Obesity clinic

The steady, continuing rise of obesity in the world population is one of the greatest public health concerns: it favours the onset of many conditions, such as type 2 diabetes mellitus, high blood pressure, ischaemic heart disease and other diseases that to varying degrees worsen quality of life and shorten it, with a very high social and economic cost. Managing obesity requires a coordinated multidisciplinary approach and the development of effective prevention strategies.

To tackle the problem, community services and dedicated specialist centres need to work together, so as to optimise how care is shared between the hospital and local clinics. Once referred to the Centre, the patient is offered a first outpatient assessment by a multispecialist team that includes the endocrinologist, the dietitian, the psychiatrist and the psychologist. Depending on the degree of obesity and the associated diseases, a tailored diagnostic and treatment pathway is defined: the patient may start an outpatient pathway, with measures that include dietary and behavioural education and, where appropriate, anti-obesity medication. In selected cases bariatric surgery may be considered.

Definition and classification of obesity

• Obesity is a chronic, relapsing and progressive disease.
• It is an excessive and/or abnormal accumulation of adipose tissue that impairs health.
• The body mass index (BMI) is a rough indicator of the amount of adipose tissue: BMI = weight (kg) / height² (m²).

Calculate your body mass index (BMI)

Your BMI is

Enter a weight between 20 and 400 kg and a height between 80 and 250 cm.

• Underweight
• Normal weight
• Overweight
• Class I obesity
• Class II obesity
• Class III obesity

The calculation applies to adults and is only a guide: BMI does not distinguish between fat mass and muscle mass and does not replace a medical assessment. The data you enter stays on your device.

Obesity is associated with many diseases

The care pathway

The Pathway is a hospital-wide reference for the diagnosis and treatment of this disease. Starting from an initial outpatient screening assessment, the Centre offers a multidisciplinary diagnostic and treatment pathway aimed at identifying the causes of obesity, recognising possible associated complications and defining the treatment strategy, in line with national and international guidelines.

Care pathway for the non-critical patient with obesity

The pathway is tailored to the degree of obesity, the comorbidities and the clinical condition.

To carry out these activities the Centre has dedicated outpatient clinics. In cases of severe obesity, the Centre uses the inpatient ward, which has rooms and equipment suitable for managing severe obesity (reinforced beds, hoists, walkers, scales). If the patient is in a critical condition (severe respiratory or cardiovascular failure, uncontrolled glucose metabolism, disability), other hospital Units with the appropriate expertise can be involved.

The care of a patient with childhood-onset obesity must be multidisciplinary from the onset of the disease and requires a specific clinical pathway that allows a correct diagnosis, guaranteed access to the best standards of clinical quality and continuous support for the patient and their family. For this reason the obesity clinic has developed an effective network involving all the specialists in the field.

The Centre's activities

Direct care of patients with obesity

Patients with obesity receive a first outpatient assessment at the Centre by a multidisciplinary team that includes the endocrinologist, the dietitian and the psychologist: depending on the degree of obesity, the comorbidities and the clinical condition, a diagnostic and treatment pathway is identified according to the guidelines of the Italian Society of Obesity (SIO) and in line with European and international care pathways.

If the patient's clinical condition is not critical, they may be referred to an outpatient pathway aimed at weight loss through dietary and behavioural education, with anti-obesity medication where appropriate; in selected cases bariatric surgery may be considered. If the patient's clinical condition is critical (severe respiratory or cardiovascular failure, uncontrolled glucose metabolism and others), a personalised, facilitated pathway is started, with the involvement of specific Units.

To carry out these activities the Centre relies on:

• Dedicated multidisciplinary outpatient clinics (endocrinologist, dietitian, psychologist, psychiatrist)
• Outpatient Day Service
• Inpatient ward with rooms and equipment suitable for managing severe obesity (reinforced beds, hoists and more)

Consultation activity

For the Units of Cisanello Hospital and for hospital and outpatient facilities in the community.

Research activity

Research focuses on the genetic and biomolecular factors underlying the development of obesity, on the mechanisms of obesity and its complications, and on the effects of drug treatments and surgery. The Centre also takes part in multicentre clinical trials of new anti-obesity drugs and collaborates with other research centres in Italy and abroad.

Laboratory activity

The analysis of the known genes responsible for monogenic obesity is performed using next-generation sequencing (NGS). When a potentially disease-causing variant is found, it is important to carry out family screening to identify other family members who are affected or who carry the mutation. Consanguineous populations offer an opportunity to reveal rare and low-frequency variants associated with the development of obesity. The strategic use of NGS in these populations may help to uncover new molecular pathways that influence energy balance.

Metabolic chamber

It is a room designed to study human metabolism precisely and in detail. Although it looks like an ordinary bedroom, with a desk, television and bathroom, it is equipped with advanced technology that makes it an extremely powerful research and diagnostic tool. How the metabolic chamber works

How to access

1. Book a first outpatient endocrinology visit by calling the CUP booking centre, 050 995995.
2. At the first visit specific tests are prescribed and you receive an appointment for a second visit at the Centre.
3. During the second visit the most suitable diagnostic and treatment pathway is assessed and a dietary assessment is carried out, with a personalised nutritional plan. In selected cases a bariatric surgery pathway may be considered.

Where and contacts

Where

Building 7: outpatient visits, consultations and Day Service
View the map

Telephone

050 995077

Inpatient admissions for the assessment of severe obesity take place in Building 8. The Centre's activity is carried out in the facilities of the Endocrinology I Unit, Cisanello Hospital.

Staff

• Prof. Ferruccio SantiniHead
• Prof. Giovanni CeccariniStaff physician
• Prof. Alessio BasoloStaff physician
• Dr. Paola FierabracciStaff physician
• Dr. Donatella GiglioStaff physician
• Dr. Silvia MagnoStaff physician
• Dr. Guido SalvettiStaff physician
• Dr. Giovanna ScartabelliStaff physician
• Dr. Chita LippiConsultant psychologist

All staff

Accreditations

The obesity clinic of the Endocrinology 1 Unit is accredited by the Italian Society of Obesity (SIO) and by the European Association for the Study of Obesity (EASO).

Documents and useful links

• Pathway for non-syndromic monogenic obesity (PDF in Italian, 1.9 MB)
• SIO – Italian Society of Obesity