The “7 Steps Multidisciplinary Program” Approach to Morbidly Obese Patients: An Italian Experience

Abstract: The aim of this longitudinal study is to describe a multi-step long-term multidisciplinary approach to morbidly obesity and report 5 years results in a representative sample of obese patients. One hundred sixty four obese patients, enrolled to the long term, multidisciplinary weight loss program at San Luca’s Hospital (Torino, Italy), were all recruited from May 2005 to December 2005 and they were followed up until December 2010. The weight loss goals were individually established on a year-to-year basis, based on the “7 steps” model, and were reviewed every 6 months. Of the whole sample 123 were females and 41were males; the mean age was 46.9 (14-77) years, and the mean BMI was 44.4 (37-56) kg/m2. The drop out rate during the whole study period was about the 53% mainly due lack of motivation as well as scarce perception of treatment outcomes. Eight percent (n=13) did not achieve their goals, 39% (n=64) achieved their goals either through “non surgical treatment” (n= 25) or throughout invasive procedures (n=39) such as intragastric balloon and lap-band (n=18), intragastric balloon and gastric bypass (n=14) , intragastric balloon and lap band followed by gastric by-pass surgery (n=7). The results obtained during the “non surgical treatment” procedure together with those obtained using intra-gastric balloon and lap-band procedures were successful since these procedures allowed some of the patients to achieve their proposed goals, even if their weight loss was inferior to that obtained with gastric by-pass surgery.