Treatment of obesity is generally only indicated above a BMI of 30. However, certain factors can lead to medical intervention being useful even from a BMI of 25. This is particularly useful in the case of abdominal obesity or two additional risk factors. The same applies to existing diseases that can be improved by weight reduction.
For a successful therapy an individual and realistic time schedule has to be set up. The aim should first be to stabilize the current weight and then to reduce it slowly. The following are some strategies that could be used in weight loss.
Reducing calorie intake
The main focus should be on reducing fat intake, and ideally the total energy consumed should be reduced. A total daily energy deficit of 500 to 800 kcal should be aimed for.
Physical activity
Physical activity can increase calorie consumption. In addition, exercise can also decrease appetite and better control stress. For many, exercise is also a stabilizing social event. In addition, exercise always has a positive effect on the cardiovascular system, which is particularly negatively affected by obesity.
Ideally, one should exercise at least three times a week for 30 minutes. Of course, it is better to exercise more often and for longer periods. In general, however, one should set achievable goals. After all, it is better to exercise a little on a regular basis than to do irregular intensive workouts. These have no additional positive influence on the weight and can also have a demotivating effect.
Further support
Depending on the personal situation, weight reduction can be supported by many other measures. These include behavioural therapies, psychosocial support and participation in self-help groups.
Drug therapy
Both tablets and powder forms exist to help with weight loss. For example, the anti-adipositive Orlistat (Xenical) is used, which inhibits the pancreas so that fats can no longer be absorbed as well. Another drug is the anorectic Sibutramin (Reductil), which promotes the feeling of satiety via messenger substances in the brain. Other drugs are currently in development.
However, even the best over-the-counter drug is not suitable as the sole means of weight reduction, which is why drugs should be taken in combination with other weight-reducing measures if necessary. In addition, it is only indicated in special cases and after the failure of conservative, non-drug measures.
Surgical therapy
In the case of these, patients must always be informed in detail about the risks and consequences of the operation. This is because the existing obesity also greatly increases the risk during surgery.
The indication for surgery is only given from a BMI of 40. With a BMI above 35, surgery can be considered if concomitant diseases require rapid weight reduction or if all other attempts at therapy have failed.
In principle, these surgical interventions attempt to reduce the volume of the stomach. This results in limited food intake, which in turn leads to weight reduction.
The various procedures include:
- GastricBanding:a silicone band is placed around the stomach and then filled with fluid as needed. This makes the entrance to the stomach smaller, and only small amounts of food can be taken in at a time.
- Vertical gastroplasty: Part of the stomach is separated by staple sutures and secured by a silicone band.
- Gastricballoon: A balloon is inserted into the stomach, which is filled with more or less liquid as required. This method is rarely used today because it involves some complications.
However, for a permanent reduction in body weight, eating habits should also be changed and optimized. In addition, intensive internal, nutritional and psychological care of the patient is still required after the operation.
Dietary recommendations for obesity
In order to be able to improve one's own diet, one first has to come to terms with one's own energy requirements. This depends, among other things, on height, weight, gender and physical strain in everyday life. On the basis of the energy requirement, it is then possible to estimate how many calories one should consume daily.
It is important to ensure that all food components are consumed in sufficient quantities. In order to be able to achieve this, one must deal intensively with the composition of the food and its quantitative and qualitative energy content. Even when shopping, care must be taken to buy the right foods. To do this, one should practice reading and interpreting the nutritional information on food packages correctly.
Not only the type of food consumed, but also its preparation plays a major role. Thus, one should revert to low-fat preparation methods that also do not destroy the vitamin content of the food.
No short-term changes
No matter how you change your diet, it should always be a long-term optimization and not short-term diets. These often lead to a quick weight reduction, but the feared yo-yo effect is rarely absent.
In order to be able to realize this, one should only engage in changes with which one can also live in the long term. It probably has little sustainability to say that you never snack again, however, you can drastically reduce the amount of sweets.
Concrete tips for a better diet
But what specific changes can you make now to achieve a better diet? In the following some hints are given. Ultimately, you have to try out what is feasible and effective for you.
Possible changes for a good diet:
- Eliminating or drastically reducing alcohol.
- Cutting down on carbohydrates, which prevent the body from breaking down fats
- Increasing the amount of protein in the diet, which above all also curbs the appetite
- Reducing fat intake, concentrating on unsaturated fatty acids
- Sufficient fluid intake in the form of unsweetened drinks
General measures to improve eating habits
- Meals should always be eaten in the same place, if possible.
- You should take enough time to enjoy your meal.
- An attractive preparation and presentation of the food increases the enjoyment factor.
- Distractions while eating should be completely avoided.
- Instead of ladling up, an appropriate portion should be served at the outset.
- Improved feeling of satiety through high protein intake and fat reduction
- Carbohydrates in the form of complex carbohydrates (fibre, whole grains)
- Reduction of simple carbohydrates (sugar)
- Should a feeling of hunger arise, distraction can be achieved through sporting activity, hobbies or simple measures such as brushing teeth.