Czechia Fighting Obesity

19-05-2020

Like other industrial countries, Czechia is struggling to deal with the problem of overweight and obesity. A recent report by the World Health Organization showed that some 80 percent of Czech children are not getting enough exercise. The problem has become so serious that in some cases obesity treatment for children is covered by standard health insurance.

Illustrative photo: Nenad Stojkovic, Flickr, CC BY 2.0Illustrative photo: Nenad Stojkovic, Flickr, CC BY 2.0

Olivova Children’s Medical Institution, photo: ČT24Olivova Children’s Medical Institution, photo: ČT24 I am in the town of Říčany, a Prague suburb, standing in front of a very nice and spacious building surrounded by a park. What I am looking at is Olivova Children´s Medical Institution built at the end of the 19th century, originally as an orphanage. Its founder and sponsor, Alois Oliva, was a wealthy Czech sugar producer. Kids come here to be treated mainly for respiratory ailments. And increasingly also because they are seriously obese. Vladimíra Konečná is a physiotherapist and explains that most often, excess weight is a psychosomatic problem:

“Our main goal is for the children to gain confidence. We do not underestimate anybody. On the other hand, we try to show kids who consider themselves superior to others that they are really not that superior. In 2 weeks, we can get the children on the same level – not physically but mentally. After that, we work on the physical side of things.”

Photo: The Olivova Children’s Medical Institution Youtube ChannelPhoto: The Olivova Children’s Medical Institution Youtube Channel What does a typical day look like for the kids here in the physiotherapy centre?

“Typically, we divide the day into several exercise blocks. There we split the time up into exercise sessions, lessons, water therapy, and consultations with a psychiatrist and nutritionist if need be. It is rather funny, but one of the things that we do is that we teach children how to walk. Because of the weight that they have gained in a rather short time, increasing the pressure on their joints, they move around like bears. So, besides lowering their body weight, the children learn how to walk, move around, and use their body like any healthy person.”

Vladimíra Konečná, photo: Archive of the Olivova Children’s Medical InstitutionVladimíra Konečná, photo: Archive of the Olivova Children’s Medical Institution According to Vladimíra Konečná, children’s obesity is a bigger problem now than it was, for instance, 10 or 20 years ago.

“The number of children suffering from obesity is increasing. Although I think that the issue is talked about more now. And children are becoming more self-aware, they ask for a stay here not because they were ordered to by their doctor, or because they were bullied about their weight but because they themselves want to get healthier.”

Miroslav Vacek is the director of “Olivovna”, as the institution is known locally. He points out that Czechia tries to help the families of obese children more than most if not all other countries. They do not have to pay for the treatment:

“I have to say that the Czech Republic offers a great opportunity for overweight children and their families to get healthier. Because the programs that are here, for which the state health insurance spends about forty or fifty thousand, cannot be found anywhere else. The kids stay here on a voucher and the parents don’t pay anything. And kids under the age of six also have a voucher for a parent or grandparent to stay with them which is also completely covered by insurance. I must emphasise that this is not usual in other countries, even in the advanced states of Western Europe.”

Roman Prymula, photo: Archive of the Office of the Government of the Czech RepublicRoman Prymula, photo: Archive of the Office of the Government of the Czech Republic The deputy health minister responsible for prevention of diseases is Roman Prymula. When I see him in his office in Prague he starts off with sad if not alarming statistics:

"In 2001, about one in seven children were overweight and about half of those in the one-seventh were obese. Those numbers have gotten worse over time. According to a study conducted by general practitioners, around 20 % of children are overweight or obese. When we look at just adolescents, the number is even worse, every fourth adolescent has problems with being overweight.”

So, how important does the Ministry of Health consider the fight with obesity and overweight in general, does it have a specific strategy put in place?

Photo: Sandra Cohen-Rose and Colin Rose, Flickr, CC BY 2.0Photo: Sandra Cohen-Rose and Colin Rose, Flickr, CC BY 2.0 “It is important to say that excessive weight is a world-wide problem, something of a memento of the present day. It is not just a problem of the Ministry of Health. It is a problem across the whole of society. We will have to work hard to dramatically change people’s bad habits and one health measure will not do that. We have seen a dramatic change in the habits of the younger generations especially. Not many children spend time running around in the forest anymore. Instead they sit at home doing some sort of passive activity on computers or mobile phones. It is said that a significant part of the population spends at least two hours a day on this sort of passive activity.

“Another aspect is diet, as people consume many more calories than they expend. They also consume nutritionally less than ideal foods such as sweetened drinks. With those types of drinks, it has been found that consuming one litre a day, people will gain 6-7 kilograms a year, which is absolutely alarming. Things such as fast foods are also not very helpful.”

How does the Czech Republic compare with other developed countries and specifically our neighboring states such as Germany and Austria?

Photo: Sandra Cohen-Rose and Colin Rose, Flickr, CC BY 2.0Photo: Sandra Cohen-Rose and Colin Rose, Flickr, CC BY 2.0 “A comparative study done in 2009-2010 found that the United States really does fare the worst. There about one-third of young boys suffer from obesity. In our case, the number is about 20 % in boys and about 7,5-8 % in girls. So, the situation is linked to gender. Other countries that are worse off than us are Greece and, surprisingly, Portugal. Countries such as Poland, Spain, Italy are on about the same level – around 20 % for boys. When it comes to our aforementioned neighbours, Germany and Austria, they fare quite a bit better. In Germany, about 15 % of boys are overweight, and the number of overweight girls is about the same, only differing by about two or three percent.”

On the one hand, people are getting heavier and the obesity rate is growing. On the other hand, the average life expectancy is increasing, and people have more so-called healthy years. How do those two things fit in together?

“Well, I do not think that those two facts go hand-in-hand together, more so against each other. We have reached a level of advanced health care which enables us to live longer. Civilizational problems as obesity are no doubt only holding us back. So, if it were not for obesity, I think that we could expect to live significantly longer, reaching an average of over 80 years. Unfortunately, the problems of widespread obesity, metabolic problems and health issues linked to obesity, such as high blood pressure, and diabetes are shortening the lives of many people who could otherwise live much longer thanks to our healthcare system.”

Obviously, Czechia and its authorities are taking this problem very seriously. Unfortunately, so far, the results are not very convincing, and it can hardly be a consolation that most other countries do not fare much better.

19-05-2020