title: Obesity-related disability: key factors identified by the International Classification of Functioning, Disability and Health.
abstract: OBJECTIVE
  To identify obese patients' disability features considering the level of body impairments, activity limitations and participation restrictions in relation to environmental factors' effect.
  
  
  METHODS
  Adult obese inpatients (BMI > 35) were enrolled and were administered a set of 166 ICF categories. Count-based indexes were developed for each ICF component: correlations and regression on performance and capacity indexes were performed.
  
  
  RESULTS
  Fifty-one patients (62.7% females, mean age 38.1) entered in the study. Description of ICF-based disability components is reported. Capacity is better correlated with body functions (r = 0.619, P < 0.01) and body structures (r = 0.375, P < 0.01) than performance; on the contrary, environmental barriers are correlated better with performance (r = 0.531, P < 0.01) than with capacity. Impairments in body functions and environmental barriers are the best predictors of limitations both in capacity and in performance.
  
  
  CONCLUSIONS
  Through this multidisciplinary approach, supported by ICFs biopsychosocial model, we described functioning and disability in obese patients, highlighting the strong effect of body functions' impairments and the limited one of environmental factors. This approach can guide rehabilitation programmes, the promotion of positive health outcomes and the modification of patients' lifestyle, not only intended as an issue of barriers' elimination, but as the activation and maintenance of environmental facilitators.
authors.affiliation: Neurology, Public Health and Disability Unit - Scientific Directorate, Neurological Institute C. Besta IRCCS Foundation, Milan, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Raggi
authors.forename: Amelia
authors.initials: A
authors.lastname: Brunani
authors.forename: Anna
authors.initials: A
authors.lastname: Sirtori
authors.forename: Antonio
authors.initials: A
authors.lastname: Liuzzi
authors.forename: Maria Elisa
authors.initials: ME
authors.lastname: Berselli
authors.forename: Valentina
authors.initials: V
authors.lastname: Villa
authors.forename: Francesca
authors.initials: F
authors.lastname: Ceriani
authors.forename: Matilde
authors.initials: M
authors.lastname: Leonardi
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000534:rehabilitation*; D010865:Pilot Projects; D012044:Regression Analysis