Skip to main content

Advertisement

SpringerLink
Log in

Multidisciplinary approach to obesity

  • Original Research Paper
  • Published:
Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity Aims and scope Submit manuscript

An Erratum to this article was published on 01 June 2009

Abstract

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. AIM: 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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Lang A., Silvarjan Froelicher E.: Management of overweight and obesity in adults. Eur. J. Cardiovasc. Nurs., 5, 102–114, 2006.

    Article  PubMed  Google Scholar 

  2. World Health Organization. Obesity: preventing and managing the global epidemic. Geneva, World Health Organization, 1998.

    Google Scholar 

  3. Lyznicki J.M., Young D.C., Riggs J.A., Davis R.M.; Council on Scientific Affairs, American Medical Association: Obesity: assessment and management in primary care. Am. Fam. Physician, 63, 2185–2196, 2001.

    CAS  PubMed  Google Scholar 

  4. Lenfant C.: Physicians need practical tools to treat the complex problems of overweight and obesity. Am. Fam. Physician, 63, 2139, 2001.

    CAS  PubMed  Google Scholar 

  5. National Heart, Lung and Blood Institute; North American Association for the Study of Obesity. Practical guide to the identification, evaluation, and treatment of overweight and obesity in adults. Bethesda, National Institutes of Health, 2000.

    Google Scholar 

  6. Mela D.J., Rogers P.J.: Food, eating and obesity: the psychobiological basis of appetite and weight control. 1st ed. London, Chapman & Hall, 1998.

    Book  Google Scholar 

  7. Expert Panel on the Identification, Evaluation, and Treatment of Overweight in Adults. Clinical guidelines on the identification, evaluation and treatment of overweight and obesity in adults: executive summary. Am. J. Clin. Nutr., 68, 899–917, 1998.

    Google Scholar 

  8. Miller W.C., Koceja D.M., Hamilton E.J.: A meta analysis of the past 25 years of weight loss research using diet, exercise or diet plus exercise intervention. Int. J. Obes. Relat. Metab. Disord., 21, 941–947, 1997.

    Article  CAS  PubMed  Google Scholar 

  9. Dubnov G., Brzezinski A., Berry E.M.: Weight control and the management of obesity after menopause: the role of physical activity. Maturitas, 44, 89–101, 2003.

    Article  PubMed  Google Scholar 

  10. Cioffi J.: Factors that enable and inhibit transition from a weight management program: a qualitative study. Health Educ. Res., 17, 19–26, 2002.

    Article  PubMed  Google Scholar 

  11. Isnard P., Michel G., Frelut M., Vila G., Falissard B., Naja W., Navarro J., Mouren-Simeoni M.C.: Binge eating and psychopathology in severely obese adolescents. Int. J. Eat. Disord., 34, 235–243, 2003.

    Article  PubMed  Google Scholar 

  12. American Heart Association. Heart disease and stroke statistics — 2003 update. Dallas, American Heart Association, 2002.

    Google Scholar 

  13. Bruun J.M., Helge J.W., Richelsen B., Stallknecht B.: Diet and exercise reduce low-grade inflammation and macrophage infiltration in adipose tissue but not in skeletal muscle in severely obese subjects. Am. J. Physiol. Endocrinol. Metab., 290, E961–E967, 2006.

    Article  CAS  PubMed  Google Scholar 

  14. Blair S.N., Leermarkers E.A.: Exercise and weight management. In: Wadden T.A., Stunkard A.J. (Eds.). Handbook of obesity treatment. New York, The Guilford Press, 2002.

    Google Scholar 

  15. Thompson P.O., Buchner D., Pina I.L., Balady G.J., Williams M.A., Marcus B.H.: Exercise and physical activity in the prevention and treatment of atherosclerotic cardiovascular disease: a statement from the Council on Clinical Cardiology (Subcommittee on Exercise, Rehabilitation, and Prevention) and the Council on Nutrition, Physical Activity, and Metabolism (Subcommittee on Physical Activity). Circulation, 107, 3109–3116, 2003.

    Article  PubMed  Google Scholar 

  16. Wadden T., Womble L., Stunkard A., Anderson D.: Psychosocial consequences of obesity and weight loss. In: Wadden T., Stunkard A. (Eds.). Handbook of obesity treatment. 2nd ed. New York, The Guilford Press, 2002, p. 624.

    Google Scholar 

  17. Skender M.L., Goodrick G.K., Del Junco D.J., Reeves R.S., Damell L., Gotto A.M., Foreyt J.P.: Comparison of 2-year weight loss trends in behavioral treatments of obesity: diet, exercise, and combination interventions. J. Am. Diet. Assoc., 96, 342–346, 1996.

