Interdisziplinäre S3-Leitlinie zur „Prävention und Therapie der Adipositas“ der Deutschen Adipositas-Gesellschaft (DAG) – Überblick über die Empfehlungen zu den Themen „Stigmatisierung“, „Diagnostik“ und „Therapie“

Zusammenfassung

Dieser Artikel fasst einen wesentlichen Teil der Empfehlungen der im Herbst 2024 durch die Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften (AWMF) zertifizierte S3-Leitlinie zur „Prävention und Behandlung der Adipositas“ der Deutschen Adipositas-Gesellschaft (DAG) zusammen. Aus Platzgründen ausgeklammert werden die Kapitel „Definition und medizinische Einordnung von Übergewicht und Adipositas“, da die Leitlinie hier keine Empfehlungen gibt, und „Prävention“, da die Arbeitsgruppe eigene Publikationen zum Thema plant. Hier behandelt werden die Kapitel „Stigmatisierung“ (neu in der Leitlinie enthalten), „Diagnostik“ und „Therapie“, wobei hier auch neue Bereiche wie E-Health inkludiert sind. Hinsichtlich der Ernährungstherapie gibt es heute eine Vielfalt evidenzbasierter Ansätze, die eine stärker personalisierte Therapie erlauben. Die adjuvante Pharmakotherapie hat einen deutlich größeren Stellenwert als in der vorhergehenden Version der Leitlinie, da mit den Glucagon-like Peptide-1 (GLP-1)-basierten Wirkstoffen inzwischen sehr wirksame Ansätze nicht nur zur Gewichtsreduktion, sondern auch zur Besserung von Begleit- und Folgeerkrankungen vorliegen. Für das Kapitel „Adipositaschirurgie“ der Vorgängerversion der Leitlinie wurde wegen der begrenzten Resourcen auf eine Literaturrecherche verzichtet und stattdessen auf die „Leitlinie zur Adipositaschirurgie“ der Deutschen Gesellschaft für Allgemein- und Viszeralchirurgie (DGAV) aus dem Jahr 2018 verwiesen, deren baldige Aktualisierung beschlossen ist. Beide Leitlinien werden sich zukünftig ergänzen.

Abstract

This article summarizes most of the recommendations of the current German evidence-based guideline (certified by the Association of Scientific Medical Societies in Germany, AWMF) on the “Prevention and Treatment of Obesity”, which was put together by the German Association for the Study of Obesity. For the sake of space, we left out the chapter on “Definitions”, because no recommendations are stated there. A summary of the chapter on “Prevention“, will be separately published by the respective working group. We focus on the chapters on “Stigmatization” (new in this guideline version), “Diagnostics”, and “Therapy” which is supplemented by a discussion on E-Health approaches. Considering dietary therapy, many evidence-based approaches are available nowadays, allowing more personalized treatment considerations. Pharmacotherapy as an adjunct approach has become much more important since the last version of the guideline because Glucagon-like Peptide-1 (GLP-1)-based medicines not only improved the amount of weight loss but have also shown beneficial effects on several comorbidities of obesity. The last version of the guideline also included a chapter on “Obesity Surgery”. This chapter was left unchanged, because a seperate guideline from the German Society for General and Visceral Surgery on that issue exists and will be updated rather soon. In the future both guidelines will be used back-to-back.

Interdisciplinary S3 Guideline on “Prevention and Treatment of Obesity” by the German Association for the Study of Obesity (DAG) – Overview of the recommendations on the topics “Stigmatization,” “Diagnostics,” and “Therapy”

Schlüsselwörter

Übergewicht - Adipositas - evidenzbasierte Leitlinie - Stigmatisierung - Ernährungstherapie - Pharmakotherapie

Keywords

overweight - obesity - evidence-based guideline - stigmatization - dietary therapy - pharmacotherapy

Publication History

Article published online:
13 June 2025

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