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Aktuelle Ernährungsmedizin 2025; 50(02): 115-128
DOI: 10.1055/a-2522-7423
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Gewichtneutrale Ansätze zur Behandlung von Adipositas

Weight-neutral approaches in the treatment of obesity
UlrikeA. Gisch
,
Teresa Bilic
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In Deutschland sind 19% der Erwachsenen von Adipositas betroffen [1]. Traditionelle Gewichtsreduktionsprogramme zur Behandlung von Adipositas bringen häufig nicht die gewünschten Erfolge bei der Gewichtsreduktion. Es werden daher dringend alternative Behandlungsansätze benötigt, um die Versorgung von Personen mit Adipositas zu verbessern. Bisherige Interventionen zu gewichtsneutralen Ansätzen zeigen vielversprechende Ergebnisse.

Abstract

Prevalence rates of overweight and obesity in Germany are high. The weight-centred health paradigm assumes that all individuals with a BMI≥30 kg/m² or with a BMI≥25 kg/m² and comorbidities should be advised to lose weight. However, traditional weight loss programs have limited evidence regarding long-term weight loss and other beneficial outcomes. Therefore, alternative approaches to improve the treatment of individuals with obesity are needed. The aim of this article is to provide an overview of weight-neutral approaches for the treatment of obesity including a case study of a weight-neutral nutrition counselling. Weight-neutral approaches assume that individuals with a higher weight status can also achieve health and well-being. The most prominent weight-neutral approach is Health At Every Size (HAES). HAES is based on five principles (2013): Weight inclusivity, health enhancement, eating for well-being, respectful care and life-enhancing movement. Weight-neutral programs focus on different modules: Body acceptance, eating behaviour, nutrition behaviour, physical activity, and social support. A case study of a weight-neutral nutrition counselling is presented that targeted these modules. Exercises within these modules are for example the development of a biographical timeline in which the relationship between weight and self-esteem is reflected upon, introspection through journaling, and the separation of interoception and action. The effectiveness of weight-neutral programs has been demonstrated regarding various health parameters, including cardiovascular, anthropometric, and psychological parameters as well as physical activity. However, more studies of high methodological quality are needed, especially in Germany.

Schlüsselwörter

Adipositas - gewichtsneutral - intuitives Essverhalten - Health At Every Size - Gesundheitsförderung

Keywords

Obesity - weight-neutral - intuitive eating - Health At Every Size - health promotion


Publication History

Article published online:
16 April 2025

© 2025. Thieme. All rights reserved.

Georg Thieme Verlag KG
Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany

 

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