The Journal of the International Society of Physical and Rehabilitation Medicine (Jan 2020)

International society of physical and rehabilitation medicine/European society of physical and rehabilitation medicine guidelines on physical and rehabilitation medicine professional practice for adults with obesity and related comorbidities

  • Emanuele M Giusti,
  • Chiara A M Spatola,
  • Amelia Brunani,
  • Dinesh Kumbhare,
  • Aydan Oral,
  • Elena Ilieva,
  • Carlotte Kiekens,
  • Giada Pietrabissa,
  • Gian Mauro Manzoni,
  • Marta Imamura,
  • Gianluca Castelnuovo,
  • Paolo Capodaglio

DOI
https://doi.org/10.4103/jisprm.jisprm_6_20
Journal volume & issue
Vol. 3, no. 1
pp. 11 – 21

Abstract

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Background: The World Health Organization (WHO) has declared obesity as the largest global chronic health problem in adults. In the last years, attention has been drawn to rehabilitative interventions for patients with obesity. Aim: The aim of this manuscript is to provide physical and rehabilitation medicine (PRM) physicians with evidence-based recommendations for the rehabilitation of patients with obesity and related comorbidities. Design: Evidence-based guidelines. Population: Adults with overweight or obesity. Methods: Guidelines were based on the Grading of Recommendations Assessment, Development and Evaluation and the WHO recommendations. A comprehensive search of the available evidence about rehabilitation treatments for obesity was performed, and 17 separate systematic literature reviews were conducted. For each outcome, estimates of the effects of rehabilitation treatments were computed and employed along with an assessment of quality of evidence, desirable and undesirable effects, values and preferences to formulate the recommendations. Recommendations were reviewed by a consensus expert panel using a modified Delphi process. Results: We strongly recommend providing comprehensive multiprofessional and multidisciplinary interventions including exercise, diet and behavioral or cognitive-behavioral therapy. The nutritional component of these treatments should include diets with either a high-protein or a low-fat content. It is strongly recommended to prescribe frequent moderate aerobic exercise. We strongly recommend providing cognitive-behavioral interventions as the behavioral component of rehabilitation programs. Conclusions: PRM physicians should lead multidisciplinary teams providing comprehensive and individualized rehabilitation programs for patients with overweight or obesity. These guidelines were endorsed by the International Society of Physical and Rehabilitation Medicine and by the European Society of Physical and Rehabilitation Medicine.

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