Euan Woodward

Sustainable prevention of obesity through integrated strategies: The SPOTLIGHT project’s conceptual framework and design

BackgroundThe prevalence of overweight and obesity in Europe is high. It is a major cause of the overall rates of many of the main chronic (or non communicable) diseases in this region and is characterized by an unequal socio-economic distribution within the population. Obesity is largely determined by modifiable lifestyle behaviours such as low physical activity levels, sedentary behaviour and consumption of energy dense diets. It is increasingly being recognised that effective responses must go beyond interventions that only focus on a specific individual, social or environmental level and instead embrace system-based multi-level intervention approaches that address both the individual and environment. The EU-funded project “sustainable prevention of obesity through integrated strategies” (SPOTLIGHT) aims to increase and combine knowledge on the wide range of determinants of obesity in a systematic way, and to identify multi-level intervention approaches that are strong in terms of Reach, Efficacy, Adoption, Implementation and Maintenance (RE-AIM).Methods/DesignSPOTLIGHT comprises a series of systematic reviews on: individual-level predictors of success in behaviour change obesity interventions; social and physical environmental determinants of obesity; and on the RE-AIM of multi-level interventions. An interactive web-atlas of currently running multi-level interventions will be developed, and enhancing and impeding factors for implementation will be described. At the neighbourhood level, these elements will inform the development of methods to assess obesogenicity of diverse environments, using remote imaging techniques linked to geographic information systems. The validity of these methods will be evaluated using data from surveys of health and lifestyles of adults residing in the neighbourhoods surveyed. At both the micro- and macro-levels (national and international) the different physical, economical, political and socio-cultural elements will be assessed.DiscussionSPOTLIGHT offers the potential to develop approaches that combine an understanding of the obesogenicity of environments in Europe, and thus how they can be improved, with an appreciation of the individual factors that explain why people respond differently to such environments. Its findings will inform governmental authorities and professionals, academics, NGOs and private sector stakeholders engaged in the development and implementation of policies to tackle the obesity epidemic in Europe.

An EASO Position Statement on Multidisciplinary Obesity Management in Adults

Obesity has proven to be a gateway to ill health. It has already reached epidemic proportions becoming one of the leading causes of death and disability in Europe and world-wide. Obesity plays a central role in the development of a number of risk factors and chronic diseases like hypertension, dyslipidaemia and type 2 diabetes mellitus inducing cardiovascular morbidity and mortality. Therefore weight management plays a central role in controlling the respective risk factors and their consequences. Obesity is a complex condition of multifactorial origin. Biological but also psychological and social factors interfere to lead to excess body weight and its deleterious outcomes. Obesity management cannot focus any more only on weight (and BMI) reduction. More attention is to be paid to waist circumference (or waist-to-hip ratio, especially in females), the improvement in body composition (measured with body composition tracking systems like BOD POD, dual energy X-ray absorptiometry or bioelectrical impedance analysis) which is focusing on ameliorating or maintaining fat-free mass and decreasing fat mass. Management of co-morbidities, improving quality of life and well-being of obese patients are also included in treatment aims. This statement emphasises the importance of a comprehensive approach to obesity management.

Need for a Paradigm Shift in Adult Overweight and Obesity Management - an EASO Position Statement on a Pressing public Health, Clinical and Scientific Challenge in Europe

a European Association for the Study of Obesity on behalf of the Executive Committee; b Department of Endocrinology & Nutrition, Clinica Universidad de Navarra, University of Navarra, Obesity & Adipobiology Group of the Instituto de Investigacion Sanitaria de Navarra, CIBERobn, Instituto de Salud Carlos III, Pamplona , Spain; c Department of Internal Medicine, Universitats-Klinik fur Innere Medizin, Graz , Austria; d Department of Psychological Sciences, University of Liverpool, Liverpool , UK; e Division of Endocrinology, Metabolism & Diabetes, Istanbul University Cerrahpasa Medical Faculty, Istanbul , Turkey

2014 EASO Position Statement on the Use of Anti-Obesity Drugs

The European Association for the Study of Obesity (EASO) considers obesity to be a health, research, and societal priority [1]. It promotes the study of obesity. Moreover, the EASO facilitates and engages in actions that reduce the burden of unhealthy excess weight in Europe through prevention as well as management and prevent and combat the epidemic of obesity.

