Article

Problems posed by obesity-related endocrine diseases embody a national health
crisis. Caloric excess and sedentary lifestyle from which they develop also pose
significant challenges for rehabilitation providers.
Almost two thirds of the
U.S. population are currently overweight or obese, a number that has increased by
>10% within the last decade and is expected to grow. An overweight body habitus
is strongly associated with clinical hazards, including cardiometabolic syndrome,
diabetes hypertension, and coronary artery disease.
The component health risks of
the cardiometabolic syndrome include coalescing of risk factors that predict a
health calamity unless effective interventions can be developed and widely
adopted. Obesity by itself is now considered an American Diabetes
Association-qualified disability, but it is also disturbingly prevalent in other
physical disability groupings of adults and children. This monograph describes
successes of the Diabetes Prevention Program (DPP), a National Institutes of
Health multisite randomized controlled trial that reported significant weight
reduction and a 58% decreased incidence of type-2 diabetes accompanying 1 year of
structured lifestyle intervention. This treatment benefit (1) exceeded that of
metformin pharmacotherapy, (2) was so powerful that the trial was closed before
reaching endpoints, and (3) was judged cost-effective for the patient and
society. The DPP roadmap incorporating physical activity, diet, and behavioral
approaches has been widely adapted to specific community, faith, racial, ethnic,
school, and national populations with excellent outcomes success. The lockstep
physical activity approach, activity prescription, and long-term success of the
program are described and compared with other programs to illustrate effective
countermeasures for the pandemics of obesity and obesity-related cardioendocrine
disease. We will illustrate adaptation of the DPP for a cohort of persons with
disability from spinal cord injury and the benefits observed.
CI - Copyright (c) 2016 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS