The economic impact of obesity is already worth 3% of global GDP. In our country alone, the expenditure related to this pathology is around 13 billion euros. But in our country few people still talk about prevention.
Obesity is going to rule. No longer just on our health and our bodies, but on the economic sustainability of health systems and the growth of all countries. According to the latest data from World Obesity Federationby 2035 the global economic impact of this disease will exceed 4 trillion dollarsalmost 3% of global GDP, a value comparable to the economic weight of the Covid pandemic: we are therefore about to face a financial and political emergency that should be stemmed before it is too late.
Italy, in the global debate and research, is doing its part: a very recent study by CeisCenter for economic and international studies of the University of Rome Tor Vergata, which quantified the epidemiological and economic burden of major adverse cardiovascular events in the Italian population, and consequently estimated the impact of anti-obesity drugs, highlighted surprising data. “In our country alone, the expenditure related to this pathology is already around 13 billion euros a year”, explains the professor Paolo Sciattellaamong the authors of the study. «Of these, almost 8 are direct healthcare costs, i.e. hospitalisations, drugs, specialist assistance, and over 5 derive from indirect costs: loss of productivity, disability, absences from work and healthcare support. In our study, the first of its kind in Europe, we tried to make a concrete reasoning: what would happen if we applied the benefits of new pharmacological treatments to patients with obesity and cardiovascular risk? The results suggest that, just in terms of costs related to hospitalizations for major cardiovascular events, the National Health Service could save 550 million euros in two years.”
The weight of fat on the public budgets of the National Health Service
Easy said: a little easier to do. In our country, according to ISTAT data from 2023, almost 6 million citizens – and therefore approximately 11.8% of the adult population – suffers from obesity, while 34% is overweight: the cost of therapies based on GLP-1 drugs (semaglutide or tirzepatide) is between 300 and 450 euros per month. Guaranteeing treatment even only for those who are most at risk of cardiovascular events would be impossible.
Unfortunately, everything happens in the (almost) total indifference of general practitioners, who often perpetuate the message of fat as a “stigma”, while it is a real disease, now also certified by the Pella law which, last October, made Italy the first country in the world to recognize obesity as a pathology. “It is absurd that only 17% of family doctors’ medical records report the patients’ weight and measurements,” the professor tells Panorama Silvio Buscemipresident of the Italian Obesity Society. «Just as it is unjustifiable that the data on BMI, the body mass index, are not even recorded on our electronic health records. They are very important indicators that impact the health of the individual and the community. We need more attention, and also more empathy.”
Also because when we talk about obesity we must learn to think as we do for all chronic diseases, that is, in terms of investment. «Today we know that the value of a therapy is not just the price of the package, but everything that that therapy avoids», continues Sciattella. «The blanket of public resources is always short and no one denies the problem of sustainability, but if we only think about the present we risk spending much more tomorrow. Health planning should learn to look a little further ahead.”
The revolution of adipose tissue as a true active metabolic organ
Just as it now governs the economies of various countries, fat also controls our body: the most recent studies are in fact overturning a century-old narrative that is too tied to aesthetics, to describe our fat as a true metabolic organ. The change of perspective is told in the Dutch bestseller book Fat. The secret organ Of Mariette Boon And Liesbeth van Rossumprofessors at the Erasmus University Medical Center in Rotterdam, to be released in… Italy on 16 June by the Gribaudo publishing house. «For years we have treated fat as the absolute enemy, almost as if it were a mistake of the body to be erased», say the authors, in an Italian preview for Panorama. «But the human body doesn’t do anything by chance. Adipose tissue is not a passive store of calories: it is an active, sophisticated organ that continuously communicates with the brain, immune system, liver and muscles through hormones and biological signals. We need it to live: it protects organs, stores energy, regulates body temperature, influences fertility, immunity and even the stress response. The problem, therefore, is not the fat itself, but when its biology alters and becomes inflamed.”
Meanwhile, research into anti-obesity drugs continues unabated: while a Cleveland Clinic study presented at the 2026 meeting of the American Society of Clinical Oncology suggests that anti-obesity drugs based on GLP-1 could reduce the risk of metastasis in some tumors, the era of slimming shots is about to give way to that of pills. The scientific committee ofEmmathe European regulatory agency, expressed a positive opinion on the oral version of Danish Wegovy Novo Nordiskalready approved in the United States. Even if it is not yet the definitive green light, the green light could arrive by autumn 2026. “It is hoped that oral therapy can be more accessible than injection therapy, and perhaps that the NHS can extend its prescription,” explains the professor Luca Busettovice-president of the European Association for the Study of Obesity.
That’s not all: the American pharmaceutical company Lilly presented the results of a phase 3 study on retatrutide, a molecule that acts on three targets simultaneously. The results are almost incredible: up to 28.3% average body weight loss in 80 weeks. The side effects remain typical of these drugs, i.e. nausea and gastrointestinal disorders. If the data is replicated on a large scale when people start taking them outside of clinical trials, it will be yet another breakthrough for this class of drugs that fight fat: and not just what we see, but what works silently inside us and can become inflamed and become disease. Even if the real revolution, the one capable of changing the fate of obesity, will no longer be (or not only) in the new shots or pills, but in the gaze with which we decide to observe millions of people: no longer guilty to judge, but patients to be treated. Before the cost of indifference, for all of us, becomes even heavier than the fat itself.
