Obesity therapy and treatment

If  obesity is the result  of a disease, it must first be treated. Otherwise, according to medical guidelines, overweight and obesity should be treated with therapy. You can find out exactly what the guidelines look like in the following article.

Medical Guidelines

• Bei einem  BMI  ab 30 (Obesity or obesity)
• With a BMI of 25 or more (overweight) if other factors are present:
  • Complications such as  hypertension  (high blood pressure)
  • Apple type (abdominal fat distribution pattern)
  • Diseases made worse by being overweight
  • High level of suffering of the person concerned

Important if you are overweight: diet and exercise

However, overweight therapy is only successful if the person concerned  is motivated  and ready to work actively with the therapist. The goals of the therapy must be realistic – it is better to stabilize or moderately reduce the weight first than to directly strive for a normal weight. Otherwise, frustration and early giving up are inevitable despite the start of treatment.

Ziele bei der Therapie bei Adiposita oder Adiposita promagna sind:

• Lose weight: Depending on the degree of obesity and previous fat intake, an average weight loss of 5-8 kg per year is realistic.
• Keeping your body weight stable over the long term
• Optimizing diet and exercise habits; learn what is healthy
• Reduce or prevent other risk factors and secondary diseases
• increase quality of life
• Reduce absenteeism at work
• Increase self-confidence and stress management skills

To lose weight, the daily intake of energy should be around 500-800 kcal below turnover. This energy expenditure at rest (GU) depends on body weight, gender and age and varies according to BMI. In addition, half an hour to one hour of physical activity three to five times a week is recommended to maintain weight; at least five hours of exercise per week (equivalent to around 2500 kcal) are necessary to lose weight. Behavioral therapy support also helps many affected people to lose weight.

Obesity: Therapy with drugs

Further measures as part of a therapy should only be carried out under medical supervision. So-called appetite suppressants have repeatedly shown side effects and have mostly been taken off the market in Germany (e.g. sibutramine, rimonabant).

The currently only approved active ingredient  Orlistat  (Xenical®) disrupts the absorption of fat from food, which is then excreted undigested in the stool – together with fat-soluble vitamins. This preparation can make sense temporarily if the basic therapy alone is not sufficiently successful – but only temporarily and if possible under medical supervision.

Other preparations that are repeatedly praised or used as appetite suppressants (e.g. diuretics, growth hormones,  amphetamines , thyroid hormones) are not suitable or even dangerous for the treatment of obesity.

Bariatric surgery therapy

Especially in obesity permagna or obesity grade II and other diseases such as  diabetes  (sugar diabetes), surgical measures are available for therapy. A distinction is made between purely restrictive procedures (gastric band, stomach reduction) and combined procedures, in which the metabolism of food is also restricted (by bypassing the gastrointestinal tract). The latter are usually only used in obesity permagna with a BMI greater than 50. If possible, the operation is performed laparoscopically, since the complication rate is higher with an open abdominal incision.