A Proposal of the European Association for the Study of Obesity to Improve the ICD-11 Diagnostic Criteria for Obesity Based on the Three Dimensions Etiology, Degree of Adiposity and Health Risk

Diagnostic criteria for complex medical conditions caused by a multitude of both genetic and environmental factors should be descriptive and avoid any attribution of causality. Furthermore, the wording used to describe a disorder should be evidence-based and avoid stigmatization of the affected individuals. Both terminology and categorizations should be readily comprehensible for healthcare professionals and guide clinical decision making. Uncertainties with respect to diagnostic issues and their implications may be addressed to direct future clinical research. In this context, the European Association of the Study of Obesity (EASO) considers it an important endeavor to review the current ICD-11 Beta Draft for the definition of overweight and obesity and to propose a substantial revision. We aim to provide an overview of the key issues that we deem relevant for the discussion of the diagnostic criteria. We first discuss the current ICD-10 criteria and those proposed in the ICD 11 Beta Draft. We conclude with our own proposal for diagnostic criteria, which we believe will improve the assessment of patients with obesity in a clinically meaningful way.

Looking Back - EASO Is Celebrating Its 30th Anniversary

It is unbelievable that we are celebrating the 30th anniversary of the foundation of EASO this year. It was on the 6th International Congress on Obesity held from September 14–19, 1986 in Jerusalem, when a group of European obesity experts met in the conference center to discuss and decide on the foundation of a European Association for the Study of Obesity (EASO). The participants rapidly agreed on common goals and the organizational framework. Finally, the participants, including one of the authors (HH), signed the original document containing the association’s mission. In the same session, the first Executive Committee was formally elected with Per Björntorp from Gothenburg as president, Trevor Silverstone from London as vice president, F. Arnold Gries from Düsseldorf as general secretary, and Bernard Jeanrenaud from Geneva as treasurer. The obesity community was rather small in those days, and an international conference was held only every 4 years. Noteworthy for younger readers and EASO members, World Wide Web and e-mail communication were neither invented nor imaginable back then. There was only one journal focusing on obesity topics: the International Journal of Obesity . Therefore, there was agreement that a European association would be very helpful to intensify scientific discussion and collaboration among experts across Europe. It was also stated in the founding document that one of the aims would be ‘to hold scientific meetings in Europe and study groups as appropriate’. The more general aims included ‘to promote research into obesity’, ‘to facilitate contact between individuals and organisations’ and ‘to promote action that tackles the epidemic of obesity’. Starting in 1988 with the 1st European Congress on Obesity in Stockholm chaired by Stephan Rössner, EASO has been organizing annual scientific conferences across Europe as well as many other meetings to facilitate scientific exchange. It took until 1993 before EASO was finally established as a non-profit organization under French law. In 1998, after years of continuous growth and regular rotation of both the Executive Committee and the Council, the General Assembly approved a fundamental change to the by-laws – changing the membership from individuals to national organizations. This was a substantial step forward because all Received: October 18, 2016 Accepted: October 18, 2016 Published online: November 8, 2016

ECO 2013 Report

20th European Congress on Obesity12–15 May 2013, Liverpool, UK

Opportunities for European Obesity Research in the Coming Decade - a Perspective from the European Association for the Study of Obesity (EASO)

a Institute of Cardiometabolic Disease and Nutrition (ICAN), University Pierre et Marie Curie-Paris 6; Department of Nutrition, Pitie-Salpetriere Hospital (AP-HP), Paris, France b Institute of Preventive Medicine, Copenhagen University Hospitals; the Novo Nordisk Foundation Centre for Basic Metabolic Research, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark c Department of Child and Adolescent Psychiatry, University of Duisburg-Essen, Essen, Germany d European Association for the Study of Obesity (EASO), London, e Institute of Psychological Sciences, Faculty of Medicine and Health, University of Leeds, Leeds, UK