Subscribe to RSS
DOI: 10.1055/s-0030-1269445
© Georg Thieme Verlag KG Stuttgart · New York
Gewichtserhaltung nach Gewichtsreduktion – wie der Körper sein Gewicht verteidigt
Weight maintenance after weight loss – how the body defends its weightPublication History
eingereicht: 16.6.2010
akzeptiert: 18.11.2010
Publication Date:
11 January 2011 (online)

Zusammenfassung
Die mittlere Gewichtsabnahme in den meisten konservativen Therapieprogrammen liegt nach einem Jahr bei fünf bis sechs Kilogramm. Die bisherigen Erfahrungen zeigen, dass es in unserer „adipogenen” Umwelt vielen Menschen schwer fällt, diesen Gewichtsverlust zu erhalten. Auch bei Fortführung von Therapieprogrammen kommt es bereits im zweiten Jahr zu einem mäßigen Wiederanstieg des Körpergewichts. Die Ursachen dafür sind nicht klar: es könnte an den allgemeinen Lebensbedingungen, dem individuellen Umfeld und der genetischen Prädisposition liegen, aber auch am komplexen Regulationssystem unseres Körpers „sein Gewicht zu verteidigen”. Eine dauerhafte Lebensstiländerung ist für die Gewichtserhaltung von zentraler Bedeutung. Hinsichtlich Ernährung verspricht derzeit eine fettarme Kost mit Senkung der Energiedichte den größten Nutzen. Bei weitgehendem Erhalt von Essgewohnheiten und Zufuhrmengen kann so eine ausreichende Sättigung erzielt werden.
Abstract
Mean weight loss of most conservative therapeutic weight loss programmes is about five to six kilograms after one year. In our „obesogenic” environment it is difficult for persons to maintain the new weight. Also continuation of the programme cannot prevent a moderate weight increase in the follow-up year. The reasons for this are not clear: individual lifestyle, environmental and genetic factors may play a role, but also the complex regulatory system of the body „to defend its weight”. Nevertheless, for weight maintenance a lifelong change of lifestyle is of critical importance. Concerning nutrition a fat-reduced diet with a decrease of energy density together with regular eating habits and adequate portion size promises the greatest benefit and is likely to allow sufficient satiety.
Schlüsselwörter
Adipositas - Gewichtsabnahme - Gewichtserhaltung - Sättigung
Keywords
obesity - weight loss - weight maintenance - satiety
Literatur
- 1
Alhassan S, Kim S, Bersamin A, King A C, Gardner C D.
Dietary adherence and weight loss success
among overweight women: results from the A TO Z weight loss study.
Int J Obes (Lond).
2008;
32
985-991
MissingFormLabel
- 2
Andersen R E, Wadden T A, Bartlett S J, Zemel B, Verde T J, Franckowiak S C.
Effects of lifestyle activity vs structured aerobic exercise
in obese women: a randomized trial.
JAMA.
1999;
281
335-340
MissingFormLabel
- 3
Anderson J W, Konz E C.
Obesity and disease
management: effects of weight loss on comorbid conditions.
Obes
Res.
2001;
9 Suppl 4
326S-334S
MissingFormLabel
- 4
Anderson J W, Konz E C, Frederich R C, Wood C L.
Long-term
weight-loss maintenance: a meta-analysis of US studies.
Am
J Clin Nutr.
2001;
74
579-584
MissingFormLabel
- 5
Befort C A, Stewart E E, Smith B K, Gibson C A, Sullivan D K, Donnelly J E.
Weight maintenance, behaviors and barriers among previous participants
of a university-based weight control program.
Int J Obes
(Lond).
2008;
32
519-526
MissingFormLabel
- 6
Bennett G G, Herring S J, Puleo E, Stein E K, Emmons K M, Gillman M W.
Web-based
weight loss in primary care: a randomized controlled trial.
Obesity (Silver
Spring).
2010;
18
308-313
MissingFormLabel
- 7
Berg A, Berg A, Frey I, König D, Predel H G.
Exercise
based lifestyle intervention in obese adults: results of the intervention
study m. o. B.I.L.I.s.
Dtsch Arztebl
Int.
2008;
105
197-203
MissingFormLabel
- 8
Brinkworth G D, Noakes M, Buckley J D, Keogh J B, Clifton P M.
Long-term effects of a very-low-carbohydrate
weight loss diet compared with an isocaloric low-fat diet after
12 mo.
