What does it mean if obesity is recognized as a chronic disease in Italy?

Obesity has now been officially recognized as a chronic disease in Italy. A major step forward in the fight against what the World Health Organization has called “the epidemic of the 21st century.” According to Istat data, 11.8% of Italian adults suffer from obesity (nearly 6 million people), and around 19% of children aged 8 to 9 are overweight, with 9.8% affected by obesity. Bill No. 741, titled “Provisions for the prevention and treatment of obesity,” introduced by a parliamentary initiative, was officially approved on May 7 by the Chamber of Deputies with 155 votes in favor, 103 abstentions, and none against (it must now pass in the Senate). This law formally recognizes obesity as a chronic, progressive, and relapsing disease, making Italy one of the first countries in Europe and worldwide to take this legislative step. Germany did so in 2020, followed by Alberta, Canada, in March 2025. With the approval of the 2025–2027 National Plan for the Prevention and Treatment of Obesity last March, Italy has also aligned with European guidelines, confirming that obesity is a disease requiring a multidisciplinary and systemic approach.

Obesity recognized as a chronic disease in Italy: what does it mean?

The new national plan introduces some important updates, including the inclusion of obesity treatments in the Essential Levels of Care (LEA), meaning that the national health system will cover specialist visits, diagnostic tests, and targeted therapies. Additionally, Article 3 of the bill establishes a fund with €700,000 allocated for 2025, €800,000 for 2026, and €1.2 million annually starting from 2027. Another innovative aspect is the implementation of awareness campaigns in schools aimed at combating the social stigma associated with obesity and promoting healthy lifestyles. Through these measures, Italy takes a leading role in Europe in the fight against obesity, finally acknowledging the complexity of this condition and the need for an integrated approach to its prevention and treatment. Recognizing obesity as a disease is, therefore, a fundamental step in overcoming the social stigma that often surrounds it and in promoting a therapeutic approach. As many experts in the field emphasize, it’s essential to address obesity not merely as an individual issue, but as a public health and societal challenge that demands coordinated national-level interventions. But what do the experts actually say? We spoke to three doctors working in the field, and here’s what they told us.

What doctors have to say about obesity

“From a medical perspective, recognizing obesity as a chronic disease makes perfect sense,” says nutritionist Martina Donegani. “Obesity is a chronic, multifactorial condition, not just about excess weight but involving metabolic, hormonal, and inflammatory alterations that increase the risk of cardiovascular disease, type 2 diabetes, certain cancers, and joint disorders. Officially recognizing it as a disease helps move beyond the stigma of it being a mere aesthetic issue or lack of willpower and instead treat it for what it is: a complex condition requiring a multidisciplinary approach.” “Medically, obesity has long been defined by the international scientific community as a chronic, relapsing, and progressive disease. It has its own nosological dignity, distinct from its complications, and deserves specific therapies targeting the biological causes of a disease with multifactorial and complex origins—genetic, epigenetic, environmental, social, situational, and in some cases psychological,” adds Dr. Giulia Maria Pontesilli, who specializes in obesity and metabolic diseases. “Legislative recognition has a clinical foundation and allows for a structured approach while reducing stigma and blame.” “Obesity is now universally recognized as a chronic, multifactorial, relapsing, and progressive disease by major international health organizations and scientific societies, including WHO, EASO, FIAO, AMA, and the World Obesity Federation,” confirms Dr. Francesca Dominici, also an expert in obesity and metabolic diseases. “Medically, labeling it a disease is not just semantics: it’s a necessary act to highlight its biological complexity, involving neuroendocrine regulation, chronic inflammation, metabolic and genetic alterations, its systemic impact (with over 229 associated complications), and the need for a structured, multidisciplinary, non-blaming therapeutic approach. This recognition is also crucial in tackling the medical and social stigma that still acts as a barrier to care for many people affected by obesity.” The experts clearly agree on the value of recognizing obesity, but what about the benefits that may result?

Does recognizing obesity as a chronic disease in Italy bring benefits?

Here too, all three experts agree on the clear advantages this legislation could bring. “Recognition means obesity can be included in the Essential Levels of Care (LEA), making specialist visits, nutritional therapies, psychological support, and food education more accessible,” says Dr. Donegani. “It could also pave the way for structured prevention programs, support healthcare provider training, and raise public awareness.” “In the coming years, we may identify subgroups of patients who could receive OMMs (obesity management medications) under reimbursement schemes. Currently, it’s unfeasible to extend this to the approximately 40% of the population who are overweight or obese. The aim of the law is also to reduce stigma, which frames obesity as laziness or blame, creating a wall between those affected and potential care,” states Dr. Pontesilli. “Prevention is crucial: the law calls for awareness campaigns, health education, and school programs.” “Recognizing obesity as a disease would also help channel public funds toward prevention, professional training, and developing new therapies. Not to mention breaking the stigma: shifting the narrative from personal blame to a treatable disease has a huge psychological and social impact, improving therapy adherence and quality of life for those affected,” adds Dr. Dominici.

BMI: how valid is it today?

As for BMI (Body Mass Index) mentioned in the bill we asked the doctors if it is still considered an objective method for measuring body mass. Dr. Donegani explains: “BMI is a simple and useful tool for an initial evaluation, but not enough on its own. It doesn’t account for body composition (fat vs. lean mass), fat distribution, or comorbidities. For example, a very muscular athlete might have a high BMI but no metabolic risk. That’s why it should be used alongside other metrics: waist circumference, body composition analysis, blood tests, and a general clinical assessment. It’s a simple, low-cost, fast tool that’s useful on a population level, but inaccurate because it doesn’t distinguish between fat and lean mass or measure fat distribution.” Dr. Pontesilli shares her concerns: “It also doesn’t consider age, sex, or ethnicity. A more useful indicator is the waist-to-height ratio (WHtR): according to a new framework for diagnosing and staging obesity, one should consider BMI, WHtR, and any clinical components—medical, functional, and mental—to determine treatment.” Finally, Dr. Dominici agrees and adds: “European guidelines (EASO) recommend complementing BMI with other assessment tools, like waist circumference, WHtR, and above all, a clinical evaluation of related complications (diabetes, hypertension, NAFLD, OSAS, etc.). Recognizing obesity as a disease should therefore not be based solely on BMI thresholds, but rather on a structured clinical diagnosis that takes into account the disease’s severity and functional impact.” In short, we now await the final approval of the law, hopeful that its promised benefits will indeed come to pass.