    Article  CAS  PubMed  Google Scholar 

  18. Hall R.F., Joseph D.H., Schwartz-Barcott D.: Behavioral maintenance: a closer look. Nurs. Forum, 37, 5–11, 2002.

    Article  PubMed  Google Scholar 

  19. Wing R.: Behavioral weight control. In: Wadden T.A., Stunkard A. (Eds.). Handbook of obesity. New York, The Guilford Press, 2002.

    Google Scholar 

  20. Morgan J.F., Reid F., Lacey J.H.: The SCOFF questionnaire: assessment of a new screening tool for eating disorders. B.M.J., 319, 1467–1468, 1999.

    Article  CAS  Google Scholar 

  21. Lohman T.G., Roche A.F., Martorell R.: Manuale di riferimento per la standardizzazione antropometrica. Milano, EDRA, 1992.

    Google Scholar 

  22. Durnin J.V.G.A., Womersley J.: Body fat assessed from total body density and its estimation from skinfold thickness: measurements on 481 men and women aged from 16 to 72 years. Br. J. Nutr., 32, 77–97, 1974.

    Article  CAS  PubMed  Google Scholar 

  23. Siri W.E.: Body composition, from fluid spaces and density. Analysis of methods. In: Techniques for measuring body composition. Washington, DC, National Academy of Sciences — National Research Council. 1963.

    Google Scholar 

  24. Deurenberg P., Yap M., van Staveren W.A.: Body mass index and percent body fat: a metanalysis among different ethnic groups. Int. J. Obes., 22, 1164–1171, 1988.

    Article  Google Scholar 

  25. World Health Organization. Physical Status: the use and interpretation of anthropometry. Report of a WHO Expert Committee. WHO Technical Report Series No. 854. Geneva, World Health Organization, 1995.

    Google Scholar 

  26. Report of the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Diabetes Care, 25, Suppl. 1, S5–S20, 2002.

    Google Scholar 

  27. Belfiore F., Iannello S., Volpicelli G.: Insulin sensitivity indices calculated from basal and OGTT-induced insulin, glucose and FFA levels. Mol. Gen. Metab., 63, 134–141, 1998.

    Article  CAS  Google Scholar 

  28. Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel IIl). J.A.M.A., 285, 2486–2497, 2001.

    Article  Google Scholar 

  29. Enright P.L., McBurnie M.A., Bittner V., Tracy R.P., McNamara R., Arnold A., Newman A.B.; Cardiovascular Health Study: The 6-min walk test: a quick measure of functional status in elderly adults. Chest, 122, 387–398, 2002.

    Google Scholar 

  30. ATS Committee on Proficiency Standards for Clinical Pulmonary Function. ATS statement: guidelines for the six-minute walk test. Am. J. Respir. Crit. Care Med., 2002, 166: 111–117.

    Article  Google Scholar 

  31. Borg G.: Psychophysical scaling with applications in physical work and the perception of exertion. Scand. J. Work Environ. Health, 16, Suppl. 1,55–8, 1990.

    Article  PubMed  Google Scholar 

  32. Andrews A.W., Thomas M.W., Bohannon R.W.: Normative values for isometric muscle force measurements obtained with hand-held dynamometers. Phys. Ther., 76, 248–259, 1996.

    CAS  PubMed  Google Scholar 

  33. Spielberg C.D., Gorsuch R.L., Lushene R.E.: Manual for the State Trait Anxiety Inventory. Palo Alto, Consulting Psychologist Press, 1970.

    Google Scholar 

  34. Beck A.T.: Beck Depression Inventory. Philadelphia, Center for Cognitive Therapy.

  35. San Martino L., Caputo G., Cuzzolaro M.: Studio psicometrico dell’obesità. In: Bosello O. (Ed.). Obesità. Milano, Editrice Kurtis, 1998, pp. 271–278.

  36. Brownell K.D.: Dieting readiness. Weight Control Digest, 1, 5–9, 1990.

    Google Scholar 

  37. Grossi E., Mosconi P., Groth N., Niero N., Apolone G.: Il questionario Psychological General Well-Being. Questionario per la valutazione dello stato generale di benessere psicologico. Versione italiana. Milano, Istituto di Ricerche Farmacologiche “Mario Negri”, 2002.

    Google Scholar 

  38. LARN - Livelli di assunzione raccomandati di energia e nutrienti per la popolazione italiana. Società Italiana Nutrizione Umana, Revisione 1996.