Am J Clin Nutr.
2009;
90
23-32
MissingFormLabel
- 9
Byrne S M.
Psychological aspects of weight maintenance and relapse in obesity.
J Psychosom Res.
2002;
53
1029-1036
MissingFormLabel
- 10
Chen L, Appel L J, Loria C, Lin P H, Champagne C M, Elmer P J. et
al .
Reduction in consumption of sugar-sweetened beverages
is associated with weight loss: the PREMIER trial.
Am
J Clin Nutr.
2009;
89
1299-1306
MissingFormLabel
- 11
Cussler E C, Teixeira P J, Going S B, Houtkooper L B, Metcalfe L L, Blew R M. et al .
Maintenance of weight loss in overweight
middle-aged women through the Internet.
Obesity (Silver
Spring).
2008;
16
1052-1060
MissingFormLabel
- 12
Dansinger M L, Gleason J A, Griffith J L, Selker H P, Schaefer E J.
Comparison of the Atkins, Ornish,
Weight Watchers, and Zone diets for weight loss and heart disease
risk reduction: a randomized trial.
JAMA.
2005;
293
43-53
MissingFormLabel
- 13
Dansinger M L, Tatsioni A, Wong J B, Chung M, Balk E M.
Meta-analysis: the effect of dietary counseling for weight loss.
Ann Intern Med.
2007;
147
41-50
MissingFormLabel
- 14
de Zwaan M, Hilbert A, Herpertz S, Zipfel S, Beutel M, Gefeller O. et al .
Weight loss
maintenance in a population-based sample of German adults.
Obesity
(Silver Spring).
2008;
16
2535-2540
MissingFormLabel
- 15 Deutsche Adipositas-Gesellschaft,
Deutsche Diabetes-Gesellschaft, Deutsche Gesellschaft für
Ernährung, Deutsche Gesellschaft für Ernährungsmedizin .Evidenzbasierte Leilinie Prävention und Therapie der
Adipositas. 2007
MissingFormLabel
- 16
Dulloo A G, Jacquet J.
Adaptive reduction in
basal metabolic rate in response to food deprivation in humans:
a role for feedback signals from fat stores.
Am J Clin
Nutr.
1998;
68
599-606
MissingFormLabel
- 17
Elfhag K, Rossner S.
Who succeeds in maintaining
weight loss? A conceptual review of factors associated with weight
loss maintenance and weight regain.
Obes Rev.
2005;
6
67-85
MissingFormLabel
- 18
Ello-Martin J A, Roe L S, Ledikwe J H, Beach A M, Rolls B J.
Dietary energy
density in the treatment of obesity: a year-long trial comparing
2 weight-loss diets.
Am J Clin Nutr.
2007;
85
1465-1477
MissingFormLabel
- 19
Eriksson K F, Lindgarde F.
Prevention of type
2 (non-insulin-dependent) diabetes mellitus by diet and physical
exercise. The 6-year Malmo feasibility study.
Diabetologia.
1991;
34
891-898
MissingFormLabel
- 20
Foster G D, Wyatt H R, Hill J O, Makris A P, Rosenbaum D L, Brill C. et
al .
Weight and metabolic outcomes after 2 years on
a low-carbohydrate versus low-fat diet: a randomized trial.
Ann
Intern Med.
2010;
153
147-157
MissingFormLabel
- 21
Foster G D, Wyatt H R, Hill J O, McGuckin B G, Brill C, Mohammed B S. et
al .
A randomized trial of a low-carbohydrate diet for
obesity.
N Engl J Med.
2003;
348
2082-2090
MissingFormLabel
- 22
Franz M J, VanWormer J J, Crain A L, Boucher J L, Histon T, Caplan W. et al .
Weight-loss outcomes: a systematic review and meta-analysis
of weight-loss clinical trials with a minimum 1-year follow-up.
J Am Diet Assoc.
2007;
107
1755-1767
MissingFormLabel
- 23
Gardner C D, Kiazand A, Alhassan S, Kim S, Stafford R S, Balise R R. et al .
Comparison
of the Atkins, Zone, Ornish, and LEARN diets for change in weight and
related risk factors among overweight premenopausal women: the A TO
Z Weight Loss Study: a randomized trial.
JAMA.
2007;
297
969-977
MissingFormLabel
- 24
Goldstein D J.
Beneficial health effects of modest weight loss.
Int
J Obes Relat Metab Disord.
