L'obesità nell'età evolutiva. Uso del video-feedback nell’intervento con la famiglia

Da un punto di vista psicologico, il complesso problema dell’obesità infantile richiede il coinvolgimento dei genitori per essere affrontato. Poichè senza la loro attiva partecipazione non è pensabile un intervento efficace, viene qui proposto un nuovo strumento di parent training basato sull’utilizzo di video clip tratti dal cinema come stimolo per un confronto riflessivo. Pensato per essere usato in gruppi di genitori, il percorso affronta con gradualità e progression, tematiche salienti del rapporto genitori-figli intorno al tema dell’alimentazione, dei vissuti emotivi legati al cibo, le dinamiche familiari durante i pasti senza tralasciare i risvolti affettivi individuali legati all’obesità, per far si che la famiglia possa essere sia contesto di cambiamento che di promozione di salutari stili di vita

The role of both parents’ attachment pattern in understanding childhood obesity

Within the research area on the determinants of childhood obesity, a relatively new approach is the use of attachment theory to explore the mechanisms underlying children’s obesity risk, especially considered as emotion regulation strategies in parent–child relationship. Feware the empirical researches that have addressed this issue.The empirical investigations have used self-report measures to assess adult attachment. In attachment studies, the use of interview methods and/or performance-based instruments is advised to evaluate the entire range of possible adult attachment patterns and comprehensively explain the emotional strategies, correlates, and consequences of individual differences in attachment system functioning. The aim of this study was to explore the extent to which both parents’ attachment patterns serve as self-regulative mechanisms related to childhood overweight/obesity by the Adult Attachment Projective Picture System (AAP) in a sample of 44 mothers and fathers of children referred for obesity. Insecure attachment was found as a risk factor both for mothers and fathers. Also unresolved/disorganization was found to play a significant role in childhood obesity. The role of father’s attachment was explored and findings suggested considering it in etiology and treatment of childhood obesity

Multidisciplinary lifestyle intervention in the obese: its impact on patients perception of the disease, food and physical exercise

Background and aims: To be successful, lifestyle intervention in obesity must take into account patients' views. The aim of the present study, conducted using a narrative-autobiographical approach, was to report on the perception of disease, food and physical exercise in a group of 80 obese patients during a structured multidisciplinary lifestyle intervention. Methods and Results: Patients underwent lifestyle intervention, of three months' duration, structured in the following steps: 1) an initial medical examination; 2) an interview by a psychologist; 3) an assessment by a dietician, 4) a physical examination by a specialist in sports medicine; 5) an individualized program consisting of 24 sessions (two per week) of structured indoor exercise 6) eight sessions of group therapeutic education; 7) Nordic walking activity combined with walking excursions during weekends. All the narrative autobiographic texts obtained during the lifestyle intervention were submitted for content analysis; data were analysed according to the ''grounded theory'' method. According to patients' descriptions at the end of the intervention, lifestyle intervention resulted in enhanced self-efficacy and a reduction in their dependency on food and people; their fear of change was also diminished because, by undergoing intervention, they had experienced change. Conclusion: The findings made in the present qualitative analysis suggest that whenever multidisciplinary lifestyle intervention is planned for patients with obesity, it is of the utmost importance to tailor the approach while taking the following key aspects into account: motivation, barriers and/or facilitators in lifestyle change, patients' perceptions of obesity and relationship with food, diet and exercise. © 2011 Elsevier B.V

Mutual interactions between depression/quality of life and adherence to a multidisciplinary lifestyle intervention in obesity

