Obesity is a complex multifactorial disease that affects almost 60% of adults and one in three children in Europe. The obesity community has to become louder and change the harmful narrative of ‘eat less, move more’, Jacqueline Bowman-Busato told EURACTIV in an interview.
Jacqueline Bowman-Busato is the EU policy lead at EASO, the European Association for the Study of Obesity, and the joint head of the scientific secretariat of MEP Interest Group on Obesity.
Not a single EU country is on track to reach the target of reducing obesity rates by 2025. What do you see as one of the main challenges or issues?
A lot of people think that obesity is about the size and it’s about ‘eat less, move more’. And that’s actually quite an erroneous and harmful narrative of policymakers. It’s just incorrect. There’s a lot of misinformation and every time we try to correct it, then there’s this deluge of louder voices for various reasons to say no, it’s okay to be the fourth highest, independent cause of premature mortality. That’s actually the attitude that we’re facing. It’s horrible. And I always say to my colleagues, both policymaker colleagues in the European Parliament, as well as my own within an EASO, that the obesity community has been the most polite and quiet out of all of the major medical condition communities.
Do you think that obesity community can learn from other communities how to become “louder”?
I’ve been here since 1995 and I remember when cancer was not sexy. I remember when cancer was a pariah. And then the cancer community, so all of the different stakeholders, got their narrative aligned, and they started speaking up, they put the evidence piece behind what they were saying. We started doing that as well, we’re just 20 years behind. So that’s what we’re working on, which is hard. It’s really hard to do it.
COVID has brought more focus on health, did it help the obesity community as well?
COVID helped us jump a bit, we jumped about three or four years, because of COVID. We got data from studies on the biological risk for people living with severe obesity which showed that the more severe obesity was the more severe COVID was. It wasn’t actually about size, it was actually about inflammation, compromised immune system, just like all of the other vulnerable groups. So all of a sudden, everybody: policymakers, practitioners, who were not obesity specialists, and people living with obesity had to stop, look at their narrative and say: but wait, that doesn’t make sense. Because we’re so used to talking about food, exercise and all of a sudden, we’re talking about cytokine storms [life-threatening systemic inflammatory syndromes involving elevated levels of circulating cytokines and immune-cell hyperactivation that can be triggered by various health conditions]. So how does that marry with the individualized fault, personal responsibility and sugar taxes that we’ve been preaching for decades? This was a kind of Eureka moment for policymakers in different parts of the institutions, that maybe we need to take a fresh look and we need to actually align with the science. And just maybe we need to start applying how we address other non-communicable diseases (NCDs), instead of just going for this, eat less, move more.
You saw the report from the World Health Organization that came out recently, what are your thoughts on it?
I think this report coming out is very helpful, for actually stating what’s the state of play. From that perspective, that’s why it’s useful to have a baseline that is more updated, to build upon, and then take other institutional documents, particularly EU level institutional documents, such as the Strategic Foresight report of 2020, which specifically mentions cancer and obesity as the two NCDs that are major challenges in terms of vulnerable groups. Clearly, a lot has been done for cancer, zero, for obesity, I mean, zero. So for us from an MEP interest group perspective, and the broader obesity community across it’s a good starting point. It’s also really encouraging that member states have said, we need some help, that there’s so much political goodwill to do something about obesity.
What help are we talking about here?
The member states across the board want to be efficient and effective, and multisectoral. What they’re clearly struggling with is how to actually put policies together at the national level. At the EU level, we can make a favorite environment. Because what you see is that actually quite a few policies that impact the health outcomes for people living with obesity, are not actually health policies per se. So they just impact health outcomes, and that’s what we’re able or the MEPs able to think about at the EU level and encourage other EU institutions as well as national level. Hence why they’re working together a lot with national stakeholders to actually work out what goes where.
[Edited by Zoran Radosavljevic]