1992;
16
397-415
MissingFormLabel
- 25
Goodpaster B H, Delany J P, Otto A D, Kuller L, Vockley J, South-Paul J E. et
al .
Effects of Diet and Physical Activity Interventions
on Weight Loss and Cardiometabolic Risk Factors in Severely Obese
Adults: A Randomized Trial.
JAMA.
2010;
304
1795-1802
MissingFormLabel
- 26
Hagan R D, Upton S J, Wong L, Whittam J.
The effects of aerobic
conditioning and/or caloric restriction in overweight men
and women.
Med Sci Sports Exerc.
1986;
18
87-94
MissingFormLabel
- 27
Heshka S, Anderson J W, Atkinson R L, Greenway F L, Hill J O, Phinney S D. et al .
Weight loss with self-help compared with
a structured commercial program: a randomized trial.
JAMA.
2003;
289
1792-1798
MissingFormLabel
- 28
Heymsfield S B, Harp J B, Reitman M L, Beetsch J W, Schoeller D A, Erondu N. et al .
Why do obese patients not lose more weight when treated with
low-calorie diets? A mechanistic perspective.
Am J Clin
Nutr.
2007;
85
346-354
MissingFormLabel
- 29
Jakicic J M, Otto A D.
Physical activity
considerations for the treatment and prevention of obesity.
Am
J Clin Nutr.
2005;
82
226S-229S
MissingFormLabel
- 30
Knowler W C, Barrett-Connor E, Fowler S E, Hamman R F, Lachin J M, Walker E A. et al .
Reduction in the incidence of type 2 diabetes
with lifestyle intervention or metformin.
N Engl J Med.
2002;
346
393-403
MissingFormLabel
- 31
Leibel R L, Rosenbaum M, Hirsch J.
Changes in energy expenditure resulting from altered body weight.
N Engl J Med.
1995;
332
621-628
MissingFormLabel
- 32
Lindstrom J, Eriksson J G, Valle T T, Aunola S, Cepaitis Z, Hakumaki M. et al .
Prevention of diabetes mellitus in subjects with impaired glucose
tolerance in the Finnish Diabetes Prevention Study: results from
a randomized clinical trial.
J Am Soc Nephrol.
2003;
14
S108-S113
MissingFormLabel
- 33
Lowe M R, Kral T V, Miller-Kovach K.
Weight-loss maintenance 1, 2 and 5 years
after successful completion of a weight-loss programme.
Br
J Nutr.
2008;
99
925-930
MissingFormLabel
- 34
Lowe M R, Miller-Kovach K, Phelan S.
Weight-loss maintenance in overweight individuals one to five
years following successful completion of a commercial weight loss
program.
Int J Obes Relat Metab Disord.
2001;
25
325-331
MissingFormLabel
- 35
Lowe M R, Tappe K A, Annunziato R A, Riddell L J, Coletta M C, Crerand C E. et al .
The effect of training in reduced energy
density eating and food self-monitoring accuracy on weight loss
maintenance.
Obesity (Silver Spring).
2008;
16
2016-2023
MissingFormLabel
- 36
MacMahon S W, Wilcken D E, Macdonald G J.
The effect of weight reduction on left ventricular
mass. A randomized controlled trial in young, overweight hypertensive
patients.
N Engl J Med.
1986;
314
334-339
MissingFormLabel
- 37 Max Rubner Institut BfEuL .Nationale Verzehrsstudie II. 2008
MissingFormLabel
- 38
Phelan S, Wyatt H, Nassery S, Dibello J, Fava J L, Hill J O. et al .
Three-year weight
change in successful weight losers who lost weight on a low-carbohydrate
diet.
Obesity (Silver Spring).
2007;
15
2470-2477
MissingFormLabel
- 39
Phelan S, Wyatt H R, Hill J O, Wing R R.
Are
the eating and exercise habits of successful weight losers changing?.
Obesity (Silver Spring).
2006;
14
710-716
MissingFormLabel
- 40
Pi-Sunyer X, Blackburn G, Brancati F L, Bray G A, Bright R, Clark J M. et
al .
Reduction in weight and cardiovascular disease
risk factors in individuals with type 2 diabetes: one-year results
of the look AHEAD trial.
Diabetes Care.
2007;
30
1374-1383
MissingFormLabel
- 41
Rock C L, Flatt S W, Sherwood N E, Karanja N, Pakiz B, Thomson C A.
