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GUIDELINE
Year : 2020  |  Volume : 3  |  Issue : 1  |  Page : 11-21

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


1 Department of Psychology, Catholic University of Milan, Milan; Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, San Giuseppe Hospital, Verbania, Italy
2 Rehabilitation Unit and Research Laboratory in Biomechanics and Rehabilitation, Istituto Auxologico Italiano IRCCS, San Giuseppe Hospital, Verbania, Italy
3 Division of Physical Medicine and Rehabilitation, University of Toronto, Toronto, Canada
4 Department of Physical and Rehabilitation Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
5 Department of Physical and Rehabilitation Medicine, University Hospital “Sv. Georgi”, Plovdiv, Bulgaria
6 Department of Physical and Rehabilitation Medicine, University Hospitals Leuven, Leuven, Belgium; Spinal Unit, Montecatone Rehabilitation Institute, Imola, Italy
7 Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, San Giuseppe Hospital, Verbania; Faculty of Psychology, eCampus University, Novedrate, Italy
8 Institute of Physical and Rehabilitation Medicine, University of São Paulo School of Medicine, São Paulo, Brazil

Correspondence Address:
Dr. Emanuele M Giusti
Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, San Giuseppe Hospital, Verbania
Italy
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jisprm.jisprm_6_20

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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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