Multidisciplinary approach to obesity.
Obesity, associated with morbidity and mortality, is a complex disorder, characterised by an increase in fat mass (FM). Most authors agree in considering essential an integrated treatment made up of nutritional intervention, physical reconditioning programme and cognitive-behavioural psychotherapy. However, the feasibility is problematic and data in literature confirming the validity of this approach are poor.


OBJECTIVE
To verify the efficacy of a multidimensional approach (Nutritional Psycho-Physical Reconditioning - NPPR) in obesity treatment.


METHODS
All patients admitted from June 2002 to June 2004 (464 subjects) ranged from 18 to 65 years old, with a body mass index (BMI) >30 kg/m2 were included in the programme. After the nutritional status evaluation a standard dietetic treatment (group N) or an integrated and multidisciplinary obesity treatment (group NPPR) was proposed.


RESULTS
In group NPPR treatment duration was significantly higher (142.6+/-26 vs 48.6+/-55 days - p=0.000), while the drop-out amount was definitely lower (5.5 vs 54.4%; p=0.000). Weight loss compared to the initial weight and the difference between initial and final FM resulted significantly higher in group NNPR. Subjects in NPPR obtained a higher increase in the distance covered in a 6-minute walk test (59.9+/-19 vs 40.5+/-17 m; p=0.04) and in muscular strength. State and trait anxiety, mood and quality of life scores improved in NPPR subjects while remained substantially stable in group N.


CONCLUSIONS
An integrated approach to obesity is the way to be pursued in order to obtain important and at least short-term results.
Donini
L M
LM
Department of Medical Physiopathology (Food Science Laboratory), University of Rome La Sapienza, 00185 Rome, Italy. lorenzomaria.donini@uniroma1.it
Donini
M L
ML
Savina
C
C
Castellaneta
E
E
Coletti
C
C
Paolini
M
M
Scavone
L
L
Civale
C
C
Ceccarelli
P
P
Zaninotto
S
S
Tineri
M
M
Grossi
G
G
De Felice
M R
MR
Cannella
C
C
D000328:Adult; D000368:Aged; D019440:Anti-Obesity Agents / Q000627:therapeutic use*; D015992:Body Mass Index; D015928:Cognitive Behavioral Therapy; D019033:Delivery of Health Care, Integrated; D004038:Diet, Reducing; D005260:Female; D006801:Humans; D033183:Interdisciplinary Communication; D008297:Male; D008875:Middle Aged; D009751:Nutritional Requirements; D009752:Nutritional Status; D009753:Nutritive Value; D009765:Obesity / Q000178:diet therapy / Q000188:drug therapy / Q000523:psychology / Q000628:therapy*; D010348:Patient Care Team; D016896:Treatment Outcome; D015431:Weight Loss; D055815:Young Adult
D019440:Anti-Obesity Agents