title: Towards a multidisciplinary approach to understand and manage obesity and related diseases.
abstract: Overnutrition and sedentary lifestyle result in overweight or obesity defined as abnormal or excessive fat accumulation that may impair health. According to the WHO, the worldwide prevalence of obesity nearly doubled between 1980 and 2008. In 2008, over 50% of both men and women in the WHO European Region were overweight, and approximately 23% of women and 20% of men were obese. Comprehensive diagnostic and therapeutic approaches should include nutritional treatment to favor the best metabolic and nutritional outcome, as well as to induce potential disease-specific benefits from selected nutritional regimens. Obesity is usually accompanied by an increased muscle mass. This might explain why obesity, under particular circumstances such as cancer or high age, might have protective effects, a phenomenon named the 'obesity paradox'. However, loss of muscle mass or function can also occur, which is associated with poor prognosis and termed 'sarcopenic obesity'. Therefore, treatment recommendations may need to be individualized and adapted to co-morbidities. Since obesity is a chronic systemic disease it requires a multidisciplinary approach, both at the level of prevention and therapy including weight loss and maintenance. In the present personal review and position paper, authors from different disciplines including endocrinology, gastroenterology, nephrology, pediatrics, surgery, geriatrics, intensive care medicine, psychology and psychiatry, sports medicine and rheumatology, both at the basic science and clinical level, present their view on the topic and underline the necessity to provide a multidisciplinary approach, to address this epidemic.
authors.affiliation: University of Hohenheim, Department of Nutritional Medicine, Stuttgart, Germany. Electronic address: bischoff.stephan@uni-hohenheim.de.
authors.forename: Stephan C
authors.initials: SC
authors.lastname: Bischoff
authors.affiliation: University of Clermont Auvergne, Human Nutrition Unit, Department of Clinical Nutrition, CHU Clermont-Ferrand, France. Electronic address: yves.boirie@clermont.inra.fr.
authors.forename: Yves
authors.initials: Y
authors.lastname: Boirie
authors.affiliation: Uppsala University, Dept. of Public Health and Caring Sciences/Clinical Nutrition and Metabolism, Uppsala, Sweden. Electronic address: tommy.cederholm@pubcare.uu.se.
authors.forename: Tommy
authors.initials: T
authors.lastname: Cederholm
authors.affiliation: Aristotle University of Thessaloniki, Medical Nutrition, School of Medicine, Thessaloniki, Greece. Electronic address: mhourd@auth.gr.
authors.forename: Michael
authors.initials: M
authors.lastname: Chourdakis
authors.affiliation: Hospital General Universitario Gregorio Marañón, Nutrition Unit, Madrid, Spain. Electronic address: cuerda.cristina@gmail.com.
authors.forename: Cristina
authors.initials: C
authors.lastname: Cuerda
authors.affiliation: Université Catholique de Louvain, Metabolism and Nutrition Research Group, Louvain Drug Research Institute, Brussels, Belgium. Electronic address: nathalie.delzenne@uclouvain.be.
authors.forename: Nathalie M
authors.initials: NM
authors.lastname: Delzenne
authors.affiliation: Center for Translational Research in Aging and Longevity, Dept. Health and Kinesiology, Texas A&M University, College Station, TX 77843-4253, USA. Electronic address: nep.deutz@tamu.edu.
authors.forename: Nicolaas E
authors.initials: NE
authors.lastname: Deutz
authors.affiliation: Université Lyon, UCBL, Carmen, CENS, Renal Unit, Centre Hospitalier Lyon SUD, Pierre Benite, Lyon, France. Electronic address: denis.fouque@chu-lyon.fr.
authors.forename: Denis
authors.initials: D
authors.lastname: Fouque
authors.affiliation: Geneva University Hospital, Clinical Nutrition, 1211 Geneva 14, Switzerland. Electronic address: Laurence.Genton@hcuge.ch.