    Google Scholar 

  39. ACSM’s Guidelines for Exercise Testing and Prescription. 6th ed. Baltimore, Lippincott Williams & Wilkins, 2006.

  40. Marshall J.D., Hazlett C.B., Spady D.W., Conger P.R., Quinney H.A.: Validity of convenient indicators of obesity. Hum. Biol., 63, 137–153, 1991.

    CAS  PubMed  Google Scholar 

  41. Lohman T.G., Caballero B., Himes J.H., Davis C.E., Stewart D., Houtkooper L., Going S.B., Hunsberger S., Weber J.L., Reid R., Stephenson L.: Estimation of body fat from anthropometry and biolectrical impedance in native American children. Int. J. Obes. Relat. Metab. Disord., 24, 982–928, 2000.

    Article  CAS  PubMed  Google Scholar 

  42. Katzmarzyk P.T., Craig C.L., Bouchard C.: Adiposity, adipose tissue distribution and mortality rates in Canada Fitness Survey follow-up study. Int. J. Obes., 26, 1054–1059, 2002.

    Article  CAS  Google Scholar 

  43. Bemben M.G., Massey B.H., Bemben D.A., Boileau R.A., Misner J.E.: Age-related variability in body composition methods for assessment of percent fat and fatfree mass in men aged 20–74 years. Age Ageing, 27, 147–153, 1998.

    Article  CAS  PubMed  Google Scholar 

  44. Klipstein-Grobusch K., Georg T., Boeing H.: Interviewer variability in anthropometric measurements and estimates of body composition. Int. J. Epidemiol., 26, S174–S180, 1997.

    Article  PubMed  Google Scholar 

  45. Anderson J.W., Konz E.C., Frederich R.C., Wood C.L.: Long-term weight-loss maintenance: a meta-analysis of US studies. Am. J. Clin. Nutr., 74, 579–584, 2001.

    CAS  PubMed  Google Scholar 

  46. Renjilian D.A., Perri M.G., Nezu A.M., McKelvey W.F., Sherrner R.L., Anton S.D.: Individual versus group therapy for obesity: effects of matching participants to their treatment preferences. J. Consult. Clin. Psychol., 69, 717–721, 2001.

    Article  CAS  PubMed  Google Scholar 

  47. Andersson I., Rössner S.: Weight development, dropout pattern and changes in obesity-related risk factors after two years treatment of obese men. Int. J. Obes. Relat. Metab. Disord., 21, 211–216, 1997

    Article  CAS  PubMed  Google Scholar 

  48. Caranti D.A., de Mello M.T., Prado W.L., Tock L., Siqueira K.O., de Piano A., Lofrano M.C., Cristofalo D.M.J., Lederman H., Tufik S., Damaso A.R.: Shortand long-term beneficial effects of a multidisciplinary therapy for the control of metabolic syndrome in obese adolescents. Metabolism, 56, 1293–1300, 2007.

    Article  CAS  PubMed  Google Scholar 

  49. Hamdy O.: Lifestyle modification and endothelial function in obese subjects. Expert Rev. Cardiovasc. Ther., 3, 231–241, 2005.

    Article  CAS  PubMed  Google Scholar 

  50. Sarlio-Lähteenkorva S., Rissanen A.: Weight loss maintenance: determinants of long-term success. Eat. Weight Disord., 3, 131–135, 1998.

    Article  PubMed  Google Scholar 

  51. Mann T., Tomiyama A.J., Westling E., Lew A.M., Samuels B., Chatman J.: Medicare’s search for effective obesity treatments: diets are not the answer. Am. Psychol., 62, 220–233, 2007.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Medical Physiopathology (Food Science Laboratory), University of Rome La Sapienza, P.le Aldo Moro 5, 00185, Rome, Italy

    M. L. Donini & C. Cannella

  2. Rehabilitation Clinical Institut “Villa delle Querce”, Nemi (RM), Italy

    C. Savina, E. Castellaneta, C. Coletti, M. Paolini, L. Scavone, C. Civale, P. Ceccarelli, S. Zaninotto, M. Tineri, G. Grossi & M. R. De Felice

Authors
  1. M. L. Donini
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. C. Savina
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. E. Castellaneta
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. C. Coletti
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. M. Paolini
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. L. Scavone
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. C. Civale
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. P. Ceccarelli
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. S. Zaninotto
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. M. Tineri
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. G. Grossi
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. M. R. De Felice
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. C. Cannella
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to M. L. Donini.

Additional information

An erratum to this article is available at http://dx.doi.org/10.1007/BF03327796.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Donini, M.L., Savina, C., Castellaneta, E. et al. Multidisciplinary approach to obesity. Eat Weight Disord 14, 23–32 (2009). https://doi.org/10.1007/BF03327791

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF03327791

Key words

Search

Navigation