Erfolge konservativer Ansätze zur Therapie von Adipösen

 

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Zusammenfassung

Die konservative Adipositasbehandlung stellt für fast alle adipösen Patienten die primäre Therapiemaßnahme dar; sie sollte leitliniengerecht in Form einer strukturierten, multimodalen und möglichst langfristigen Behandlung erfolgen. Sie ist risikoarm, in der praktischen Durchführung aber anspruchsvoll und zeitaufwendig. Vorhandene Studien lassen den Schluss zu, dass eine solche Therapie bei vielen Patienten, unabhängig vom Schweregrad der Adipositas, mittel- und auch langfristig erfolgreich ist und neben der Gewichtsreduktion signifikante Verbesserungen der Risikofaktoren und Komorbiditäten bewirkt. Die Behandlungsergebnisse hängen den meisten Publikationen zufolge wesentlich von der Intensität, Regelmäßigkeit und Konstanz der therapeutischen Unterstützung ab; sie können aber von vielfältigen physiologischen, psychischen und sozialen Faktoren beeinflusst werden.

Abstract

Conservative therapy is the primary therapeutic approach for nearly all obese patients. It should be performed according to existing guidelines in terms of a structured, multimodal, if possible long-term lifestyle intervention. It has little risk, but it is ambitious and time consuming in everyday practice. Present studies support the conclusion that such kind of therapy is successful in many patients independent of the degree of obesity and not only in the short run, and that it will additionally cause significant improvements in risk factors and comorbidities. According to most publications the results in weight loss (maintenance) depend substantially on intensity, regularity and constancy of therapeutic support; but they can be influenced by manifold physiological, psychic, and social factors.

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