authors.forename: Laurence
authors.initials: L
authors.lastname: Genton
authors.affiliation: Hospital Central de la Defensa Gomez Ulla, Department of Endocrinology and Nutrition, Madrid, Spain. Electronic address: carmengilm19@gmail.com.
authors.forename: Carmen
authors.initials: C
authors.lastname: Gil
authors.affiliation: Ludwig-Maximilians-Universität Munich, Dr. von Hauner Children's Hospital, Univ. of Munich Medical Centre, München, Germany. Electronic address: office.koletzko@med.lmu.de.
authors.forename: Berthold
authors.initials: B
authors.lastname: Koletzko
authors.affiliation: Complutense University Madrid, Department of Medicine & Hospital Doce de Octubre, Endocrinology and Nutrition, Madrid, Spain. Electronic address: mleon@h12o.es.
authors.forename: Miguel
authors.initials: M
authors.lastname: Leon-Sanz
authors.affiliation: Schneider Children's Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, Israel. Electronic address: shamirraanan@gmail.com.
authors.forename: Raanan
authors.initials: R
authors.lastname: Shamir
authors.affiliation: Rabin Medical Center, Beilinson Hospital, Endocrine Institute, Petah Tikva, Israel; Sackler School of Medicine, Tel Aviv University, Israel. Electronic address: joelle.singer@gmail.com.
authors.forename: Joelle
authors.initials: J
authors.lastname: Singer
authors.affiliation: Sackler School of Medicine, Tel Aviv University, Israel; Rabin Medical Center, Beilinson Hospital, Critical Care Medicine and Institute for Nutrition Research, Petah Tikva, Israel. Electronic address: psinger@clalit.org.il.
authors.forename: Pierre
authors.initials: P
authors.lastname: Singer
authors.affiliation: University of Hohenheim, Department of Nutritional Medicine, Division of Applied Psychology, Stuttgart, Germany. Electronic address: N.Stroebele@uni-hohenheim.de.
authors.forename: Nanette
authors.initials: N
authors.lastname: Stroebele-Benschop
authors.affiliation: Karolinska Institutet, Department of Clinical Science, Danderyd Hospital & Department of Surgery, Ersta Hospital, Stockholm, Sweden. Electronic address: anders.thorell@erstadiakoni.se.
authors.forename: Anders
authors.initials: A
authors.lastname: Thorell
authors.affiliation: Hospital St. Georg Leipzig, Department of General, Visceral and Oncological Surgery, Leipzig, Germany. Electronic address: arved.weimann@sanktgeorg.de.
authors.forename: Arved
authors.initials: A
authors.lastname: Weimann
authors.affiliation: University of Trieste, Department of Medical, Surgical and Health Sciences, Trieste, Italy. Electronic address: barazzon@units.it.
authors.forename: Rocco
authors.initials: R
authors.lastname: Barazzoni
mesh_terms: D000818:Animals; D000068959:Body Weight Maintenance; D002648:Child; D002908:Chronic Disease / Q000517:prevention & control*; D003131:Combined Modality Therapy / Q000639:trends; D064806:Dysbiosis / Q000209:etiology / Q000517:prevention & control; D019317:Evidence-Based Medicine; D014943:Global Health; D006801:Humans; D024821:Metabolic Syndrome / Q000209:etiology / Q000517:prevention & control; D008875:Middle Aged; D008954:Models, Biological; D024510:Muscle Development; D065626:Non-alcoholic Fatty Liver Disease / Q000209:etiology / Q000517:prevention & control; D009765:Obesity / Q000175:diagnosis / Q000503:physiopathology / Q000517:prevention & control / Q000628:therapy*; D010348:Patient Care Team / Q000639:trends; D063766:Pediatric Obesity / Q000175:diagnosis / Q000503:physiopathology / Q000517:prevention & control / Q000628:therapy; D057285:Precision Medicine; D011379:Prognosis; D055948:Sarcopenia / Q000209:etiology / Q000517:prevention & control
keywords: Fatty liver disease; Metabolic syndrome; Microbiota; Multidisciplinary; Sarcopenic obesity; Weight maintenance