In 2022, the obesity clinic of UZ Leuven was awarded an accreditation of the European Association for the Study of Obesity. Since then the Leuven obesity centre became part of a large European expertise network which aims to share insights and knowledge about obesity. But to fully live up to the role as a university obesity centre, primary care for obesity and obese people must also be set up professionally. Belgian obesity specialists have therefore developed a roadmap for organising efficient obesity care in our country.
Chronic disease
The number of people with overweight and obesity is increasing worldwide. More than half of the Belgian population suffers from overweight or obesity. This is taking its toll: overweight leads to a fair number of diseases and excess mortality. During the coronavirus pandemic, overweight people were ill more seriously and ended up more in intensive care more frequently. The World Health Organisation already recognised obesity as a chronic disease in 1948, which means that people who suffer from it are entitled to adequate treatment. But this is where our country falls short, according to the obesity clinic at UZ Leuven
Prof. dr. Bart Vanderschueren, endocrinologist at UZ Leuven: “It is high time to give overweight and obesity the attention it deserves. People with overweight and obesity find themselves in an unfair battle with their metabolism. Our knowlege about obesity and how we can help people with obesity, has evolved significantly. It now comes down to applying those scientific insights into our clinical care. But not all obesity should be medicalised: a lot of people can be helped just as well by their GP, dietician or by psychological counselling.”
GP is key
In cooperation with the Belgian Association for the Study of Obesity and Eetexpert, UZ Leuven developed a roadmap for the organisation of obesity care in the wider area. It can serve as a guide for discussing obesity, assessing its severity and initiating treatments according to the stage of obesity. To make a clear difference with commercial organisations capitalising on weight loss, a clear structure about who can find help where is necessary. GPs, dieticians, physiotherapists and psychologists have to work closely together and can refer to an obesity centre.
If there is a need for hospital treatment, a recognised obesity centre can play a part. Only in a number of cases, a multidisciplinary obesity clinic is necessary and it can only work well if patients are taken care of properly in the first line. Lifestyle adjustments are always the cornerstone of the treatment, but if these prove inadequate, the latest types of medication that act on the hunger and satiety system can be used. In addition there is the possibility of a surgical procedure: over the last couple of year bariatric surgery has become less invasive and therefore safer.
People with obesity find themselves in an unfair battle with their metabolism.
prof. dr. Bart Van der Schueren
Start care pathway for children
Frank Vandenbroucke, minister for Social Affairs and Public Health: “Obesity is a chronic disease, which deserves the best and especially correct and affordable care, just like any other chronic disease. This is exactly the ambition of our new and integrated obesity care pathway, specifically aimed at children and adolescents. With this reform, we want to rely on a scientific basis to (1) detect obesity as early as possible, (2) support children and young people with obesity - but also their families - as quickly and adequately as possible, and (3) provide the necessary care with the right treatment. The child and his family are at the centre of this new approach. We don't let go of them, which is important, because during every important 'growth stage' - e.g. the transition to secondary school, but also a growth spurt or when your body changes during puberty - there is the risk of a relapse. There always has to be a possibility to lead a child or an adolescent back, and smoothly, to an intensive programme, but equally the reverse and step down in care if things are going well. Collaboration across the board of our care is also the key here. This wide care pathway, which encompasses all aspects of obesity in children and adolescents, will be developed by mid-2023 by a NIHDI working group that includes the voice of all stakeholders.”
Prof. dr. Bart Vanderschueren: “Prevention against obesity in adolescents is very important, because otherwise, obesity can turn into a lifelong battle. But we do hope that adult obesity care will also get a clear pathway. The Belgian healthcare system needs structure and a professional approach for people with obesity. The step-by-step approach in which the GP plays a crucial role and collaborates with other healthcare workers is the only way to turn the tide. Such a roadmap should be implemented by the government, so that every person is entitled to an efficient approach. In addition, the reimbursment for the treatment and follow-up of obesity is an urgent matter. Obesity not only results in premature death, it also causes diabetes, cardiovascular disorders, cancer and sleep apnoea. Moreover there are big psychic and social consequences. This costs the government handfuls of money and put a strain on the healthcare system.”
The roadmap for GPs was set up by the UZ Leuven obesity clinic, in collaboration with Eetexpert, the Flemish Knowledge Centre for eating and weight problems, and BASO. On Saturday 4 March it is World Obesity Day. The UZ Leuven obesity clinic organised a symposium about a step-by-step approach for obesity care.