What is the role of TDRs and MRPs?
According to the World Health Organization, obesity is “one of the greatest public health challenges of the 21st century”. Its prevalence has tripled in many European countries since the 1980s, and the number of those affected continues to rise at an alarming rate. Based on the latest estimates, up to 70% of the entire population is overweight, with 10 to 30% of the European adult population being obese. Over 40 serious health conditions are linked to obesity, ranging from type 2 diabetes to cardiovascular disease, osteoarthritis, liver disease, obstructive sleep apnoea and an increased risk of cancer. This imposes huge costs on the Member States’ health services and the wider economy, with millions of working days lost due to weight-related illnesses.
The costs to health services of treating the resultant ill health are estimated to be in the region of 7% of total health care expenditure in Europe, with the indirect costs due to loss of productivity, adding as much again. Overall obesity costs the EU Member States around €59 billion a year from indirect health care costs alone. However, the broader economic impact could be as high as €118 to €236 billion, with rising childhood obesity auguring badly for the future.
Whilst it is generally accepted that the main cause of obesity is the consumption of more energy than we expend, there are limitations in the quantity and quality of information available to the public regarding effective methods for addressing obesity and overweight. Indeed, too often the focus has been on preventing obesity, a worthy aim in itself but one that often comes at the cost of focusing on those millions who are already obese. It is the treatment of millions of people who, unless action is taken now, will represent a serious challenge to the long-term financial viability of the Member States’ health systems.
There are a number of different methods currently used to help overweight and obese people from losing weight, from increased exercise and participation in slimming clubs through the use of commercial formula diets or drugs, and, in an increasing number of cases, surgery. In choosing the right option, different factors have to be taken into account: the amount of weight to lose, the general health and fitness of each individual and the cost-effectiveness of the proposed solution, as well as personal preferences.
Formula low calorie diet (LCD) and very low calorie diet programmes (VLCD) are an economical, viable and effective solution to fill the gap between weight loss advice (and the very limited number of obesity drugs available), which is often used for smaller weight loss (8-10kg), and bariatric surgery for larger weight losses (25-40kg).
TDRs and MRPs – freely available within the EU market for more than 30 years now – provide an effective way of helping overweight and obese individuals to lose weight more rapidly than would otherwise be possible. To tackle obesity properly, public health professionals and policy makers need to develop a greater understanding of the relevance, role and application of VLCDs and LCDs, their effectiveness and their cost-effectiveness.