05/01/2026
On October 1st, 2025, the Italian Parliament definitively approved the first national law worldwide that officially recognizes obesity as a chronic, progressive, and relapsing disease, with major clinical, social, and public health implications.
I) Context and content of the law
The new law (published in the Official Gazette on October 9th, 2025) establishes provisions for the prevention, treatment, and protection of the health of people living with obesity.
Article 1 formally defines obesity as a chronic, progressive, and relapsing disease, and not merely as a precursor or risk factor for other conditions. This represents a crucial conceptual shift from obesity as a risk condition to a fully recognized nosological entity requiring priority intervention.
Article 2 establishes the objective of including obesity care within the Essential Levels of Care (LEA) of the Italian National Health Service, thus ensuring equitable and sustainable access to diagnosis, treatment, and appropriate therapeutic pathways across the country.
The law also provides an initial allocation of public funding dedicated to educational initiatives, primary and secondary prevention, and treatment programs, with progressive implementation over subsequent years.
II) Clinical and healthcare impact
With this legislation, Italy assumes a leadership role in addressing obesity as a complex disease, formally recognizing that:
Obesity is a chronic and relapsing disease, associated with multiple complications (cardiovascular, metabolic, oncological) that significantly reduce life expectancy and quality of life
Patient management must be multidisciplinary and personalized, integrating prevention, medical therapy, nutritional counseling, psychological support, and surgical treatment
Access to care must be structured and guaranteed by the National Health Service, with systematic monitoring and periodic reporting to Parliament.
III) Institutional collaboration and the role of scientific societies
The leading Italian scientific societies involved in obesity care, including the Italian Society for Obesity Surgery and Metabolic Diseases (SICOB), together with other academic and clinical organizations, will collaborate closely with governmental institutions to:
Support the effective implementation of the law
Contribute to the development of diagnostic and therapeutic pathways
Promote updated clinical guidelines and specialist education for the entire healthcare community.
IV) International scientific relevance and Nature Medicine publication
This historic legislative achievement is further strengthened by the recent publication in Nature Medicine of a landmark scientific document proposing a new framework for the diagnosis, staging, and management of obesity as a clinical disease.
The principles outlined in this high-impact publication reinforce the concept of obesity as a chronic, complex, and multidimensional disease, providing strong scientific support to the paradigm now formally adopted by Italian law and aligning clinical science with health policy at the highest level.
V) Future perspectives
SICOB hopes that the Italian regulatory framework may serve as a model and catalyst at the European and international levels, encouraging other countries and supranational institutions to formally recognize obesity as a chronic disease, with similar implications for healthcare systems and public health policies.
In this context, SICOB remains committed to its scientific, clinical, and educational mission, ensuring that this landmark legislation translates into effective, sustainable, and integrated care pathways, with particular emphasis on metabolic and bariatric surgery as a fundamental component of patient management when clinically indicated.
Sincerely,
Maurizio De Luca, MD
President, SICOB Italian Society for Obesity Surgery and Metabolic Diseases
