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From simplicity towards complexity: the Italian multidimensional approach to obesity

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Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity Aims and scope Submit manuscript

An Erratum to this article was published on 25 February 2014

Abstract

Obesity is the result of a complex interplay among several factors leading to medical, functional and psychosocial consequences that markedly reduce life expectancy and impair quality of life. Is obesity itself a disease? Is obesity a brain disease? Who should treat obesity? This paper is a narrative review aimed to describe and to argue the prevalent position of some major Italian scientific and academic institutions dealing with obesity. According to the recent statements and recommendations published by the Italian Society for Obesity (SIO) and the Italian Society for the Study of Eating Disorders (SISDCA), the management of obese patients should include five main levels of care: (1) primary care, (2) outpatient treatment, (3) intensive outpatient treatment, (4) residential rehabilitative treatment, and (5) hospitalization. Ideally, patients suffering from obesity need a multidimensional evaluation intended to design an individualized treatment plan applying different procedures and therapeutic strategies (diet, physical activity and functional rehabilitation, educational therapy, cognitive-behavior therapy, drug therapy, and bariatric surgery). This thorough approach should address not only weight loss but also quality of weight loss, medical and psychiatric comorbidity, psychosocial problems, and physical disability. Such management of obesity requires an effective multiprofessional team, while health services have to overcome a number of administrative and organizational barriers that do not account for diseases requiring resources and professionals from different areas of medicine. Integrating several competences in a team-based approach demands specific education, skills and expertise. As for other diseases, the principles of complexity theory may offer a model useful to implement both teamwork and care delivery for patients with obesity.

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The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Experimental Medicine-Medical Physiopathology, Food Science and Endocrinology Section, Sapienza University of Rome, P.le Aldo Moro, 5, 00185, Rome, Italy

    Lorenzo M. Donini & Andrea Lenzi

  2. SISDCA: Italian Society for the Study of Eating Disorders, Rome, Italy

    Lorenzo M. Donini, Nazario Melchionda & Massimo Cuzzolaro

  3. Department of Eating and Weight Disorders, Villa Garda Hospital, Garda (VR), Italy

    Riccardo Dalle Grave

  4. ADI: Italian Association of Dietetics and Clinical Nutrition, Rome, Italy

    Antonio Caretto & Lucio Lucchin

  5. Perrino Hospital, Brindisi, Italy

    Antonio Caretto

  6. Dietetic and Clinical Nutrition Unit, Regional General Hospital, Bolzano, Italy

    Lucio Lucchin

  7. SIO: Italian Society of Obesity, Rome, Italy

    Enzo Nisoli & Paolo Sbraccia

  8. Department of Medical Biotechnology and Translational Medicine, University of Milan, Milan, Italy

    Enzo Nisoli

  9. Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy

    Paolo Sbraccia

  10. University College of Italian Endocrinologists, Rome, Italy

    Andrea Lenzi

  11. SIE: Italian Society of Endocrinology, Rome, Italy

    Andrea Lenzi

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  1. Lorenzo M. Donini
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  2. Riccardo Dalle Grave
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  9. Massimo Cuzzolaro
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Correspondence to Lorenzo M. Donini.

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Donini, L.M., Grave, R.D., Caretto, A. et al. From simplicity towards complexity: the Italian multidimensional approach to obesity. Eat Weight Disord 19, 387–394 (2014). https://doi.org/10.1007/s40519-013-0097-9

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  • DOI: https://doi.org/10.1007/s40519-013-0097-9

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