Obesity is an epidemic worldwide and has become a major driver in the burden of chronic diseases. Obesity is considered a public health problem, which, in addition to being highly prevalent, is a risk factor for many chronic-degenerative diseases such as atherosclerosis, hypertension, insulin resistance, diabetes type 2, and dyslipidemia, metabolic syndrome, and cardiovascular diseases.
The World Health Organization defines overweight and obesity as abnormal or excessive fat accumulation that may impair health. There are different ways to measure overweight or obesity with the most common measurement being body mass index (BMI). Individuals with a BMI over 25 are classified as overweight and those over 30 are classified with obesity. Guidelines for obesity treatment recommend a lifestyle intervention for the management and prevention of obesity. This includes behavior modification, dietary counseling, and physical activity. This approach resulted in generally positive outcomes for the patients in terms of knowledge of healthy lifestyle choices, weight, body mass index, and waist circumference. Weight reduction is well documented to improve cardiovascular risk factors (such as blood pressure, low-density lipoprotein cholesterol, and triglycerides) and blood glucose metabolism in individuals who are overweight or with obesity.
Based on the 2006 CCPG, a weight management program should involve a nutrition health professional, an exercise professional, and a clinical psychologist. With this type of interdisciplinary team, all aspects of an individuals’ life are considered (i.e., lifestyle, mental health, behaviors). A weight loss program which is directed by dietitians, exercise professional, and/or psychologist, with physician or nurse practitioner (prescriber) oversight, is considered a clinically managed weight loss program. An interdisciplinary team of highly trained healthcare professionals has the ability to provide medically sound and safe advice in all aspects of an individuals’ life.
Clinicians are able to actively monitor a participants’ health and potentially adjust medications throughout the weight loss program. A study found that an interdisciplinary intervention with physician oversight produced greater and more clinically significant weight loss. Additionally, interdisciplinary weight loss programs have shown improvement in other areas other than weight, such as eating behaviors, lipid profiles, aerobic capacity, and overall quality of life.
The consumer marketplace is overwhelmed with weight loss programs, with the majority being focused on calorie-reduced diets. Not all of these programs include exercise, and most do not include physician oversight and may not be customizable.
Evidence presented in the studies analyzed confirms the success of the multidisciplinary obesity treatment program. Therefore, more support should be given and more investment should be allocated for this type of intervention.
The most important effects of the multidisciplinary treatment on the population investigated include improvements in the anthropometric parameters, such as the reduction in Total Body Mass (TBM). Body Mass Index (BMI), and body fat. In a study with adolescents of both genders in Germany found a significant reduction in body weight, BMI, and body fat after a nine- month intervention. In other study found that improvements in the biochemical parameters and moderate weight loss, especially abdominal fat loss, reduced cardiovascular risk in obese individuals, showing that the treatment was successful.
In the studies involving adults, there were improvements in the anthropometric and biochemical parameters, especially a reduction in BMI and in the lipid and glycemic profiles. In all articles reviewed, there was no difference between the results of the studies with adolescents and those of the studies with adults in terms of the psychological, anthropometric, and biochemical variables and the nutritional profile.
Based on evidence presented in the studies, it can be said that the multidisciplinary treatment for obesity greatly contributed to the reduction in the anthropometric indicators, especially BMI and the biochemical, social, and psychological parameters. Thus, these findings demonstrate that there is a need to expand the range of this type of treatment since it has proven to be effective in the fight against obesity and its comorbidities.
Karimi, H
Master of clinical Nutrition & Dietetics
References
- Cachero K, et al. Efficacy and safety of clinically managed weight loss programs: a systematic review and meta-analysis protocol. Systematic Reviews.2021.
- Catchings S, et al. The Treatment of Obesity in the Multidisciplinary Setting. The Journal for Nurse Practitioners.2021,707-711.
- Mendes A, et al. Multidisciplinary programs for obesity treatment in Brazil: A systematic review. Rev. Nutr.Campinas.2016,863-880.
