Donini L M, Savina C, Castellaneta E, Coletti C, Paolini M, Scavone L, Civale C, Ceccarelli P, Zaninotto S, Tineri M, Grossi G, De Felice M R, Cannella C
Department of Medical Physiopathology (Food Science Laboratory), University of Rome La Sapienza, 00185 Rome, Italy.
Eat Weight Disord. 2009 Mar;14(1):23-32. doi: 10.1007/BF03327791.
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.
To verify the efficacy of a multidimensional approach (Nutritional Psycho-Physical Reconditioning - NPPR) in obesity treatment.
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.
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.
An integrated approach to obesity is the way to be pursued in order to obtain important and at least short-term results.
肥胖与发病率和死亡率相关，是一种复杂的病症，其特征为脂肪量（FM）增加。大多数作者一致认为，综合治疗至关重要，该治疗由营养干预、身体康复计划和认知行为心理治疗组成。然而，其可行性存在问题，且文献中证实该方法有效性的数据较少。
验证多维方法（营养身心康复 - NPPR）在肥胖治疗中的疗效。
纳入2002年6月至2004年6月收治的所有年龄在18至65岁、体重指数（BMI）>30 kg/m²的患者（464名受试者）。在评估营养状况后，提出标准饮食治疗（N组）或综合多学科肥胖治疗（NPPR组）。
NPPR组的治疗持续时间显著更长（142.6±26天对48.6±55天 - p = 0.000），而退出量明显更低（5.5%对54.4%；p = 0.000）。与初始体重相比，NPPR组的体重减轻以及初始和最终FM之间的差异显著更大。NPPR组的受试者在6分钟步行测试中的行走距离增加更高（59.9±19米对40.5±17米；p = 0.04），肌肉力量也有所增强。NPPR组受试者的状态和特质焦虑、情绪及生活质量评分有所改善，而N组则基本保持稳定。
为了获得重要且至少是短期的效果，应采用综合方法治疗肥胖。
