Medical history (history of illness) represents an important component in the diagnosis of obesity (overweight). Family history Is there a frequent occurrence of obesity in your family? Social history What is your profession? Is there any evidence of psychosocial stress or strain due to your family situation? Current medical history/systemic history (somatic and psychological complaints). … Overweight (Obesity): Medical History
Congenital malformations, deformities, and chromosomal abnormalities (Q00-Q99). Klinefelter syndrome – genetic disorder with mostly sporadic inheritance: numerical chromosomal aberration (aneuploidy) of the sex chromosomes (gonosomal anomaly) occurring only in boys or Men occurs; in the majority of cases characterized by a supernumerary X chromosome (47, XXY); clinical picture: large stature and testicular hypoplasia (small testis), … Overweight (Obesity): Or something else? Differential Diagnosis
Adipose tissue is a connective tissue that is composed of adipocytes (fat cells). It is divided into two forms – white adipose tissue and brown adipose tissue – with different functions. White adipose tissue has the following functions: Storage or depot fat – lipid stores (triglycerides); reserves to manage up to 40 days without food … Overweight (Obesity): Adipose Tissue as an Endocrine Organ
A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body weight, height [determination of BMI for classification of overweight]; the further: Inspection Skin, mucous membranes and sclerae (white part of the eye). Abdomen (abdomen) Shape of the abdomen? Skin color? Skin texture (skin lesions)? … Overweight (Obesity): Examination
Laboratory parameters of the 1st order – obligatory laboratory tests. Fasting glucose (fasting blood glucose), oral glucose tolerance test (oGTT) if necessary. HbA1c (long-term blood glucose). Fasting insulin serum level (HOMA index)Note: Insulin and testosterone serum levels are inversely correlated! Metabolic parameters Liver: alanine aminotransferase (ALT, GPT), aspartate aminotransferase (AST, GOT), gamma-glutamyl transferase (γ-GT, gamma-GT; … Overweight (Obesity): Test and Diagnosis
Therapy goals The first step is to aim for a “metabolically healthy” overweight. The goal of therapy with antiadiposita (slimming agents) is to reduce body weight in individuals with a BMI ≥ 30 kg/m². Therapy recommendations Drug therapy for overweight and obesity is not a primary form of therapy. It should be used only when … Overweight (Obesity): Drug Therapy
Mandatory medical device diagnostics. Electrical impedance analysis (measurement of body compartments/body composition) – for determination of body fat, extracellular body mass (blood and tissue fluid), body cell mass (muscle and organ mass), and total body water including body mass index (BMI, body mass index) and waist-to-hip ratio (THV); very valid measurement method (part of the … Overweight (Obesity): Diagnostic Tests
Within the framework of micronutrient medicine (vital substances), the following vital substances (micronutrients) are used for supportive therapy. Chromium and zinc can reduce the feeling of hunger and cravings and favorably affect the carbohydrate metabolism. Selenium is an important antioxidant trace element in the weight loss phase. Obese people are often deficient in L-carnitine and … Overweight (Obesity): Micronutrient Therapy
According to the guidelines of the German Obesity Society, surgical therapy is considered when conservative therapy has failed to achieve the therapeutic goal and BMI ≥ 40 kg/m2 (extreme obesity) exists or BMI ≥ 35 kg/m2 and significant comorbidities (concomitant diseases such as, for example, diabetes mellitus type 2, coronary heart disease (CHD), heart failure, … Overweight (Obesity): Surgical Therapy
To prevent obesity (overweight), attention must be paid to reducing individual risk factors. Behavioral risk factors Diet Chronic overeating High caloric intake ↑↑ High fat diet (1 g of fat provides 9.3 kcal); this results in stimulation of leptin and insulin secretion. This results in initial stimulation of beta receptors, but then down-regulation occurs, so … Overweight (Obesity): Prevention
In obese patients, heat dissipation is limited by a reduced ratio of body surface area to body mass, so obese people sweat profusely, especially after meals. Early musculoskeletal problems such as early knee and hip osteoarthritis and degenerative spinal conditions may occur more frequently in obese individuals. Furthermore, overweight people have a tendency to varicosis … Overweight (Obesity): Symptoms, Complaints, Signs
The basic obesity therapy program consists of nutrition therapy, exercise therapy, and behavior therapy (see Nutritional and Sports Medicine and Psychotherapy below). Indications for the basic program are BMI (body mass index) ≥ 25 kg/m2 + medical risk factors and BMI ≥ 30 kg/m2. The therapy goal is moderate weight loss (reduction phase) within 6-12 … Overweight (Obesity): Therapy
