Table 1.

The rationale for the approaches used in obesity management

Approaches/measurements used	Rationale/explanations
Improve communication and motivation	Motivation is essential for adherence to treatment; readiness to change will be evaluated over the long term using motivational interviewing (MI)
Avoid stigmatization in a health care setting	Stigmatization is very frequent in healthcare settings; the consequences are an increase in eating disorders, which worsen the degree of obesity, as well as an increase in depression, suicidal thoughts or even, in the worst cases, suicide; stigmatization can decrease using MI
Measure waist circumference	It is a good indicator of visceral fat and a useful predictor of cardiometabolic diseases; it can be measured at regular intervals to monitor the decrease of visceral fat
Treat comorbidities	Comorbidities should be treated as a priority, mainly the cardiometabolic diseases, to decrease mortality
Use a multidisciplinary team	A multidisciplinary team (obesity medical specialist, dietician or nutritionist, specialist in physical activity, psychiatric or psychologist, nurse and patient's GP) is more efficient; this team will work in a network system
Assess weight loss	5–10% weight loss from initial weight is already sufficient to decrease comorbidities
Consider lifestyle behaviour change	Behavioural modifications can induce 5–15% weight loss; it will also help to improve body image, self-esteem, self-affirmation and quality of life
Increase physical activity	Fit patients with obesity have a lower mortality risk, all aetiologies included, than normal weight sedentary patients. Moreover, regular physical activity decreases weight regain and the risk of weight cycling after weight loss
Avoid weight cycling	After weight loss, particular attention will be given to avoiding weight regain and weight cycling; patients can weigh themselves approximately every 2 weeks; if the patient gains 3–4 kg quickly, he/she should not wait too long before visiting the GP to be assessed