Defining the appropriate setting for treating obese patients: do we have the right tools?

Luisella Vigna, Amelia Brunani, Gianna Maria Agnelli, Maria Rosaria Ingenito, Silvia Tomaino, Dario Consonni, Paolo Capodaglio, Lorenzo Maria Donini

Research output: Contribution to journalArticle

Abstract

Purpose: To allocate obese patients to the correct therapeutic setting, the Italian Obesity Society (SIO) has suggested a new algorithm based on the Edmonton obesity staging system (EOSS). The aim of our study was to apply in two retrospective cohorts of obese patients both the EOSS and the activities of daily life (ADL) scale to identify also their rehabilitation needs. Methods: 288 out-patients and 298 in-patients were recruited. All patients were evaluated with a multidisciplinary approach and the mental, mechanical, and metabolic comorbidities were scored. Results: The 2 groups differed for gender (28.8% men in out-patients, p = 0.001), age (> 60 years in in-patients, p = 0.03), BMI (40.8 ± 6.3 kg/m2 in in-patients, p < 0.001), and ADL (44.0 ± 16.0 in in-patients, p < 0.001). EOSS distribution was significant different: stages 0 and 1 were more present in out-patients and stages 3 and 4 in in-patients. In both groups, BMI increased significantly in EOSS category [95% CI + 1.4 (+ 0.5; + 2.2) for out-patients and + 1.7 (+ 0.7; + 2.6) for in-patients] and ADL were positively correlated with EOSS [95% CI + 5.0 (+ 2.5; + 7.4) for out-patients and + 9.9 (+ 7.7; + 12.2) for in-patients]. Mean ADL difference between the two groups, adjusted for age (over/under 60 years), BMI category, and EOSS was 24.8 (p < 0.0001). Conclusions: SIO algorithm seems an effective tool for staging obesity in relation to the clinical impairment. To better define the correct rehabilitative allocation of obese patients, we suggest to integrate the SIO algorithm with the ADL score. Level of evidence: Level III, retrospective case-control analytic study.

Original languageEnglish
Pages (from-to)871-876
JournalEating and Weight Disorders
Volume23
Issue number6
DOIs
Publication statusPublished - 2018

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Obesity
Outpatients
Comorbidity
Rehabilitation
Age Groups

Keywords

  • Activities of Daily Life (ADL) scale
  • Edmonton Obesity Staging System (EOSS)
  • Obesity
  • SIO algorithm

ASJC Scopus subject areas

  • Clinical Psychology
  • Psychiatry and Mental health

Cite this

Defining the appropriate setting for treating obese patients : do we have the right tools? / Vigna, Luisella; Brunani, Amelia; Agnelli, Gianna Maria; Ingenito, Maria Rosaria; Tomaino, Silvia; Consonni, Dario; Capodaglio, Paolo; Donini, Lorenzo Maria.

In: Eating and Weight Disorders, Vol. 23, No. 6, 2018, p. 871-876.

Research output: Contribution to journalArticle

Vigna, Luisella ; Brunani, Amelia ; Agnelli, Gianna Maria ; Ingenito, Maria Rosaria ; Tomaino, Silvia ; Consonni, Dario ; Capodaglio, Paolo ; Donini, Lorenzo Maria. / Defining the appropriate setting for treating obese patients : do we have the right tools?. In: Eating and Weight Disorders. 2018 ; Vol. 23, No. 6. pp. 871-876.
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abstract = "Purpose: To allocate obese patients to the correct therapeutic setting, the Italian Obesity Society (SIO) has suggested a new algorithm based on the Edmonton obesity staging system (EOSS). The aim of our study was to apply in two retrospective cohorts of obese patients both the EOSS and the activities of daily life (ADL) scale to identify also their rehabilitation needs. Methods: 288 out-patients and 298 in-patients were recruited. All patients were evaluated with a multidisciplinary approach and the mental, mechanical, and metabolic comorbidities were scored. Results: The 2 groups differed for gender (28.8{\%} men in out-patients, p = 0.001), age (> 60 years in in-patients, p = 0.03), BMI (40.8 ± 6.3 kg/m2 in in-patients, p < 0.001), and ADL (44.0 ± 16.0 in in-patients, p < 0.001). EOSS distribution was significant different: stages 0 and 1 were more present in out-patients and stages 3 and 4 in in-patients. In both groups, BMI increased significantly in EOSS category [95{\%} CI + 1.4 (+ 0.5; + 2.2) for out-patients and + 1.7 (+ 0.7; + 2.6) for in-patients] and ADL were positively correlated with EOSS [95{\%} CI + 5.0 (+ 2.5; + 7.4) for out-patients and + 9.9 (+ 7.7; + 12.2) for in-patients]. Mean ADL difference between the two groups, adjusted for age (over/under 60 years), BMI category, and EOSS was 24.8 (p < 0.0001). Conclusions: SIO algorithm seems an effective tool for staging obesity in relation to the clinical impairment. To better define the correct rehabilitative allocation of obese patients, we suggest to integrate the SIO algorithm with the ADL score. Level of evidence: Level III, retrospective case-control analytic study.",
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AU - Vigna, Luisella

AU - Brunani, Amelia

AU - Agnelli, Gianna Maria

AU - Ingenito, Maria Rosaria

AU - Tomaino, Silvia

AU - Consonni, Dario

AU - Capodaglio, Paolo

AU - Donini, Lorenzo Maria

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AB - Purpose: To allocate obese patients to the correct therapeutic setting, the Italian Obesity Society (SIO) has suggested a new algorithm based on the Edmonton obesity staging system (EOSS). The aim of our study was to apply in two retrospective cohorts of obese patients both the EOSS and the activities of daily life (ADL) scale to identify also their rehabilitation needs. Methods: 288 out-patients and 298 in-patients were recruited. All patients were evaluated with a multidisciplinary approach and the mental, mechanical, and metabolic comorbidities were scored. Results: The 2 groups differed for gender (28.8% men in out-patients, p = 0.001), age (> 60 years in in-patients, p = 0.03), BMI (40.8 ± 6.3 kg/m2 in in-patients, p < 0.001), and ADL (44.0 ± 16.0 in in-patients, p < 0.001). EOSS distribution was significant different: stages 0 and 1 were more present in out-patients and stages 3 and 4 in in-patients. In both groups, BMI increased significantly in EOSS category [95% CI + 1.4 (+ 0.5; + 2.2) for out-patients and + 1.7 (+ 0.7; + 2.6) for in-patients] and ADL were positively correlated with EOSS [95% CI + 5.0 (+ 2.5; + 7.4) for out-patients and + 9.9 (+ 7.7; + 12.2) for in-patients]. Mean ADL difference between the two groups, adjusted for age (over/under 60 years), BMI category, and EOSS was 24.8 (p < 0.0001). Conclusions: SIO algorithm seems an effective tool for staging obesity in relation to the clinical impairment. To better define the correct rehabilitative allocation of obese patients, we suggest to integrate the SIO algorithm with the ADL score. Level of evidence: Level III, retrospective case-control analytic study.

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