Obesity - therapy and treatment

If the overweight is the consequence of a disease, it must first be treated. Otherwise, overweight and obesity, according to the medical guidelines to counter with a therapy. Exactly what the guidelines look like is explained in the following article.

Medical guidelines

  • At a BMI from 30 (obesity or obesity permagna)
  • At a BMI from 25 (overweight), if there are other factors:
    • Already follow-up diseases such as hypertension (hypertension)
    • Apple type (abdominal fat distribution pattern)
    • Diseases that are worsened by obesity
    • High suffering of the person concerned

Important for obesity: diet and exercise

However, overweight therapy is only successful if the person is motivated and already cooperates actively with the therapist. The goals of the therapy must be realistic - better first to stabilize the weight or lower moderately than directly to strive for the normal weight. Otherwise, frustration and premature abandonment are inevitable despite the treatment started.

Objectives of therapy for obesity or obesity permagna are:

  • Losing weight: Depending on the degree of obesity and previous fat intake, an average weight loss of 5-8 kg per year is realistic.
  • Keep body weight stable in the long term
  • Optimize habits regarding diet and physical activity; learn what is healthy
  • Lower or prevent other risk factors and sequelae
  • Increase quality of life
  • Reduce outages at work
  • Strengthen self-confidence and stress management skills

To lose weight, the daily intake of energy should be around 500-800 kcal below the sales. This energy expenditure at rest (GU) depends on the body weight, gender and age and varies according to BMI.Dazu recommends regularly three to five times a week half to one hour of physical activity for weight maintenance; to lose weight, at least five hours of exercise per week (equivalent to about 2500 kcal) is necessary. A behavioral support also helps many people lose weight.

Obesity: Therapy by medication

Further measures in the context of a therapy should at best be carried out under medical supervision. So-called appetite suppressants have repeatedly shown side effects and are mostly taken out of the market in Germany (for example sibutramine, rimonabant).

Currently, the only approved active ingredient Orlistat (Xenical®) disturbs the fat intake of the food, which is accordingly undigested again excreted through the stool - together with fat-soluble vitamins. Temporarily this preparation can make sense, if the basic therapy alone does not have a sufficient success - however only temporarily and if possible under medical supervision.

Other drugs that are repeatedly praised or used as an appetite suppressant (for example, diuretics, growth hormones, amphetamines, thyroid hormones) are not suitable or even dangerous for the treatment of obesity.

Therapy by bariatric surgery

Especially with obesity permagna or with a grade II obesity and other diseases such as diabetes (diabetes), surgical measures are available during therapy. In this case, purely restrictive procedures (gastric band, gastric reduction) are distinguished from combined methods in which additionally the metabolism of the food is restricted (through gastrointestinal bypasses). The latter are usually only used in obesity permagna with a BMI greater than 50. If possible, laparoscopic surgery is performed, as the complication rate is higher in an open abdominal incision.

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