International Women’s Day in ELPA 2025, Physical activity and health, obstacles and opportunities
ELPA is pleased to host the voice of RN Dr. JUDr. Hana Vrabcová. She graduated in pharmacy and law from Comenius University in Bratislava. She completed her postgraduate studies in pharmacy at the Institute for the Education of Physicians and Pharmacists. She later pursued further education in counselling, nutrition, and lifestyle management at NutriAcademy of the Institute of Healthy Lifestyle in the Czech Republic. She is a member of the European Coalition for People Living with Obesity (ECPO) and the chairwoman of the non-profit organisation Slovak Coalition of People with Obesity and Overweight (SKLON), which is a member of the European Liver Patients’ Association (ELPA). Her mission is to create better conditions for improving the health of citizens and patients with overweight and obesity, as well as to raise awareness about obesity as a disease that significantly impacts quality of life. She is also a member of the Presidium of the Association for the Protection of Patients’ Rights (AOPP).
Women, Health, and Physical Activity. Your initiatives emphasise the importance of physical activity for health. Based on your experience, what are women’s most significant obstacles in maintaining regular physical activity, and how can they be overcome?
In my opinion, women often lack motivation, time for sports activities, and awareness of the significance of physical exercise for their health. Many women (and I believe men as well) do not realise how different types of physical activities affect our health and reduce the risk of various diseases, including cancer.
Besides their professional duties, most women have to take care of their families and children, leaving them with little time for hobbies and sports. One solution could be providing more information and education on the benefits of physical activity for women’s health and disease prevention, supported by the state and healthcare professionals. This could include media campaigns, morning exercise programs on television, motivational initiatives, free access to sports facilities for families, and ensuring safety while exercising.
Did you know we have a “small pharmacy” inside our bodies? According to experts, our muscles are highly active tissues that produce substances called myokines. These positively affect muscles, distant organs, adipose tissue, the liver, and the brain. By engaging in regular and adequate physical activity, we activate our own “muscle pharmacy,” producing a natural medicine that benefits us. Regular physical activity is essential for maintaining health. It is one of the most effective ways to combat chronic diseases, including liver diseases. It is crucial to have the motivation to exercise and understand that it is a key way to maintain physical health, improve mental well-being, reduce stress, enhance appearance, and serve as a form of self-treatment.
The main barriers to sports in women’s lives include time constraints related to work or family responsibilities and the cost of sports activities. For younger women, the primary barriers are education and employment, followed by family obligations. For women over 65, the main barriers are health conditions and physical fitness. Education plays a vital role in integrating sports into daily life. Women should be encouraged to engage in physical activities from childhood.
Obesity and Non-Communicable Diseases (NCDs). Your podcast series focuses on education and obesity prevention. How do you see the role of women in leading discussions about obesity, and what steps can be taken to increase awareness and action in this area?
Women tend to be more empathetic, better at understanding and relating to the situation of individuals with obesity, and more inclined to find solutions to help them. An increasing number of experts recognise obesity as a chronic disease that requires careful treatment, just like any other medical condition.
Obesity management is based on four pillars: healthy eating, physical activity, behavioural and psychological changes, and medical treatment (medication and surgical procedures).
The first step is identifying the causes of weight gain and obesity. One fundamental factor is biology—our bodies have built-in mechanisms to protect against starvation, which can make sustained weight loss difficult. Recent scientific advances also highlight genetic predispositions to obesity. Genetics influence body weight, fat distribution, and metabolism. Our genes account for 40–70% of the likelihood of developing obesity.
Maintaining a healthy weight is also complicated by limited access to healthcare. Without access to qualified healthcare professionals, most people with obesity struggle to maintain a healthy weight in the long term. Other factors influencing weight include diet (ultra-processed foods contribute to obesity), sleep quality and quantity (lack of sleep disrupts hormones affecting weight), high-stress levels, mental health conditions (certain disorders and medications can lead to weight gain), and physical inactivity combined with a sedentary lifestyle. Life changes such as early adulthood, pregnancy, menopause, illnesses, nutrition, medications, and prenatal development also contribute to obesity. Food marketing and weight-based discrimination also play significant roles, as they can have serious consequences for individuals living with obesity.
Empowering Women Through Community Initiatives. Projects like “Walks for Health and Obesity Prevention” and participation in the Bratislava Marathon promote physical activity for everyone. How do such initiatives specifically support women’s health, and what impact have you observed so far?
Experts say that low physical activity among women increases the risk of various diseases, many of which can be prevented. Walking is an excellent way to strengthen not only physical health but also mental and emotional well-being. It is one of the most straightforward and affordable forms of physical activity, as it does not require special equipment or skills.
On our website, we have published videos created by experts demonstrating proper walking techniques as part of our Walking School program.
Our “Walks for Health and Obesity Prevention” project and participation in the Bratislava Marathon provide a unique opportunity for women to come together, find support, and do something beneficial for their health and well-being. Bratislava offers beautiful surroundings, forests, and nature, making these activities a great way to engage in sports and outdoor recreation.
Nutrition and Women’s Health. Your training for older adults emphasises proper nutrition and physical activity. What dietary and lifestyle changes can women make to prevent obesity and related diseases as they age?
