From simplicity towards complexity: the Italian multidimensional approach to obesity

Area of Science:

• Medical Science
• Public Health
• Psychology

Background:

• Obesity is a complex condition with significant medical, functional, and psychosocial consequences.
• It reduces life expectancy and impairs quality of life, prompting debate on its classification as a disease, potentially a brain disease.
• Current management approaches often face administrative and organizational barriers.

Purpose of the Study:

• To review and present the prevailing stance of major Italian scientific and academic institutions on obesity management.
• To outline a structured, multidimensional approach to treating obesity.
• To highlight the necessity of multiprofessional teams and integrated care models.

Main Methods:

• Narrative review of statements and recommendations from the Italian Society for Obesity (SIO) and the Italian Society for the Study of Eating Disorders (SISDCA).
• Analysis of proposed five-level care model for obese patients.
• Discussion of individualized treatment plans incorporating diverse therapeutic strategies.

Main Results:

• A five-level care model is recommended: primary care, outpatient, intensive outpatient, residential rehabilitative, and hospitalization.
• Individualized treatment plans should integrate diet, physical activity, rehabilitation, education, cognitive-behavior therapy, pharmacotherapy, and bariatric surgery.
• Effective management necessitates a multiprofessional team, addressing weight loss quality, comorbidities, psychosocial issues, and physical disability.

Conclusions:

• Obesity requires a multidimensional evaluation and individualized treatment plan.
• Overcoming administrative barriers and fostering multiprofessional, team-based care is crucial for effective obesity management.
• Complexity theory principles can inform teamwork and care delivery models for obesity.