[The evaluation of the efficacy of a multidisciplinary treatment in a group of obese patients with a BMI > or = 35 and a change in lung function].
OBJECTIVE
To assess the efficacy of an interdisciplinary protocol for treating obesity in a group of patients with BMI > or = 35 and with altered respiratory function that was not necessarily related to obesity or not.


METHODS
Forty obese individuals between 18 and 60 years of age with altered respiratory function were enrolled. Spirometric values, plethysmograph volumes, arterial blood gases, and nighttime respiratory polygraphs were recorded. Following psychological and nutritional evaluation, the patients commenced year-long treatment for obesity involving a personalized diet and psychological counseling. Follow-up was weekly and individualized at first; in later sessions, patients were grouped. Lung function tests were repeated after loss of 5 kg. Sleep polygraphy was repeated after loss of 10 kg.


RESULTS
Weight loss over 15 kg was achieved by 48.6% of the patients. Respiratory function variables: FVC, FEV1, RV, ERV, PaO2 and SatO2 after treatment changed significantly from initial levels. Significant differences were also seen in the severity of sleep apnea and pressures needed for continuous positive airway pressure. Uric acid, glucose and triglyceride blood levels became normal in 89%, 61% and 50% of the patients, respectively, after weight loss. No characteristic psychological profile was identified for severe obesity, although levels of anxiety, eating behavior, marital adjustment and perception of body image were aspects that were fundamentally altered.


CONCLUSIONS
In the difficult group of obese patients with BMI > or = 35, interdisciplinary treatment has proven effective for achieving substantial weight loss, while improving respiratory function and severity of sleep disorder. This therapy, which is at present viable for few centers, deserves consideration in the interest of benefiting the increasing number of obese patients.
Luque
R
R
Servicio de Neumología, Hospital Aránzazu, Donostia.
Berdejo
R
R
Elbusto
A
A
Arrázola
X
X
Royo
I
I
Salegi
I
I
del Campo
L
L
de la Torre
P
P
D000328:Adult; D015992:Body Mass Index; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008168:Lung / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000175:diagnosis / Q000473:pathology / Q000503:physiopathology / Q000628:therapy*; D010348:Patient Care Team / Q000706:statistics & numerical data; D011599:Psychopathology; D015431:Weight Loss