Adipositastherapie – facts and fiction!

Zusammenfassung

Übergewicht und deren Folgeerkrankungen haben in den letzten Jahren auch in der Schweiz epidemische Ausmaße angenommen. Adipositas ist als eine multifaktorielle, neuroendokrine, chronische Erkrankung anerkannt worden. Als unabhängiger, modifizierbarer Risikofaktor für Diabetes mellitus Typ 2, Herzkreislauferkrankungen etc. sollte eine Therapie frühzeitig, effizient und vor allem langfristig, wahrscheinlich lebenslang, erfolgen. Zu den langfristigen konservativen, evidenzbasierten Therapiekonzepten gehört eine intensive Basistherapie, respektive eine Änderungen des Lifestyles bestehend aus: Reduktion der Gesamtkalorienzufuhr um mindestens 500 kcal unter dem individuellen Bedarf, Reduktion der Energiedichte der Mahlzeiten und Erhöhung der täglichen körperlichen Aktivität um mindestens 30 Minuten moderater Intensität. Nach Ausschöpfen der Basistherapie stehen als zusätzliche medikamentöse Unterstützung bisher zwei Medikamente zur Verfügung: Sibutramin und Orlistat.

Summary

Obesity is becoming epidemic also in Switzerland. Recently, obesity was recognized as a multifactorial, neuroendocrine, chronic illness. In addition, obesity is an independent and the only modifiable risk factor for co-morbidities e. g. diabetes mellitus type 2 or coronary heart disease. Therefore the therapy should be efficient and feasible on a longterm basis, probably lifelong. Evidence based long-term therapy or lifestyle changes consist of: Reduction of the total calorie intake of at least 500 kcal under the individual need, reduction of energy density of meals and increase of daily physical activity at least 30 minutes with moderate intensity. So far two drugs are recommended to support weight loss therapy: Sibutramine and Orlistat.

Schlüsselwörter

Adipositas - Sibutramin - Orlistat

Keywords

Obesity - sibutramine - orlistat

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