Interdisziplinäre Adipositastherapie

Zusammenfassung

Adipositas ist eine globale Epidemie mit zunehmender Prävalenz, die einen interdisziplinären Ansatz für eine effektive Langzeitbehandlung erfordert. Trotz der Verfügbarkeit neuer medikamentöser Therapien bleibt die Anzahl der Patient*innen, die in Deutschland eine angemessene Behandlung erhalten, unzureichend. Das Disease Management Programm (DMP) für Adipositas, das im November 2023 eingeführt wurde, zielt darauf ab, die medizinische Versorgung zu verbessern, derzeit gibt es jedoch keine Kostendeckung für medikamentöse Therapie, postoperative Betreuung und umfassende Ernährungs- und Bewegungstherapien. Die Behandlung von Adipositas erfordert einen vielschichtigen Ansatz. Lebensstilinterventionen wie Ernährungsumstellungen und Bewegung sind wesentlich, aber oft nicht ausreichend für einen signifikanten Gewichtsverlust. Pharmakologische Behandlungen, insbesondere GLP-1-Agonisten, haben vielversprechende Ergebnisse gezeigt. Diese können jedoch aufgrund der fehlenden Kostenübernahme nur eingeschränkt eingesetzt werden. Die bariatrische Chirurgie bleibt die effektivste Langzeitbehandlung mit einem durchschnittlichen Gewichtsverlust von 30–40%. Sie wird für Patient*innen mit einem BMI über 40 kg/m² oder über 35 kg/m² mit Begleiterkrankungen empfohlen. Die Integration von chirurgischen und konservativen Therapien ist entscheidend für optimale Ergebnisse.

Abstract

Obesity is a global epidemic with increasing prevalence, necessitating an interdisciplinary approach for effective long-term treatment. Despite the availability of new pharmacological therapies, the number of patients receiving adequate treatment in Germany remains insufficient. The Disease Management Program (DMP) for Obesity, introduced in November 2023, aims to improve medical care by focusing on conservative treatments, though it currently lacks coverage for medication, post-surgical care, and comprehensive nutritional and exercise therapies. Obesity treatment requires a multifaceted approach, including lifestyle interventions, pharmacotherapy, and surgical options. Lifestyle interventions, such as dietary changes and exercise, are essential but often insufficient for significant weight loss. Pharmacological treatments, particularly GLP-1 agonists have shown promising results. However, these treatments are not widely accessible due to cost issues. Bariatric surgery remains the most effective long-term treatment, with average weight loss of 30–40%. It is recommended for patients with a BMI over 40 kg/m² or over 35 kg/m² with comorbidities. The integration of surgical and conservative therapies is crucial for optimal outcomes.

Schlüsselwörter

Adipositas - Disease Management Program - Interdisziplinäre Therapie - bariatrische Chirurgie

Keywords

Obesity - Disease Management Program - Interdisciplinary Therapy - Bariatric Surgery

Publication History

Article published online:
20 September 2024

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