OPEN Spain

Obesity in Spain

Economic impact

• In Spain, the current cost to the National Healthcare System caused by obesity-related health problems is already €2 billionⁱⁱ. If the trend continues, by 2030 by 2030, it is estimated that more than 10 million people over 18 will be living with obesity in Spain, which will result in a cost of €3 billion^iv. It is therefore essential that the responsible administrations act to build a system that effectively supports people living with obesity and enables healthcare providers to adequately care for patients.
• Currently in Spain there are no reimbursed drugs for obesity, yet there are more than 11 million patients on the waiting list for bariatric surgery^v. People living with obesity have health complications, leading to additional costs due to the treatment needed for up to 236 comorbidities or pathologies associated with obesity^vi. In Europe, people living with obesity have 20% more healthcare costs and 68% treatment costs than people who do not have the disease^vii.

Societal impact

• In Spain, obesity is recognised as a disease and is included in the National Health System (SNS) Portfolio of Services^viii. However, there are no active policies or plans in place to support the treatment of obesity, this includes diagnosis, care and follow up.
• Due to the lack of an effective national response, 22% or more of all adults in Spain suffer from obesity^ix. For children and adolescents (between the ages of 5 – 19), the most conclusive studies indicate that between 8.5% and 14.9% are living with obesity^x.

Individual impact

• Obesity is a chronic disease which is not recognized, often even by those affected^xi. It presents a large number of associated complications and illnesses.
• Between 2014 and 2017 there was a 14.37% increase in diabetes diagnoses, which might be related to the increase in cases of obesity and individuals who are overweight. More than 80% of people living with obesity have type 2 diabetes^xii. Furthermore, obesity is associated with an increased risk of cardiovascular diseases, such as hypertension, ischemic heart disease, heart failure, stroke, atrial fibrillation, ventricular arrhythmias and cardiac death^xiii. In fact, 4 out of 5 people with type 2 diabetes were classed as overweight or living with obesity when diagnosed^xiv.
• In addition, diseases associated with obesity include dyslipidemia, hypertension, fatty liver, obstructive sleep apnea syndrome (OSAS), infertility, some of the most prevalent tumors such as breast cancer ^xv,xvi.

Clinical challenges

• Obesity is often seen as the patient’s individual responsibility by health professionals. This is partially due to a governmental focus on nutrition and physical exercise as the solutions for obesity, a lack of training on the science and multifactorial causes of obesity, as well as inadequate patient data available to healthcare professionals^xvii. These gaps in strategy and knowledge prevent professionals from providing appropriate diagnosis and care to patients living with obesity^xviii.
• For these reasons, we must deliver greater opportunities for training and education as well as patient access to specialists to ensure they are provided with unbiased care.
• In terms of access to specialists, there is a need to establish an integrated patient pathway to enable early diagnosis and referral to these specialists – either within centers or multidisciplinary teams. These specialists and allied health professionals will then be able to help manage the multifactorial causes of obesity and the complications / comorbidities faced by people living with obesity.

Key Achievements

Although OPEN Spain is relatively new, we have already accomplished important milestones:

2020

• Drafting of an OPEN Spain Position Paper: after several digital and face-to-face meetings, a position paper was developed reflecting on the current Spanish situation and outlined recommendations for progress.
• In the context of the COVID-19 pandemic, and due to its impact on people with obesity, OPEN Spain developed a position paper addressing existing evidence on the increased risks for people with obesity and the consequences of the lockdown on the population. health authorities to urge them to find solutions.

2021

• Engagement with the spokespersons of the Health Commission of the Congress of the Deputies. As a result of these meetings, 3 non-legislative motions, one written question and one oral question were submitted by different parliamentary groups.
• Meeting at the Health Commission of the Congress of Deputies, on May 28, with the aim of promoting a common parliamentary initiative to address obesity. During this meeting, OPEN members urged the members of Congress to develop a State Plan promoting a comprehensive approach to obesity.
• Meeting with Meritxell Batet, then President of the Congress of Deputies.
• Development and Implementation of an advocacy strategy in two Spanish regions: Comunidad de Madrid and, the Canary Islands. As a result, 3 non-legislative motions and one oral question were promoted by the different regional parliamentary groups.

