How can effective health education and preventive measures reduce the development of lifestyle diseases?

- We should definitely speed up with prevention," admitted Marek Augustyn, vice president of the National Health Fund. Admittedly, the declaration was made in the specific context of obesity-related disease, but it applies to the entire spectrum of problems we are facing at the moment in the area of public health.

Obesity, however, as Prof. Lucyna Ostrowska, president of the Polish Society for the Treatment of Obesity, stressed, cannot be discussed in the context of prevention - although this is undoubtedly a very important, even fundamental, aspect. - There is no treatment path for the obese patient in Poland, and this is already a problem for 9 million people, she reminded, citing a NIK report published six months ago, which showed that only half of the audited PCPs performed even one, incomplete, basic patient measurement (patient weight control) during the year. - We have a declaration from the Polish Society of Family Medicine that the situation will improve," she stressed, while stipulating that PCPs are not sufficiently "armed" to take care of obese patients. POZ teams lack physiotherapists, psychologists, and dietitians, the expert noted, are still not a medical profession.

And although, as Marek Augustyn said, obesity has been qualified as a disease for years - because there is no doubt that it is a disease and the mother of many other diseases, patients even have reasons to avoid doctors. Katarzyna Glowinska, president of FLO - the Foundation for the Treatment of Obesity, spoke about the experiences of many patients with obesity, citing selected comments from doctors ("there is nothing wrong with you except that you are fat," "you've gotten fatter than a pig, that's why you have thyroid cancer," "there were no fat people in Auschwitz"). - This disease stigmatizes," she pointed out, appealing to students attending the KZP to pay attention to the aspect of communication with the patient in the future. A patient representative also shared the opinion that there is a lack of treatment pathways for people with obesity. - We have KOS-BAR. There was supposed to be a KOS-BMI and a program dedicated to children, but they probably won't be there because they are too expensive," she said, addressing the message to doctors: - Don't evaluate, don't slim down, just treat.

Treatment of obesity is all the more important because it entails several hundred complications, including, as Prof. Artur Mamcarz, head of the Third Department of Internal Medicine and Cardiology at WUM, said, a key risk factor for cardiovascular diseases and complications. - We have pharmacotherapy that gives excellent results and should be used not only in diabetes, although the drugs were originally dedicated to this group of patients, but also in people with obesity who do not have diabetes, he pointed out. - It is necessary to use all methods to treat obesity, he reiterated.

Experts agreed that from the point of view of prevention of all diseases, health education plays a key role, and did not hide their hopes for its imminent introduction in schools. However, education must be followed by systemic solutions. Prof. Brigid Kwiatkowska, national consultant in the field of rheumatology, pointed out that building awareness of immunizations will have no effect if they are not available, including financially, at least to people who specifically need such protection, among whom patients with autoimmune diseases - including the young - are an important group. - They all need vaccinations against influenza, SARS-CoV-2, but also pneumococcus and hemiplegia, including when they don't meet the age criterion, i.e. are under 65," she said. Patients with autoimmune diseases bear the full cost of immunizations, although all recommended vaccinations are based on recommendations from scientific societies and are an important part of their treatment.

Another example of coupling education with systemic measures is addiction prevention. Prof. Halina Car, associate dean at the Faculty of Health Sciences at the Medical University of Bialystok, noted that in the National Health Transformation Plan (for 2022-2026), alcohol was placed sixth as a factor affecting the health of Poles. A problem of particular importance, in her opinion, is the decreasing age of alcohol initiation. Meanwhile, in Poland, alcoholic beverages, especially beer, with which the lion's share of teenagers begin their consumption of this stimulant, are widely available. And although policymakers have announced and are announcing changes in this regard - especially intensely when a scandal erupts, such as the notorious "alcotubes" in packages resembling colorful children's mousses - in fact there is still little in the way of specifics. - We should return to a total ban on beer advertising and make it less accessible. Also so-called non-alcoholic beer," she argued. The expert also pointed out that as many as 78 percent of young people who have had their first experience with alcohol reached for beer with the consent or knowledge of their parents (Report: "Alcohol Initiation of Children and Youth in Poland. Diagnosis of the problem, causes and consequences". This means that adults who do not see their own problem with alcohol - including addiction ("beer is not alcohol") pass on behavioral patterns to their children.