The Yugoslav Association for the Study of Obesity (YASO) was established in October 1997, but its origins lie in three international symposia on obesity held from 1991 to 1997. The main scope of the association is to bring together individuals interested in obesity, both from the research and management point of view. There are over 180 registered members at present. The problem of obesity was recognized in this region 30 years ago when the first nutrition counselling outpatient unit started to deal with obese patients first in Belgrade and then in Novi Sad. But, despite this, there was no coherent, integrated programme, which could provide effective measures to fight the epidemic problem of obesity. The prevalence of obesity for the whole territory of Yugoslavia (former or nowadays Serbia and Monte Negro) has never been assessed, but the data available for the largest towns of Novi Sad and Belgrade indicate that in urban adult populations, the rate of overweight is pretty high at about 30 % in women, and 45 % in men. The rate of obesity (BMI>30) is 20-25% in women and 15-20% in men, with a mean BMI above 23 in all age groups. Obesity is still not generally viewed as a serious medical condition by the public, policy makers or doctors. Most consider obesity to be a cosmetic issue. Besides this negative attitude, most health care professionals (physicians, nutritionist, nurses), particularly in the primary care services, have inadequate training, knowledge and skills needed for the implementation of effective measures in obesity management strategies. Although there is a coherent and comprehensive range of health care services in our country, they are not capable of providing effective obesity management and/or preventive measures. The integrated health care services and community settings approach is missing, in contrast with other chronic disease strategies where the concept of "share care" as in diabetes care programmes, is well established. In response to all this and in accordance with the Milan Declaration, YASO has started to introduce and develop long-term preventive and management strategies which can develop the modified guidelines according to our own particular needs and health care structures YASO has organized joint meetings on obesity with:
YASO has proposed a network of health care services capable for treating all, even severely obese patients. The intention is to develop four regional management networks attached to the University centres with key components as follow :
Commenting on the lessons from Milan in Obesity Matters, Jaap Seidell wrote: "Both in terms of management and prevention, true progress can only be made if we stop regarding obesity as an abnormal response to a normal environment and, rather, consider it as a normal response to an abnormal environment".
The YASO campaign involves new public health interventions beginning the dialogue with previously unrecognized partners. First of all this involves food manufacturers and food distributors, as well as food policy makers. Initial support for the publicity launch has come from "Knjaz Milos" – the biggest soft drink and natural mineral water manufacturer in Yugoslavia. The main goal is to increase public awareness of the obesity problem and to attract partners for cooperation among food manufacturers, slimming clubs owners, and suppliers. It is planned to form a pool of commercial partners to provide financial support for YASO actions in the field of obesity. Later on YASO intends to bring together everybody and everything that could have a key role in shaping and supporting social and environmental policies that can help patients improve their diets and become physically active. This will involve urban planners, rehabilitation centres, fitness centres, and the mass media. YASO has formed a Commission for Functional Food, Dietetic Products and Slimming Programmes, which is issuing a Code listing the conditions to be fulfilled in order to register a food item or a programme as one that prevents or treats obesity. The Commission will also ensure quality control and will withdraw its endorsement if a product fails to meet the standards required. YASO plans to arrange courses on obesity prevention and treatment for those interesting in starting the new programme or improving the already existing slimming programmes. Annual courses will be obligatory for those who have "Recommended" label to inform them of new issues in obesity. One of the Commission's goals will be legislative. Prof Gordana Ristic, the head of YASO's Commission for Functional Food is the member of External Advisory Group attached to the Ministry of Health and Ministry of Agriculture. She has proposed that every food item produced in Yugoslavia has to be labeled by Nutrition Information and that label "Recommended by YASO" should be recognized by a new legislative document. The endorsement of new products is fee based. Members of the Commission will give scientific advice and control over formulation and production of new products, which are intended to comply with the YASO Code. Products will be tested in independent laboratories chosen by YASO and those that fulfil the requirements "low fat, low calories, low sugar, high nutritional value, high fibres," given in the Code will earn the Recommended label. Those products will have complete Nutrition Information and some of them will include a leaflet with information about obesity issued by YASO. For the past 10 years, we have been involved with "Cigota" – a spa treatment that is originally created and supervised by university professors from Belgrade Faculty of Medicine, who are members of YASO. There have been more than 16,000 participants
in the "obesity managing and healthy weight promotion" oriented programme.
That cooperation is well established and the "Cigota"-center for diseases
of metabolism and thyroid gland, has become an educational centre for obesity
spa treatment.
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