PURPOSE: To analyse the short-term effectiveness of an intensive multidimensional inpatient programme specifically developed for patients with severe obesity. METHODS: A multidisciplinary team managed a 3-week residential programme characterised by the integration of nutritional and physical rehabilitation with psychological and educational intervention. All patients consecutively admitted in 10 months were analysed at admission and discharge for changes in the following domains: anthropometry (weight, body mass index (BMI), waist and neck circumferences), cardiovascular risk factors (glycaemia, HbA1c, lipid profile, blood pressure), quality of life, eating behaviour, and physical performance (VO2peak by incremental cycle ergometer test, 6-min walking test (6MWT), chair stands test). RESULTS: 136 subjects (61% females, median age 52.7 years) with obesity (mean BMI 43.2 kg/m2) and multiple comorbidities were analysed. A 3.9% BMI reduction and a reduction in waist (-3.8%) and neck (-3.3%) circumferences were observed. Glycaemic control was achieved in 68% of patients with uncontrolled diabetes at admission. Blood pressure control was achieved in all patients with uncontrolled hypertension at admission. Total cholesterol (-16%), LDL-cholesterol (-19%) and triglycerides (-9%) were significantly reduced. Psychometric assessment showed improvements in quality of life perception and binge eating disorder. Finally, a significant improvement in physical performance (+4.7% improvement in VO2peak, with longer distances in 6MWT and a higher number of standings) was observed. CONCLUSIONS: Our preliminary data prove that a 3-week programme determined a clinically significant multi-dimensional improvement in patients with severe obesity. Long-term follow-up data are needed to confirm the efficacy of our rehabilitation setting.
PURPOSE: To analyse the short-term effectiveness of an intensive multidimensional inpatient programme specifically developed for patients with severe obesity. METHODS: A multidisciplinary team managed a 3-week residential programme characterised by the integration of nutritional and physical rehabilitation with psychological and educational intervention. All patients consecutively admitted in 10 months were analysed at admission and discharge for changes in the following domains: anthropometry (weight, body mass index (BMI), waist and neck circumferences), cardiovascular risk factors (glycaemia, HbA1c, lipid profile, blood pressure), quality of life, eating behaviour, and physical performance (VO2peak by incremental cycle ergometer test, 6-min walking test (6MWT), chair stands test). RESULTS: 136 subjects (61% females, median age 52.7 years) with obesity (mean BMI 43.2 kg/m2) and multiple comorbidities were analysed. A 3.9% BMI reduction and a reduction in waist (-3.8%) and neck (-3.3%) circumferences were observed. Glycaemic control was achieved in 68% of patients with uncontrolled diabetes at admission. Blood pressure control was achieved in all patients with uncontrolled hypertension at admission. Total cholesterol (-16%), LDL-cholesterol (-19%) and triglycerides (-9%) were significantly reduced. Psychometric assessment showed improvements in quality of life perception and binge eating disorder. Finally, a significant improvement in physical performance (+4.7% improvement in VO2peak, with longer distances in 6MWT and a higher number of standings) was observed. CONCLUSIONS: Our preliminary data prove that a 3-week programme determined a clinically significant multi-dimensional improvement in patients with severe obesity. Long-term follow-up data are needed to confirm the efficacy of our rehabilitation setting.
Authors: Jaana Lindström; Pirjo Ilanne-Parikka; Markku Peltonen; Sirkka Aunola; Johan G Eriksson; Katri Hemiö; Helena Hämäläinen; Pirjo Härkönen; Sirkka Keinänen-Kiukaanniemi; Mauri Laakso; Anne Louheranta; Marjo Mannelin; Merja Paturi; Jouko Sundvall; Timo T Valle; Matti Uusitupa; Jaakko Tuomilehto Journal: Lancet Date: 2006-11-11 Impact factor: 79.321