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Long-term efficacy of medical treatments for obesity

Langzeit-Wirkung therapeutischer Verfahren bei Fettsucht

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Summary

Obesity is a chronic, usually life-long condition. Therefore, the success of any treatment should be measured by the long-term weight loss. More patients lose weight than maintain the weight loss after the active phase of therapy has ended.

Conservative approaches like dietary restrictions or behavior modification techniques have been only modestly successful in weight maintenance. Both are, therefore, suitable for patients with milder degrees of obesity. Anorexicants seem to have specific but limited use in the treatment of obesity. Fasting and protein sparing modified fast are indicated for patients with a high degree of obesity, i.e. for those who are at least 30% or 25 kg or more over their ideal body weight. Both these procedures have definite risks. Rapid weight loss is induced by fasting but long-term follow-ups showed gradual regain of weight loss. Combinations of various techniques such as behavior modification, exercise, proper nutritional instruction and protein-sparing modified fast seem to have the best chance for long-term success.

Zusammenfassung

Die Fettsucht ist ein chronischer, meist lebenslanger Zustand. Ein über längere Zeit anhaltender Gewichtsverlust ist deshalb der beste Meßpunkt eines Behandlungserfolgs. Es gibt allerdings mehr Patienten, die abnehmen, als solche, die ihre Gewichtsabnahme noch nach Beendigung der aktiven Behandlungsphase beibehalten.

Konservative Maßnahmen, wie Diät oder Verhaltenstherapie, sind nur mäßig erfolgreich das Gewicht beizubehalten. Sie eignen sich daher nur für wenig übergewichtige Patienten. Anorexika spielen eine spezifische aber begrenzte Rolle bei der Behandlung der Fettsucht. Fasten und „protein-sparing modified fast“ sind indiziert bei Patienten mit hochgradiger Fettsucht, d.h. Patienten, die mindestens 30% bzw. 25 kg mehr als ihr ideales Gewicht wiegen. Beide Methoden sind mit besonderen Risiken verbunden. Fasten führt zwar zu einem schnellen Gewichtsverlust, aber nach einiger Zeit nimmt der Patient allmählich wieder zu. Die Kombination verschiedener Methoden, wie Verhaltenstherapie, physische Aktivität, angemessene Anweisungen über Ernährung und „protein-sparing modified fast“ scheinen die besten Aussichten auf einen anhaltenden Erfolg zu bieten.

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References

  1. Bray GA (ed) (1979) Obesity in America, Vol. 4. NIH Publication No 79–359

  2. Abraham S, Johnson CL (1980) Prevalence of severe obesity in adults in the United States. Am J Clin Nutr 33:364–369

    PubMed  Google Scholar 

  3. Drenick EJ, Bale GS, Seltzer F et al. (1980) Excessive mortality and causes of death in morbidly obese men. JAMA 243:443–445

    PubMed  Google Scholar 

  4. Christakis G (1967) Community programs for weight reduction: Experience of the Bureau of Nutrition, New York City, Can J Public Health 58:499–504

    PubMed  Google Scholar 

  5. Seaton DA, Rose K (1965) Defaulters from a weight reduction clinic. J Chronic Dis 18:1007–1011

    PubMed  Google Scholar 

  6. Craddock D (1969) Obesity and its management. E&S Livingston, Edinburgh London, The Williams and Wilkins, Baltimore, p 116

    Google Scholar 

  7. Fellows HH (1931) Studies of relatively obese individuals during and after dietary restrictions. AM J Med Sci 181:301–312

    Google Scholar 

  8. Stunkard A, McLaren-Hume M (1959) The results of treatment for obesity. A review of the literature and report of a series. AMA Arch Intern Med 103:79–85

    PubMed  Google Scholar 

  9. Glennon JA (1966) Weight reduction — an enigma. Arch Intern Med 118:1–2

    PubMed  Google Scholar 

  10. Sohar E, Sheh E (1963) Follow-up of obese patients; 14 years after a successful reducing diet. Am J Clin Nutr 26:845–848

    Google Scholar 

  11. Stuart RB (1967) Behavioral control of overeating. Behav Res Ther 5:357–365

    Google Scholar 

  12. Stunkard AJ, Penick SB (1979) Behavior modification in the treatment of obesity. The problem of maintaining weight loss. Arch Gen Psychiatry 36:801–806

    PubMed  Google Scholar 

  13. Currey H, Malcolm R, Riddle E et al. (1977) Behavioral treatment of obesity. Limitations and results with the chronically obese. JAMA 237:2829–2831

    PubMed  Google Scholar 

  14. Linet OI, Metzler CM, van Tassel M (1979) Evaluation of a “free” weight control clinic. Obesity/Bariatric Med 8:152–157

