If the overweight is a result of a disease, this must first be treated. Otherwise, according to medical guidelines, overweight and obesity should be treated with therapy. To find out exactly what the guidelines are, see the following article.
Medical guidelines
- For a BMI of 30 or more (obesity or obesity permagna).
- At a BMI of 25 or more (overweight), if other factors are present:
- Already secondary diseases such as hypertension (high blood pressure).
- Apple type (abdominal fat distribution pattern).
- Diseases that are aggravated by obesity.
- High suffering pressure of the affected person
Important for overweight: diet and exercise
However, a therapy of overweight is only successful if the affected person is motivated and already to actively cooperate with the therapist. The goals of therapy must be realistic – it is better to stabilize or moderately reduce weight first, rather than aiming directly for normal weight. Otherwise, frustration and premature giving up are pre-programmed, despite the fact that treatment has begun.
Goals in therapy for obesity or obesity permagna are:
- Weight loss: Depending on the degree of obesity and previous fat intake, an average weight loss of 5-8 kg per year is realistic.
- Keep the body weight stable in the long term
- Optimize habits regarding diet and exercise behavior; learn what is healthy
- Reduce other risk factors and secondary diseases respectively prevent
- Increase quality of life
- Reduce absenteeism at work
- Strengthen self-confidence and stress management skills
To lose weight, the daily intake of energy should be around 500-800 kcal below turnover. This energy consumption at rest (GU) depends on body weight, gender and age, and varies according to BMI.To do this, it is recommended to regularly do half an hour to one hour of physical activity three to five times a week to maintain weight; for weight loss, at least five hours of exercise per week (equivalent to about 2500 kcal). Behavioral therapy support also helps many sufferers lose weight.
Obesity: therapy through medication
Further measures in the context of a therapy should be carried out at most under medical supervision. So-called appetite suppressants have repeatedly shown side effects and are mainly withdrawn from the market in Germany (for example, sibutramine, rimonabant).
The at present only admitted active substance Orlistat (Xenical) disturbs the fat admission of the food, which is excreted accordingly undigested again over the stool – together with fat-soluble Vitaminen. Temporarily this preparation can make sense, if the basis therapy alone does not have sufficient success – however only temporarily and if possible under medical supervision.
Other preparations that are repeatedly praised or used as appetite suppressants (for example, diuretics, growth hormones, amphetamines, thyroid hormones) are not suitable or even dangerous for the therapy of obesity.
Therapy using bariatric surgery
Especially in cases of obesity permagna or obesity grade II and concurrent other diseases such as diabetes (diabetes), surgical measures are available in the therapy. Purely restrictive procedures (gastric banding, stomach reduction) are distinguished from combined procedures in which the metabolism of food is also restricted (by gastrointestinal bypasses). The latter are usually only used in cases of obesity permagna with a BMI greater than 50. When possible, laparoscopic surgery is performed because the complication rate is higher with an open abdominal incision.
