increase access to effective obesity treatment, but also to create mechanisms that will change the conditions of our daily lives, allowing us to build a real ecosystem that promotes health, not disease. This includes the ability to make healthy choices, including in the field of communication - e.g. switching from a car to a bike, or nutrition - less processed products should be cheaper and more easily available.

"There is no doubt that if we were not bombarded with so many advertisements, we would probably be able to respond to many food temptations more effectively. There is no doubt that it is absurd that VAT on bottled water in Poland is exactly the same as on all carbonated drinks. There is no doubt at all that our problem is that there is no health education in schools," the specialist listed.

She recalled that the Partnership for the Prevention and Treatment of Obesity (Stop Obesity Partnership), which currently brings together over 70 organizations, including scientific societies (such as the Polish Society for the Treatment of Obesity) and universities, social organizations, employers' and patients' organizations, as well as business organizations, has developed a long-term obesity reduction plan for Poland.

"In this plan, we strongly emphasize the need to separate activities related to obesity prevention from activities that will serve to organize an effective, safe and accessible, but also modern, diagnostic and treatment system," explained Gałązka-Sobotka.

She emphasized that this is not a so-called quick political project or a project for a quick campaign, but an action requiring responsible leadership, planned for decades. "Today we need determination to neutralize at least some of the risk factors for the development of obesity, but also vigilance, similar to that in oncology, so as not to ignore the first symptoms of the disease and to include effective interventions, e.g. dietary, at the initial stage of its development. To do this, we have to do a huge amount of work in terms of educating society, medical professionals in all fields, but also decision-makers," the specialist concluded.

Joanna Morga (PAP)

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