    Google Scholar 

  15. Rooth G, Carlström S (1970) Therapeutic fasting. Acta Med Scand 187:455–463

    PubMed  Google Scholar 

  16. MacCuish AC, Munro JF, Duncan LJP (1968) Follow-up study of refractory obesity treated by fasting. Br Med J 1:91–92

    PubMed  Google Scholar 

  17. Gilliland IC (1968) Total fasting in the treatment of obesity. Postgrad Med J 44:58–61

    PubMed  Google Scholar 

  18. Duncan GG, Hunscher MA, Cristofori FC et al. (1965) Intermittent total fasts and obesity. Indications, results and preventable hazards. Postgrad Med 38:523–535

    PubMed  Google Scholar 

  19. Hunscher MA (1966) A post-hospitalization study of patients treated for obesity by a total fast regimen. Metabolism 15:383–393

    PubMed  Google Scholar 

  20. Berger M, Granz M, Berchtold P et al. (1976) Verlaufsuntersuchungen zum Langzeiteffekt der Nulldiät. Dtsch Med Wochenschr 101:601–605

    PubMed  Google Scholar 

  21. Bayer PM, Fegal U, Pointner H (1977) Langzeitergebnisse nach Nullkalorien-Diät. Wiener Klin Wochenschr 89:222–224

    Google Scholar 

  22. Hermann LS, Iversen M (1968) Death during therapeutic starvation. Lancet 2:217

    Google Scholar 

  23. Göschke H, Hausser R, Lauffenburger T et al. (1976) Langzeiterfolg von Fastenkuren. Resultate von 132 konsekutiven Patienten nach 1–6 1/2 Jahren. Schweiz Med Wochenschr 106:713–717

    PubMed  Google Scholar 

  24. Johnson D, Drenick EJ (1977) Therapeutic fasting in morbid obesity. Arch Intern Med 137:1381–1382

    PubMed  Google Scholar 

  25. Hoffman R (1978) Starvation diets in the treatment of obesity. Obesity/Bariatric Med 7:10–20

    Google Scholar 

  26. Lindner PG, Blackburn GL (1976) Multidisciplinary approach to obesity utilizing fasting modified by protein-sparing therapy. Obesity/Bariatric Med 5:198–216

    Google Scholar 

  27. Bistrian BR (1978) Clinical use of a protein-sparing modified fast. JAMA 240:2299–2302

    PubMed  Google Scholar 

  28. Blackburn L, Bistrian R, Flatt JP (1974) In: Howard A (ed) Recent advances in obesity research. Technomic Publishing Company, Westport, pp 279–281

    Google Scholar 

  29. Vertes V, Genuth SM, Hazelton M (1977) Supplemented fasting as a large-scale outpatient program. JAMA 238:2151–2153

    PubMed  Google Scholar 

  30. Linn R, Stuart SL (1976) The last chance diet. Lyle Stuart, Secaucus, NJ

  31. FDA Drug Bulletin (1978) Liquid protein and sudden cardiac deaths — an update. 8:18–19

    Google Scholar 

  32. Bistrian BR, Sherman M (1978) Results of the treatment of obesity with a protein-sparing modified fast. Intern J Obesity 2:143–148

    Google Scholar 

  33. Lindner P (1979) Personal communication

  34. Yang SP, Martin LJ, Schneider G (1980) Weight reduction utilizing a protein-sparing modified fast. J Am Diet Assoc 76:343–346

    PubMed  Google Scholar 

  35. Gotto AM, Vertes V, Jackson D (1980) Obesity — a new approach to an old problem. Heart and Lung 9:719–725

    PubMed  Google Scholar 

  36. Scoville BA (1975) In: Bray GA (ed) Obesity in perspective. Fogarty International Center on Preventive Medicine, Washington, DC, DHEW Publication No (NIH) 75–708, pp 441–443

  37. Lasagna L (1980) In: Stunkard AJ (ed) Obesity. Saunders, Philadelphia, pp 292–299

  38. Enzi G, Baritussio A, Marchiori E et al. (1976) Short-term and long-term clinical evaluation of a non-amphetamine anorexiant (Mazindol) in the treatment of obesity. J Int Med Res 4:304–318

    Google Scholar 

  39. Hudson KD (1977) The anorectic and hypotensive effect of fenfluramine in obesity. J Roy Coll G P 27:497

    Google Scholar 

  40. Munro JF (1979) Clinical aspects of the treatment of obesity by drug: a review. Int J Obesity 3:171–180

    Google Scholar 

  41. Stunkard AJ, Wilcoxon Craighead L, O'Brien R (1980) Controlled trial of behaviour therapy, pharmacotherapy, and their combination in the treatment of obesity. Lancet 2:1045–1047

    PubMed  Google Scholar 

Download references

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  1. Bronson Clinical Investigational Unit, Bronson Methodist Hospital, Kalamazoo, USA

    Otto I. Linet

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  1. Otto I. Linet
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Linet, O.I. Long-term efficacy of medical treatments for obesity. Klin Wochenschr 60, 115–120 (1982). https://doi.org/10.1007/BF01711275

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