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Psychologische Aspekte der Adipositas

Konsequenzen für Therapieinhalte, Therapieindikation und Therapieerfolg

Psychological aspects of obesity

Consquences for content, indication, and success of therapy

  • Leitthema
  • Published:
Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz Aims and scope

Zusammenfassung

Adipositas rein auf die medizinische Problematik zu reduzieren wird der Komplexität des Störungsbildes nicht gerecht. Im Mittelpunkt stehen für die betroffenen Kinder und Jugendlichen weniger die aktuellen und zukünftigen körperlichen Gesundheitsbeeinträchtigungen, sondern die psychosozialen Aspekte der Adipositas. Gerade das hohe Maß an Stigmatisierung trägt wesentlich zur psychosozialen Belastung der Betroffenen bei. Einschränkungen der Lebensqualität, aber auch erhöhte Prävalenzen von psychischen Störungen werden bei übergewichtigen und adipösen Kindern und Jugendlichen berichtet. Im Sinne eines psychosozialen Teufelskreises nehmen diese wiederum Einfluss auf das Ernährungs- und Bewegungsverhalten und somit auf zentrale Stellgrößen von Gewichtskontrollmaßnahmen. Daher haben sich in der Therapie komplexe multimodale Programme, die diesen Zusammenhängen Rechnung tragen, längst etabliert. Zahlreiche Studien unterstreichen die Wirksamkeit von Lebensstilprogrammen mit moderaten Gewichtsverlusten. Elterneinbezug und Vermittlung von Verhaltensstrategien sind mit besseren Ergebnissen verbunden. Zukünftige Studien sollten verschiedene psychosoziale Outcomes einbeziehen und sich der Frage nach den psychosozialen Prädiktoren für kurz- und langfristige Behandlungseffekte widmen.

Abstract

To simply reduce obesity to the medical set of problems falls short due to the complexity of the disorder. The focus of the affected children and adolescents is less on acute and future somatic health impairments but on the psychosocial aspects of obesity. The high degree of stigmatization especially accounts for the psychosocial burdens of the persons concerned. Constraints in the quality of life and a higher prevalence of mental disorders are reported by overweight and obese children and adolescents. In the sense of a vicious psychosocial circle, these variables in turn influence our eating and exercise behavior and hence central influences of weight control actions. Therefore, complex multimodal programs, which take into account these relationships, have long since been established in therapy. Numerous studies have underscored the efficacy of such lifestyle interventions resulting in moderate weight loss effects. Parent involvement and including behavioral strategies is associated with better results. Future studies should focus more on various psychosocial outcomes and addressing the question of psychosocial predictors of short- and long-term treatment success.

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  1. Universität Potsdam Beratungspsychologie, Karl-Liebknechtstr. 24-25, 14476, Potsdam, Deutschland

    P. Warschburger

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Warschburger, P. Psychologische Aspekte der Adipositas. Bundesgesundheitsbl. 54, 562–569 (2011). https://doi.org/10.1007/s00103-011-1264-7

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