Skip to main content
Log in

Die krankhafte Fettsucht

Somatische oder psychische Erkrankung?

Adipositas. A somatic or psychic disorder?

  • Leitthema
  • Published:
Der Chirurg Aims and scope Submit manuscript

Zusammenfassung

Krankhafte Fettsucht oder Adipositas, definiert als ein Body-Mass-Index ≥30 kg/m2, ist heute epidemisch verbreitet und nimmt weltweit kontinuierlich zu. Lebensstilfaktoren wie Ernährung, Bewegung und psychosoziale Bedingungen entscheiden über die Manifestation und den Schweregrad dieser Erkrankung, die zudem eine starke genetische Komponente aufweist. Zahlreiche epidemiologische Studien zeigen eindeutig, dass Adipositas nicht nur zu einer Vielzahl von Folgeerkrankungen führt, sondern auch das Leben verkürzt. Daraus leitet sich die Notwendigkeit für eine evidenzbasierte, risikostratifizierte Behandlung ab. Bei extremer Adipositas mit einem BMI ≥40 kg/m2 stellen chirurgische Verfahren die wirksamste Therapie dar. Diese bessern die meisten somatischen und psychischen Komorbiditäten signifikant und wirken wahrscheinlich lebensverlängernd.

Abstract

Obesity, defined as a body mass index of ≥30 kg/m2, is a modern epidemic and is increasing worldwide. Depending on genetic make-up, lifestyle factors such as nutrition, physical activity, and psychosocial conditions are the main determinants of its manifestation and severity. Numerous epidemiological studies show consistently that obesity is associated with many comorbidities and, moreover, reduces life expectancy. For this reason, there is a need for evidence-based treatment considering the individual risk. For patients with extreme obesity exceeding a BMI of 40 kg/m2, surgical intervention is the most effective treatment, not only to improve most somatic and psychological comorbidities significantly but also to prolong life.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Literatur

  1. Allison DB, Fontaine KR, Manson JE, Stevens J, VanItallie TB (1999) Annual deaths attributable to obesity in the United States. JAMA 282:1530

    Article  CAS  PubMed  Google Scholar 

  2. Anderson JW, Konz EC, Frederich RC, Wood CL (2002) Long-term weight loss maintenance: a meta-analysis of US studies. Am J Clin Nutr 74:579

    Google Scholar 

  3. Bender R, Jockel KH, Trautner C et al. (1999) Effect of age on excess mortality in obesity. JAMA 281:1498

    Article  CAS  PubMed  Google Scholar 

  4. Calle EE, Rodriguez C, Walker-Thurmond K, Thun MJ (2003) Overweight, obesity, and mortality from cancer in a prospectively studied cohort of US adults. N Engl J Med 348:1625

    Article  PubMed  Google Scholar 

  5. Christou NV, Sampalis JS, Liberman M et al. (2004) Surgery decreases long-term mortality, morbidity, and health care use in morbidly obese patients. Ann Surg 240:416

    PubMed  Google Scholar 

  6. Despres JP, Lemieux J, Prud’homme D (2001) Treatment of obesity: need to focus on high risk abdominally obese patients. Br Med J 322:716

    CAS  Google Scholar 

  7. Ditschuneit HH, Flechtner-Mors M, Johnson TD, Adler G (1999) Metabolic and weight-loss effects of a long-term dietary intervention in obese patients. Am J Clin Nutr 69:198

    CAS  PubMed  Google Scholar 

  8. Flegal KM, Carroll MD, Ogden CL, Johnson CL (2002) Prevalence and trends in obesity among US adults, 1999–2000. JAMA 288:1723

    Article  PubMed  Google Scholar 

  9. Fontaine KR, Redden DT, Wang C, Westfall AO, Allison DB (2003) Years of life lost due to obesity. JAMA 289:187

    PubMed  Google Scholar 

  10. Gortmaker SL, Must A, Perrin JM et al. (1993) Social and economic consequences of overweight and adolescence and young adulthood. N Engl J Med 329:1008