Based on my experience educating older adults, where women participate more than men, I consider education on healthy nutrition, appropriate physical activities, and mental health crucial. This aligns with the United Nations Decade of Healthy Ageing (2021–2030) and the WHO’s innovative strategies for promoting healthy ageing across the European region. Other key objectives include improving health, preventing non-communicable diseases (NCDs), and fostering a community of older adults with shared interests in physical activities, exercise, and walks.
The key lifestyle changes revolve around four core pillars: nutrition, physical activity, behavioural changes, and mental well-being. The fourth pillar may include medication prescribed by a specialist or, in some cases, bariatric surgery.
Lifestyle modification is essential in treating obesity, and incorporating regular active exercise is crucial. A combination of cardio and strength training tailored to the individual’s abilities is recommended.
Regarding diet, it is essential to:
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Limit animal fats
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Prioritize nuts, seeds, and lean meats
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Include fish, vegetables, fruits, and fibre for a healthy gut microbiome
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Maintain a proper hydration routine while avoiding sugary drinks
For individuals with obesity, it is necessary to carefully manage associated conditions, such as high blood pressure, lipid metabolism disorders, prediabetes, and diabetes.
Many people believe that a miracle pill will cure all health problems—but this is not the case. Treating obesity requires personal commitment and proactive self-care.
Health is the most valuable thing we have in life. Preventing diseases is always better than treating them. An unhealthy lifestyle, low physical activity, and an obesogenic environment are significant contributors to the rise of lifestyle-related diseases, particularly obesity and diabetes.
Stella Kyriakides, Former European Commissioner for Health and Food Safety, stated:
“Good health is the foundation of strong societies and strong economies. Prevention will always be better than treatment. That is why health promotion and disease prevention are key components of our work in the health sector and a primary focus of the European plan to fight cancer. The HealthyLifestyles4All initiative will help highlight the importance of a healthy lifestyle for all generations and social groups. It will raise awareness about the importance of healthy living, support a shift towards more sustainable diets, and promote responsible food business and marketing practices.”
Your Personal Journey and Advocacy. As an advocate for liver patients and someone deeply engaged in health awareness, what personal experiences have shaped your passion for these initiatives, and what message would you like to share with women on International Women’s Day?
Since childhood, I have struggled with being overweight due to my grandmother’s delicious cooking. She was an excellent cook and baked amazing pastries and apple strudels. Whatever was on the plate had to be eaten, and refusing or eating slowly was prohibited. These habits were very difficult to break later in life.
After graduating from high school, I started studying pharmacy at Comenius University in Bratislava, where I had to adjust to dormitory life, living away from my hometown of Brno, and coping with demanding studies. Being separated from home and having to take care of myself, far from my grandmother’s kitchen, was in many ways the best (though, at first, the most painful) “diet.” To my delight, my weight dropped, and I managed to keep it off for more than ten years.
Later, during each pregnancy, I gained about 10 kg. Over time, despite being active—taking care of my family and children, studying, and working in a pharmacy—my weight slowly increased. I started experiencing health issues. I didn’t feel well; I was sweating excessively, climbing stairs became a struggle, and the excess abdominal fat made it difficult for me to bend down.
That was when I realised I was obese, and according to doctors, I should start taking medication for high blood pressure, possibly cholesterol-lowering drugs—just like many of my patients at the pharmacy, unless I did something about it.
I knew what was at stake—heart disease, diabetes, musculoskeletal disorders.
I told myself there must be a way to fight obesity and lose the extra weight.
My biggest motivation and challenge was to change my approach to nutrition and overall lifestyle and improve my compromised health. That’s why I decided to start professionally focusing on healthy eating, nutrition, and lifestyle changes alongside my work in the pharmacy. This allowed me to test new methodologies and expert recommendations on obesity treatment firsthand. At the same time, through counselling, I could help patients and others struggling with similar issues.
One of the most helpful tools in my transformation was the InBody multifunctional diagnos
tic device, which we have used for over ten years. It measures physiological body values, harmful visceral fat levels, and basal metabolism through bioimpedance analysis.
For physical activity, I wanted a form of exercise that was both pleasant and beneficial. In the end, I chose Pilates. I love it for its principles, which combine flexibility, natural elegance, and agility.
I gradually lost 17 kg. I know I will never return to the ideal weight of my youth, and there will always be some extra pounds. But I am more mobile and feel great—and that’s what matters most.
My personal guardian, InBody, regularly monitors my muscle mass, body fat percentage, and visceral fat levels. I am happy that my blood pressure and glucose levels are normal.
It is essential to understand that a lifestyle change requires more than proper nutrition and exercise—a mental shift is equally important. I call this the “magic trio.”
Looking back, I can say that bad habits, attitudes toward food, and lifestyle choices learned in childhood and family settings are key factors that shape our future health.
Obesity was a challenge for me from childhood—to overcome it, I had to change my lifestyle and habits. My biggest motivation was to maintain my health—and I succeeded.
My message for International Women’s Day: Health is the most valuable thing we have in life. Let’s take care of it.