Italian clinical practice GRADE-based guidelines on the diagnosis and treatment of overweight and obesity, endorsed by the Italian National Institute of Health
Year: 2026
Type: article
Abstract: Obesity is a chronic relapsing disease associated with increased morbidity and mortality and reduced quality of life. The present GRADE-based guidelines have been commissioned by the Italian Society of Obesity (SIO) by the Italian National Health Institute to provide evidence-based recommendations on obesity diagnosis and treatment. The panel identified 13 clinical questions, organised into four domains: A. diagnostic criteria (4 questions); B. medical nutrition therapy (4 questions); C. pharmacological, surgical, and endoscopic treatments (4 questions); and D. miscellaneous (1 question). The expert panel recommends adopting at least one anthropometric index of abdominal visceral fat distribution beyond body mass index (BMI) for better clinical risk stratification. A structured lifestyle intervention (i.e., medical–nutritional treatment—MNT), preferably based on cognitive–behavioural therapeutic approach and including physical activity and a balanced diet, should be offered to all subjects living with obesity. Pharmacological or surgical treatment should be offered in addition to MNT when MNT is unable to reach clinical goals. In particular, pharmacological treatment should be considered as the preferred option for subjects with BMI > 27 kg/m 2 with comorbidities, and for those with BMI 30–39.9 kg/m 2 , based on individual therapeutic goals and needs, adopting surgical treatment in selected cases or in case of OMM failure to reach clinical goals. For subjects with a BMI > 40 kg/m 2 , surgical treatment may be considered conversely as a preferable option. Reduction of at least 10% of the initial body weight is associated with a better quality of life and a reduced risk of incident depression. The current guideline is endorsed by the Italian National Institute of Health, providing the new, updated clinical and legal reference for professionals involved in the management of subjects living with obesity in Italy.
Authors: Rocco Barazzoni, Silvio Buscemi, Luca Busetto, Paolo Sbraccia, Simona Bo, Emanuele Cereda, Marco Chianelli, Sonja Chiappetta, Riccardo Dalle Grave, Walter de Caro, Giovanni Docimo, Giuseppe Galloro, Primiano Iannone, Frida Leonetti, Fabrizia Lisso, Maria Caterina Manca, Gerardo Medea, Manuela Merli, Anna Maria Moretti, Giuseppe Navarra, Uberto Pagotto, Barbara Paolini, Giovanni Papa, Nicola Perrotta, Andrea Pession, Vincenzo Pilone, Vincenzo Provenzano, Cecilia Ricciardi Rizzo, Maurizio Santomauro, Cristina Segura Garcia, Federico Spandonaro, Samir Sukkar, Patrizia Todisco, Dario Tuccinardi, Andrea Vania, Valentina Vanzi, Riccardo Williams, Iris Zani, Benedetta Ragghianti, Giovanni Antonio Silverii, Amanda Belluzzi, Maria Masulli, Maddalena Redini, Matteo Monami
Institutions: University of Trieste, University of Palermo, University of Padua, University of Rome Tor Vergata, Azienda Ospedaliera Citta' della Salute e della Scienza di Torino, University of Turin, Policlinico San Matteo Fondazione, Ospedale Regina Apostolorum, Casa di Cura Villa Garda, Sapienza University of Rome, University of Campania "Luigi Vanvitelli", Federico II University Hospital, University of Naples Federico II, Ospedale Maggiore Carlo Alberto Pizzardi, Ospedale Santa Maria Goretti, Ospedale Sant'Anna, Azienda USL di Bologna, Policlinico Umberto I, University of Bari Aldo Moro, University of Messina, IRCCS Azienda Ospedliero-Universitaria di Bologna Policlinico di Sant'Orsola, Azienda Ospedaliera Universitaria Senese, Ospedale San Carlo, University of Bologna, University of Pavia, Magna Graecia University, Ospedale Policlinico San Martino, Università Campus Bio-Medico, Campus Bio Medico University Hospital, Azienda Ospedaliero-Universitaria Careggi, University of Florence, Ospedale Santa Maria della Misericordia di Rovigo
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $4,490
OpenAlex ID: W7123880391