The paper presents a comparison between the performances of two full scale wastewater treatment plants operating in Italy, considering the mass balances including P treatments, and results coming from an analysis of 16 similar plants in Europe and USA, in order to evaluate sludge overproduction due to chemical P removal adoption. Specific production of 9.5 and 12.5 kgTS/P.E.y were found for a BNR and denitrification plant scheme respectively. These results were compared, on a mass balance basis, with the performances coming from the adoption of the integrated waste/wastewater cycles, in which OFMSW fermentation is used as C source to promote BNR performances and P removal from anaerobic supernatants as struvite crystals. ASM2 simulations are used to verify the advantages coming from this approach in terms of sludge reduction. A complete mass balance of the process is carried out, and it is shown that this last process allows us to achieve the lowest sludge production among the processes considered, coupling this with the economic benefits coming from OFMSW disposal and struvite crystallisation.