RSS-Feed abonnieren
DOI: 10.1055/s-0042-119691
Edmonton Obesity Staging System (EOSS) der Interventionsbedürftigkeit bei Adipositas
Ein Instrument zur Differenzierung der Adipositas-SchweregradeEdmonton Obesity Staging System (EOSS) for the stratification of obesity treatment – An instrument for assessment of the severity of obesityPublikationsverlauf
Publikationsdatum:
29. November 2016 (online)
Der weltweite Anstieg der Adipositasprävalenz stellt unsere Gesundheitssysteme vor enorme Herausforderungen. Da das Adipositas-assoziierte Risiko für Folgeerkrankungen, aber auch das individuelle Ansprechen auf gewichtsreduzierende Therapiestrategien heterogen ist, sollte eine Stratifizierung des Adipositas-Schweregrades vor Einleitung einer Therapie erfolgen. Eine bariatrische Operation ist derzeit der einzige evidenzbasierte Ansatz, der eine nachhaltige Gewichtsreduktion bei stark adipösen Patienten erzielen kann. Da die Mittel im Gesundheitssystem jedoch begrenzt sind, ist es wichtig, herauszufinden, welche Patienten am meisten von einem operativen Eingriff zur Gewichtsreduktion profitieren. Das Edmonton Obesity Staging System (EOSS) kann hierbei ein wichtiges Instrument sein, um die Indikation für einen bariatrischen Eingriff bei Patienten mit Adipositas neu zu definieren. Weiterführende Untersuchungen müssen zeigen, wie sich das EOSS in die tägliche Praxis bei der Therapie von Patienten mit Übergewicht und Adipositas integrieren lässt.
The increase in the prevalence of obesity represents a challenging task for health care systems. Since the obesity associated risk to develop comorbid disorders and the individual response to weight reducing therapies are heterogeneous, a stratification of the severity of obesity should be assessed prior to the initiation of weight loss interventions. Bariatric surgery is so far the only long-term effective evidence based treatment strategy to significantly reduce body weight in patients with obesity. In the light of limited resources it will be more and more important to identify those individuals who may benefit the most from a surgical treatment of obesity. The Edmonton Obesity Staging System (EOSS) has been demonstrated to be a valuable diagnostic tool to stratify and prioritize patients for different treatment strategies including bariatric surgery. Future studies, including real-world observations are required to validate the EOSS in clinical practice and whether obesity treatment could be optimized using this systematic approach.
-
Literatur
- 1 World Health Organization. Obesity and overweight. Fact sheet No 311. 05/2012 http://www.who.int/mediacentre/factsheets/fs311/en/
- 2 Kelly T, Yang W, Chen CS et al Global burden of obesity in 2005 and projections to 2030. Int J Obes (Lond) 2008; 32: 1431-1437
- 3 Weinstein AR, Sesso HD, Lee IM et al Relationship of physical activity vs body mass index with type 2 diabetes in women. JAMA 2004; 292: 1188-1194
- 4 Raggi MC, Sharma AM, Jacob S. Edmonoton Obesity Staging System: Therapiedringlichkeit bei Adipositas abschätzen. Diabetologie, Stoffwechsel und Herz 2012; 21: 321-324
- 5 Wadden TA. Treatment of obesity by moderate and severe caloric restriction. Results of clinical research trials. Ann Intern Med 1993; 119: 688-693
- 6 Sjöström L, Lindroos AK, Peltonen M et al Swedish Obese Subjects Study Scientific Group. Lifestyle, diabetes, and cardiovascular risk factors 10 years after bariatric surgery. N Engl J Med 2004; 351: 2683-2693
- 7 Ravussin E, Lillioja S, Knowler WC et al Reduced rate of energy expenditure as a risk factor for body-weight gain. N Engl J Med 1988; 318: 467-472
- 8 Hebebrand J, Friedel S, Schäuble N et al Perspectives: molecular genetic research in human obesity. Obes Rev 2003; 4: 139-146
- 9 Frayling TM, Timpson NJ, Weedon MN et al A common variant in the FTO gene is associated with body mass index and predisposes to childhood and adult obesity. Science 2007; (11) 316: 889-894
- 10 Simmons R. Perinatal programming of obesity. Semin Perinatol 2008; 32: 371-374
- 11 Wirth A, Wabitsch M, Hauner H. Clinical practice guideline: The prevention and treatment of obesity. Dtsch Arztebl Int 2014; 111: 705-713
- 12 Klöting N, Fasshauer M, Dietrich A, Kovacs P, Schön MR, Kern M, Stumvoll M, Blüher M. Insulin-sensitive obesity. Am J Physiol Endocrinol Metab 2010; 299: E506-15
- 13 Reaven GM. Importance of identifying the overweight patient who will benefit the most by losing weight. Annals of Internal Medicine 2003; 138: 420-423
- 14 Stefan N, Kantartzis K, Machann J et al Identification and characterization of metabolically benign obesity in humans. Archives of Internal Medicine 2008; 168: 1609-1616
- 15 Sharma AM, Kushner RF. A proposed clinical staging system for obesity. Int J Obes (Lond) 2009; 33: 289-295
- 16 Padwal RS, Pajewski NM, Allison DB, Sharma AM. Using the Edmonton obesity staging system to predict mortality in a population-representative cohort of people with overweight and obesity. CMAJ 2011; 183: E1059-66
- 17 Kuk JL, Ardern CI, Church TS et al Edmonton Obesity Staging System: association with weight history and mortality risk. Appl Physiol Nutr Metab 2011; 36: 570-576
- 18 Sjöström L, Gummesson A, Sjöström CD et al Swedish Obese Subjects Study. Effects of bariatric surgery on cancer incidence in obese patients in Sweden (Swedish Obese Subjects Study): a prospective, controlled intervention trial. Lancet Oncol 2009; 10: 653-662
- 19 Blüher M. Pharmacological therapy versus bariatric surgery for patients with obesity and type 2 diabetes. Internist (Berl) 2015; 56: 143-148 150-152
- 20 Buchwald H, Avidor Y, Braunwald E et al Bariatric surgery: a systematic review and meta-analysis. JAMA 2004; 292: 1724-1737
- 21 Gill RS, Birch DW, Shi X et al Sleeve gastrectomy and type 2 diabetes mellitus: a systematic review. Surg Obes Relat Dis 2010; 6: 707-713
- 22 Picot J, Jones J, Colquitt JL et al Weight loss surgery for mild to moderate obesity: a systematic review and economic evaluation. Obes Surg 2012; 22: 1496-1506