Obesity therapy - Making it work [27.05.20]
Obesity is defined as the pathological increase in body fat and is a significant risk factor for a large number of chronic diseases. It restrains the health and quality of life of almost one in four Germans. Prof. Stefan Bischoff and Anna Schweinlin from the Institute of Nutritional Medicine at the University of Hohenheim explain how obesity therapy can be successful. In their latest publication, they summarize the evidence-based intervention strategies that can lead to long-term weight reduction. In particular, they advocate a well-structured, holistic approach under professional supervision.
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Publication
Bischoff, S.C., Schweinlin, A., 2020. Obesity therapy. Clinical Nutrition ESPEN 0. doi.org/10.1016/j.clnesp.2020.04.013
Abstract
Obesity is a chronic, systemic disease defined as a pathologically increased fat mass, which is associated with an increased health risk. A BMI >30 kg/m2 is usually considered as a sign of obesity. Obesity requires a multidisciplinary and multimodal treatment, which varies depending on the phase of disease and the purpose (e.g. weight loss, weight maintenance). The treatment should be based on evidence. The goal of obesity therapy is to reduce the body weight by reducing fat mass in the long term in combination with a change in behavior, which aims to improve obesity-associated risk factors, reduce obesity-related illnesses, reduce the risk of premature mortality, incapacitation and early retirement, and improve quality of life. Non-surgical lifestyle therapy comprises nutrition, exercise, behavior change (“basic therapy”) which becomes more effective when combined with initial formula diet. A formula diet as initial therapy is indicated if a relative weight loss more than 10% is intended. A successful and sustained obesity therapy needs a clear structure, a well-trained team of professionals, and the coverage of the costs. Drugs can support obesity therapy, while other drugs can promote weight gain. The multimodal approach is the most effective non-surgical therapy resulting in a relative weight loss of 15–25%. The primary obesity therapy should be with a non-surgical approach, but bariatric surgery may be needed if the problem cannot otherwise be solved. A clear and realistic interface to bariatric surgery needs to be defined. Weight maintenance strategies including and beyond dietetic concepts are usually needed throughout life for long-term stabilization of body weight. © 2020 European Society for Clinical Nutrition and Metabolism