2022

• Public presentation of OPEN Spain to the media and society in a well-received press conference. In addition, launch of its X (formerly Twitter) account (@OPEN_es).
• Meeting with Carolina Darias, then Minister of Health and Pilar Aparicio, Director General of Public Health, on April 2022; they both showed their support to OPEN Spain and agreed to collaborate with its members.
• Event at the Spanish Congress of Deputies to present the Decalogue of the Rights of People Living with Obesity. Among the participants were the members of the Health Commission, Carolina Darias, former Minister of Health, and Meritxell Batet, President of the Congress of Deputies.
• Development of an advocacy strategy in two Spanish regions: Comunidad Valenciana and Andalucia. As a result, 3 non-legislative motions and several information requests were presented by the different regional parliamentary groups.

Priorities in 2023 and Beyond

OPEN Spain remains committed to its mission and continues to:

• Pursue the State Plan for Obesity (a multidisciplinary and comprehensive plan that includes all stages and treatment options for the disease).
• Raise awareness on obesity among politicians, health professionals and the society in general, for example, by obtaining their signature on the Bill of Rights of People with Obesity.
• Build technical legitimacy by promoting the development of an econometric study on the cost of obesity in Spain.
• Develop initiatives that lead to better management of obesity, for example, by encouraging the coordination of multidisciplinary teams for the diagnosis and treatment of the disease.
• Maintaining collaboration within the international OPEN network to achieve global objectives and share national experiences.

2022 – Event at the Spanish Congress of Deputies to present the Decalogue of the Rights of People Living with Obesity. OPEN members with Carolina Darias, former Minister of Health, and Meritxell Batet, former President of the Congress of Deputies.

Members of OPEN Spain

Status: September 2023

• Mr. Íñigo Alli Martínez, former Councilor for Social Policies, Family and Equality of the Government of Navarra, former Deputy for Navarra in the Congress of Deputies and former Spokesperson for the Commission for Comprehensive Disability Policies, Founder of Sindrome Up! Social Innovation Consulting​.
• Dr. Felipe Casanueva, Professor of Medicine- Department of Medicine, Endocrine Section Santiago de Compostela University and Biomedical Research Institute IDIS. Head of the Department of Nutrition and Endocrinology of the University Hospital of Santiago (CHUS).
• Prof. Gema Frühbeck, Co-Director of the Obesity Area & Head of the Metabolic Research Laboratory of the Endocrinology and Nutrition Department in Clínica Universidad de Navarra, Full Professor & Vice Dean of Research of the Faculty of Medicine of the University of Navarra and CIBERobn group leader​.
• Dra. Susana Monereo Megías, Head of the Endocrinology and Nutrition department in Ruber Internacional Hospital. Quiron Salud Group.
• Mr. Federico Luis Moya, Expert Patient. Executive Director of the National Híspalis Bariatric and Obesity Association. Patient advisor at the Spanish Society for the Study of Obesity (SEEDO). Member of the Board of Directors and Spanish representative at the European Coalition for People living with Obesity (ECPO).
• Dr. Andreu Palou Oliver, Professor of Biochemistry and Molecular Biology at the University of the Balearic Islands, Director of the Laboratory of Molecular Biology, Nutrition and Biotechnology and Director of the ‘nutrigenomics and obesity’ group at UIB, IDISBA and CIBERobn.
• Dr. Francisco Tinahones Madueño, Head of the Endocrinology and Nutrition department in Virgen de la Victoria Hospital (Málaga, Spain) and member of CIBERobn’s Board of Directors. Professor of Medicine at the University of Malaga.​
• Dr. Antonio José Torres García, M.D., Ph.D., F.A.C.S., (Hon), FASMBS. Professor of Surgery, President of IFSO (2011-2012), Chairman of IFSO´s Board of Trustees (2015-2019), Governor of the Spanish Chapter of the American College of Surgeons (ACS), Chief of the Department of Surgery at the Clínico San Carlos hospital, Medical Director of the Multidisciplinary Obesity Unit at the Madrid Monteprincipe hospital.