[Obesity].
Obesity is an epidemic and, thereby, represents one of the central challenges for the German health-care system. A weight-reducing treatment should be started at a body mass index (BMI) >or= 30 kg/m(2) or at a BMI >or= 25 kg/m(2) if clinically significant comorbidities are present. Currently, a broad range of evidence-based treatment options for weight reduction is available. The primary treatment aims at lifestyle modification by adopting an energy-reduced diet and a higher level of physical activity. In the escalation strategy, other options such as very-low-calorie diets, weight-reducing drugs and - in morbidly obese patients - bariatric surgery should be considered. All treatment measures should be tailored to the individual requirements, wishes and facilities of the patient. In addition, the patient should be encouraged to take responsibility for his/her weight management. However, there is urgent need to improve the structural preconditions for effective obesity management in Germany.
Hauner
Hans
H
Else Kröner-Fresenius-Zentrum für Ernährungsmedizin, TU München, München, Germany. hans.hauner@lrz.tum.de
D000328:Adult; D050110:Bariatric Surgery / Q000191:economics; D015992:Body Mass Index; D003131:Combined Modality Therapy; D017046:Cost Savings; D003430:Cross-Sectional Studies; D003937:Diagnosis, Differential; D004038:Diet, Reducing / Q000191:economics; D019317:Evidence-Based Medicine; D015444:Exercise; D005858:Germany; D006801:Humans; D019458:Insurance Coverage / Q000191:economics; D008019:Life Style; D009313:National Health Programs / Q000191:economics*; D009765:Obesity / Q000150:complications / Q000191:economics / Q000453:epidemiology / Q000628:therapy*; D010043:Outcome and Process Assessment, Health Care; D010348:Patient Care Team; D010349:Patient Compliance; D012307:Risk Factors; D015431:Weight Loss