    Article  CAS  PubMed  Google Scholar 

  11. Greenberg I, Perna F, Kaplan M, Sullivan MA (2005) Behavioral and psychological factors in the assessment and treatment of obesity surgery patients. Obes Res 13:244

    PubMed  Google Scholar 

  12. Hauner H, Hamann A, Husemann B et al. (2003) Prävention und Therapie der Adipositas. Evidenzbasierte Leitlinie. Diab Stoffw 12 [Suppl] 2:35

    Google Scholar 

  13. Herpertz S, Kielmann R, Wolf AM et al. (2003) Does obesity surgery improve psychosocial functioning? A systematic review. Int J Obes Relat Metab Disord 27:1300

    CAS  PubMed  Google Scholar 

  14. Hsu LK, Benetti PN, Dwyer J et al. (1998) Nonsurgical factors that influence the outcome of bariatric surgery: a review. Psychosom Med 60:338

    CAS  PubMed  Google Scholar 

  15. Hu FB, Li TY, Colditz GA et al. (2003) Television watching and other sedentary behaviors in relation to risk of obesity and type 2 diabetes in women. JAMA 289:1785

    Article  PubMed  Google Scholar 

  16. Kelly J, Tarnoff M, Shikora S et al. (2005) Best practice recommendations for surgical care in weight loss surgery. Obes Res 13:227

    PubMed  Google Scholar 

  17. Lichtman SW, Pisarka K, Berman ER et al. (1992) Discrepancy between self-reported and actual caloric intake and exercise in obese subjects. N Engl J Med 327:1893

    CAS  PubMed  Google Scholar 

  18. MacDonald KG, Long SD, Swanson MS et al. (1997) The gastric bypass operation reduces the progression and mortality of non-insulin-dependent diabetes mellitus. J Gastrointest Surg 1:213

    Article  PubMed  Google Scholar 

  19. Nielsen SJ, Popkin BM (2003) Patterns and trends in food portion sizes, 1977–1998. JAMA 289:450

    Article  PubMed  Google Scholar 

  20. Olshansky SJ, Passaro DJ, Hershow RC et al. (2005) A potential decline in life expectancy in the United States in the 21st century. N Engl J Med 352:1138

    Article  CAS  PubMed  Google Scholar 

  21. Rolls BJ, Morris EL, Roe LS (2002) Portion size of food affects energy intake in normal-weight and overweight men and women. Am J Clin Nutr 76:1207

    CAS  PubMed  Google Scholar 

  22. Saunders R (1999) Binge eating in gastric bypass patients before surgery. Obes Surg 9:72

    Article  CAS  PubMed  Google Scholar 

  23. Schulze MB, Manson JE, Ludwig DS, et al. (2004) Sugar-sweetened beverages, weight gain, and incidence of type 2 diabetes in young and middle-aged women. JAMA 292:927

    Article  CAS  PubMed  Google Scholar 

  24. Sjöström L, Lindroos A-K, Peltonen M et al. (2004) Lifestyle, diabetes, and cardiovascular risk factors 10 years after bariatric surgery. N Engl J Med 351:2683

    Article  PubMed  Google Scholar 

  25. Waters GS, Pories WJ, Swanson MS et al. (1991) Long-term studies of mental health after the Greenville gastric bypass operation for morbid obesity. Am J Surg 161:154

    Article  CAS  PubMed  Google Scholar 

  26. World Health Organization: Obesity — Preventing and managing the global epidemic. WHO Technical Report Series 894, 2000

Download references

Interessenkonflikt:

Keine Angaben

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to H. Hauner.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Hauner, H. Die krankhafte Fettsucht. Chirurg 76, 647–652 (2005). https://doi.org/10.1007/s00104-005-1055-5

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00104-005-1055-5

Schlüsselwörter

Keywords

Navigation