Context. There is scarce knowledge of the interaction between depression/health related quality of life (HRQOL) and lifestyle intervention in obesity. Objective. To establish whether baseline mood status or HRQOL affect attendance to educational or exercise sessions and whether attendance to these two components of the intervention affects mood and/or HRQOL in obesity. Design. 282 overweight/obese subjects (BMI 33.4±5.9, 103 males, 179 females, age 53.8±13.0, mean±SD) were consecutively enrolled in a multidisciplinary lifestyle intervention program. During the intensive phase of the intervention (3 months) patients were invited to attend 8 educational sessions and 26 exercise group sessions. Results. Poor adherence to exercise sessions is predicted by baseline depressive mood (p=0.006) and by low levels of HRQOL (domains of Vitality, Physical Role Functioning, Social Functioning, Mental Composite, Physical Composite Scores) (p<0.05). Attendance to the educational sessions is associated with beneficial effects of the lifestyle intervention on depressive symptoms (p<0.013) and on several mental domains of HRQOL (p<0.041); attendance to the exercise sessions predicted the beneficial effects on perceived general health (p<0.021) and BMI (p<0.011). Attendance to both educational and exercise components is associated (p<0.05) with the reductions in waist circumference, fat mass and blood pressure observed after the intensive phase of the intervention. Conclusions. Measurement of depressive mood and HRQOL before lifestyle intervention allows identification of patients at increased risk of attrition with exercise and educational sessions. Both the exercise and the educational sessions are essential for gaining the full spectrum of psychological and clinical benefits from multidisciplinary lifestyle intervention in obesity

Description of the EUROBIS Program: A Combination of an Epode Community-Based and a Clinical Care Intervention to Improve the Lifestyles of Children and Adolescents with Overweight or Obesity

The present paper describes the Epode Umbria Region Obesity Prevention Study (EUROBIS) and aims to implement the C.U.R.I.A.MO. model through the EPODE methodology. The main goal of the EUROBIS is to change the pendency of slope of the actual trend towards the increase in the yearly rates of childhood overweight and obesity in Umbria and to improve healthy lifestyles of children and their parents. The project is the first EPODE program to be performed in Italy. The aims of the Italian EUROBIS study are: (1) a community-based intervention program (CBP) carrying out activities in all primary schools of the Umbria Region and family settings as first step, to reverse the current obesity trend on a long-term basis, and (2) a clinical care program for childhood and adolescent by C.U.R.I.A.MO. model. C.U.R.I.A.MO. model is a multidisciplinary approach to improve three key aspects of healthy lifestyles: nutrition, exercise, and psychological aspects with the strategy of a family-based approach. The community-based intervention and clinical trial provide an innovative valuable model to address the childhood obesity prevention and treatment in Italy

Description of the EUROBIS program: A combination of an Epode community-based and a clinical care intervention to improve the lifestyles of children and adolescents with overweight or obesity

The present paper describes the Epode Umbria Region Obesity Prevention Study (EUROBIS) and aims to implement the C.U.R.I.A.MO. model through the EPODE methodology. The main goal of the EUROBIS is to change the pendency of slope of the actual trend towards the increase in the yearly rates of childhood overweight and obesity in Umbria and to improve healthy lifestyles of children and their parents. The project is the first EPODE program to be performed in Italy. The aims of the Italian EUROBIS study are: (1) a community-based intervention programn (CBP) carrying out activities in all primary schools of the Umbria Region and family settings as first step, to reverse the current obesity trend on a long-term basis, and (2) a clinical care program for childhood and adolescent by C.U.R.I.A.MO. model. C.U.R.I.A.MO. model is a multidisciplinary approach to improve three key aspects of healthy lifestyles: nutrition, exercise, and psychological aspects with the strategy of a family-based approach. The community-based intervention and clinical trial provide an innovative valuable model to address the childhood obesity prevention and treatment in Italy

The Impact of Strenuous Group Physical Activity on Mood States, Personal Views, Body Composition and Markers of Myocardial Damage in Overweight/Obese Adults. The “Step-by-Step Italy’s Coast to Coast” Trek

It is clinically relevant to understand whether is safe to recommend to trained overweight/obese people long-distance treks and if these experiences could have a negative psychological impact or become even dangerous exposing the trekkers to the risk of a clinically silent myocardial damage. To answer this questions we have performed a quantitative/qualitative study comparing the changes in mood profiles, personal views, body composition and plasma troponin levels of 40 overweight/obese subjects with those of 36 healthy normal weight subjects after the participation to a trek of 388 km from the Adriatic to the Tyrrhenian seas trek: the “Step by step…Italy’s coast to coast”. The results of this study demonstrate that long distances treks are a safe activity for trained overweight/obese people which should be recommended because improves mood, health status and the relationship of participants with themselves and with the regular practice of exercise with effects similar to those obtained by healthy normal weight subjects