Why Won't the Minister Help Obese Children?

Tens of thousands of children in Sweden suffer from obesity, but the government prefers to allocate funds to leisure cards rather than medications that could actually help them.

Nacho plates drenched in melted cheese and calorie-rich sauce. Visit an amusement park this summer and look around. What has happened? American-style obesity. Especially among children.

It's probably not the lack of leisure cards—the government's flagship public health reform—that's causing the XXL clothing sizes. Nor would a ban on advertising unhealthy food, as proposed by the Public Health Agency, likely shrink the garments.

Making it easier for parents to lose weight would probably make a difference. Since obesity tends to be inherited, both genetically and socially.

Since 1980, the proportion of Swedes who are overweight has tripled. One in five Swedes has a BMI of 30 or higher. This group is not just enjoying-life overweight, but significantly large. With risks of serious health effects: cardiovascular diseases, diabetes, cancer. But also a higher risk of loneliness and suicide.

All of which Social Minister Jakob Forssmed (KD) is supposed to work to reduce.

Obesity also comes with a high cost for taxpayers: our extra pounds are estimated to cost 125 billion annually.

According to the National Board of Health and Welfare's guidelines, at least one million Swedes are entitled to receive medication for obesity. Yet last year, it was prescribed to just over 60,000 people. Fewer than 2,000 of the patients were under 19, despite the medications being approved from age 12 and studies showing they are as effective among teenagers as among adults.

– The vast majority of children and adolescents with obesity receive no help. They get neither support with lifestyle changes nor treatment with medication, says Professor Ylva Trolle Lagerros at Karolinska Institute to Läkemedelsvärlden. She points out that there are hardly any specialist clinics for overweight children in northern Sweden. And Public Health Agency figures show that it is precisely in northern Sweden—Norrbotten—where obesity is most prevalent.

We are talking about 80,000 children who need help with obesity. More should receive medication, according to Trolle Lagerros.

Part of it is about information. It takes time for the knowledge that effective medication help is available to spread. But part of it is also about economics. The medications cost a bit over 2,000 kronor a month.

How do you calculate the value of being able to pass on healthy eating habits to your children? Of being able to be physically active, play football, take a day trip by bike with sliced fruit in your backpack?

Currently, TLV, the agency that makes decisions on drug subsidies, is investigating whether a number of modern weight-loss preparations should be included in the high-cost protection. This would make it possible to distribute the medications more widely—both figuratively and literally—among the public. A decision is expected in mid-autumn.

So far, TLV has said no to similar medications. If it's a no again, it's because of the model used to calculate the benefit. It primarily considers the risk of diseases. When Saxenda, one of Novo Nordisk's drugs, was previously evaluated, the biggest benefit was that the risk of a certain form of uterine cancer decreased.

How do you calculate the value of being able to pass on healthy eating habits to your children? Of being able to be physically active, play football, take a day trip by bike with sliced fruit in your backpack?

Today, it is not done.

This should interest Social Minister Jakob Forssmed.

He has been called a public health fanatic. But he is a poor fanatic.

The government has put a lot of effort into the leisure card—a targeted grant for leisure and cultural activities for over 700 million kronor. They call it "one of the biggest public health reforms in many years." It lacks any ability to make a difference.

Not a finger has been lifted to spread knowledge about the new medications or emphasize the importance of effective obesity treatment for children. Even though it would be a public health effort worthy of the name. Children suffer from obesity and the minister says: Exercise more.