Effect
of a Free Prepared Meal and Incentivized Weight Loss Program on
Weight Loss and Weight Loss Maintenance in Obese and Overweight
Women: A Randomized Controlled Trial.
JAMA.
2010;
304
1803-1810
MissingFormLabel
- 42
Rolls B J, Roe L S, Beach A M, Kris-Etherton P M.
Provision of foods differing in energy density affects long-term
weight loss.
Obes Res.
2005;
13
1052-1060
MissingFormLabel
- 43
Ross R, Dagnone D, Jones P J, Smith H, Paddags A, Hudson R. et al .
Reduction in
obesity and related comorbid conditions after diet-induced weight
loss or exercise-induced weight loss in men. A randomized, controlled
trial.
Ann Intern Med.
2000;
133
92-103
MissingFormLabel
- 44
Sacks F M, Bray G A, Carey V J, Smith S R, Ryan D H, Anton S D. et al .
Comparison of weight-loss diets with different
compositions of fat, protein, and carbohydrates.
N Engl
J Med.
2009;
360
859-873
MissingFormLabel
- 45
Samaha F F, Iqbal N, Seshadri P, Chicano K L, Daily D A, McGrory J. et al .
A low-carbohydrate as compared with a low-fat diet in severe
obesity.
N Engl J Med.
2003;
348
2074-2081
MissingFormLabel
- 46
Schotte D E, Stunkard A J.
The effects
of weight reduction on blood pressure in 301 obese patients.
Arch
Intern Med.
1990;
150
1701-1704
MissingFormLabel
- 47
Schwartz R S.
The independent effects of dietary weight loss and aerobic training
on high density lipoproteins and apolipoprotein A-I concentrations
in obese men.
Metabolism.
1987;
36
165-171
MissingFormLabel
- 48
Shai I, Schwarzfuchs D, Henkin Y, Shahar D R, Witkow S, Greenberg I. et al .
Weight
loss with a low-carbohydrate, Mediterranean, or low-fat diet.
N Engl J Med.
2008;
359
229-241
MissingFormLabel
- 49
Svetkey L P, Stevens V J, Brantley P J, Appel L J, Hollis J F, Loria C M. et al .
Comparison of strategies for sustaining
weight loss: the weight loss maintenance randomized controlled trial.
JAMA.
2008;
299
1139-1148
MissingFormLabel
- 50
Teixeira P J, Going S B, Sardinha L B, Lohman T G.
A
review of psychosocial pre-treatment predictors of weight control.
Obes Rev.
2005;
6
43-65
MissingFormLabel
- 51
Truby H, Baic S, Delooy A, Fox K R, Livingstone M B, Logan C M. et al .
Randomised
controlled trial of four commercial weight loss programmes in the UK:
initial findings from the BBC „diet trials”.
BMJ.
2006;
332
1309-1314
MissingFormLabel
- 52
Tuomilehto J, Lindstrom J, Eriksson J G, Valle T T, Hamalainen H, Ilanne-Parikka P. et
al .
Prevention of type 2 diabetes mellitus by changes
in lifestyle among subjects with impaired glucose tolerance.
N
Engl J Med.
2001;
344
1343-1350
MissingFormLabel
- 53
Turk M W, Yang K, Hravnak M, Sereika S M, Ewing L J, Burke L E.
Randomized clinical
trials of weight loss maintenance: a review.
J Cardiovasc
Nurs.
2009;
24
58-80
MissingFormLabel
- 54
Waller K, Kaprio J, Kujala U M.
Associations between long-term physical activity, waist circumference
and weight gain: a 30-year longitudinal twin study.
Int
J Obes (Lond).
2008;
32
353-361
MissingFormLabel
- 55
Wing R R, Phelan S.
Long-term weight loss
maintenance.
Am J Clin Nutr.
2005;
82
222S-225S
MissingFormLabel
- 56
Woods S C, D’Alessio D A.
Central
control of body weight and appetite.
J Clin Endocrinol
Metab.
2008;
93
S37-S50
MissingFormLabel
- 57
Wynne K, Stanley S, McGowan B, Bloom S.
Appetite control.
J
Endocrinol.
2005;
184
291-318
MissingFormLabel
Christina Holzapfel M.Sc. Ernähr.-Wiss.
Else Kröner-Fresenius-Zentrum für
Ernährungsmedizin
Klinikum rechts der Isar,
Technische
Universität München
Ismaninger
Str. 22
81675 München
Phone: 089/41406776
Email: christina.holzapfel@wzw.tum.de