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Praktische Umsetzungen von Therapieempfehlungen zur Adipositas bei Kindern und Jugendlichen

Practical implementation of treatment guidelines concerning obesity in children and adolescents

  • Leitthema
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Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz Aims and scope

Zusammenfassung

Leitlinien empfehlen eine langfristige ambulante Lebensstilintervention bei adipösen Kindern und Jugendlichen unter Einbezug ihrer Eltern. Jedoch wird nur circa 1% von den zurzeit in Deutschland lebenden etwa 1.000.000 adipösen Kindern und Jugendlichen entsprechend behandelt. Zwischen Leitlinien und Versorgungsrealität klafft daher eine große Lücke. Mangelndes Problembewusstsein, fehlende zeitliche Ressourcen und mangelnde Motivation zur Lebensstiländerung stellen mögliche Gründe aufseiten der adipösen Kinder und ihrer Familien dar. Ferner existiert in Deutschland kein flächendeckendes Therapieangebot. Die langfristige Effektivität der einzelnen ambulanten Schulungskonzepte weicht weit auseinander (von <50% bis hin zu >70%), während die langfristige Effektivität der mit Abstand am häufigsten in Deutschland durchgeführten Maßnahme, einer kurzfristigen stationären Rehabilitation, weitgehend unbekannt ist. Generell werden vor allem ältere und extrem adipöse Kinder und Jugendliche mit einer Lebensstilintervention behandelt, während bei weniger übergewichtigen und jüngeren Kindern die Erfolgsaussichten wesentlich höher sind. Für einzelne Gruppen (zum Beispiel extrem adipöse Jugendliche, behinderte adipöse Kinder) gibt es bis heute keine sinnvollen und nachweislich effektiven Therapieangebote.

Abstract

Guidelines recommend a long-term outpatient lifestyle intervention in obese children and adolescents that also addresses the children’s parents. However, lifestyle interventions are performed only in 1% of the 1,000,000 obese children and adolescents in Germany, suggesting a large gap between guidelines and medical care in real life. Possible reasons are a lacking awareness of the consequences of overweight, no time resources, and the lack of motivation to change lifestyle habits in some obese children and their families. Furthermore, there is no treatment option throughout Germany. The long-term success rate varies widely between outpatient treatment centers (<50% up to >70%), while the long-term effectiveness of short-term, inpatient intervention (rehabilitation) is unknown. However, many more obese children are treated by short-term rehabilitation compared to long-term outpatient intervention. Older and extreme obese children and adolescents are treated by lifestyle intervention, although this kind of intervention is more effective in younger and not so obese children. Some subgroups (extreme obese adolescents, obese disabled children) have no meaningful and effective treatment options.

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Abb. 1

Notes

  1. Siehe auch Beitrag von U. Hoffmeister et al. in diesem Heft: „Evaluation von Therapieangeboten für adipöse Kinder und Jugendliche (EvAKuJ-Projekt). Welche Rolle spielen Behandlungskonzept, AGA-Zertifizierung und initiale Qualitätsangaben?“

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  1. Abteilung für Pädiatrische Endokrinologie, Diabetes und Ernährungsmedizin, Vestische Kinder- und Jugendklinik Datteln, Universität Witten/Herdecke, Dr. F. Steiner Str. 5, 45711, Datteln, Deutschland

    T. Reinehr

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Reinehr, T. Praktische Umsetzungen von Therapieempfehlungen zur Adipositas bei Kindern und Jugendlichen. Bundesgesundheitsbl. 54, 591–597 (2011). https://doi.org/10.1007/s00103-011-1259-4

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