Obesity has emerged as an escalating global epidemic, according to the World Health Organization. More than one billion people worldwide are now classified as obese, and childhood obesity rates have quadrupled since 1990.
In 2025, Italy became the first nation to enact a national law classifying obesity as a chronic, progressive, and relapsing disease.
Rather than viewing obesity merely as a consequence of personal choices, the legislation frames it as a chronic condition shaped by biological, environmental, and social factors.
The Campania region is serving as a testing ground for implementing this philosophy, launching a series of ambitious initiatives — including a contentious trial of a fasting‑mimicking diet.
Researchers are recruiting 300 overweight adolescents who will follow a controlled diet for five days every three months: 1,100 calories on the first day and 770 calories on the subsequent four days, a regimen that mimics a fast.
The objective is to provoke a “metabolic reset”.
“Fasting, or controlled food deprivation, is associated with longer and healthier lifespans,” says Dr. Longo, who has studied fasting effects for three decades.
Not all obesity specialists agree that fasting is the appropriate strategy for children.
Paediatrician Berni Canani contends that evidence supporting fasting‑mimicking diets in children remains insufficient for inclusion in Italy’s clinical guidelines.
He also worries that restrictive diets could pose psychological risks for adolescents, whose relationship with food is still forming.
“I fear that imposing food restrictions on teenagers could increase the risk of eating disorders, anorexia, and body dysmorphia,” he cautions.
Salvatore hopes to undergo surgery this summer, enabling him for the first time in years to wear a swimming costume without feeling self‑conscious.
He is not alone; across Italy, a generation of children is drifting increasingly away from the Mediterranean diet that once defined the nation’s culinary reputation.
