Zusammenfassung
Die Zunahme von Adipositas und ihrer Folgeerkrankungen, insbesondere Typ-2-Diabetes,
erfordert die Intensivierung aller bekannten präventiven und therapeutischen Maßnahmen.
Hierzu zählen bei Adipositas Grad 3 neben den konservativen Programmen gegebenenfalls
auch adipositaschirurgische (bariatrische) Operationen. Typ-2-Diabetiker profitieren
überproportional, da sich unmittelbar nach insbesondere malabsorptiven Operationsverfahren
die Stoffwechsellage dramatisch bessert, und zwar unabhängig von der erst im Laufe
von Wochen und Monaten beobachteten Gewichtsabnahme. Langzeitstudien mit bis zu 15
Jahren Follow-up belegen den nachhaltigen positiven Effekt bariatrischer Operationen
auf Gewichtsverlust, adipositasassoziierte Erkrankungen und Mortalität. Die Arbeitsgruppe
Adipositas des BDEM (Bundesverband Deutscher Ernährungsmediziner e. V.) hat einen
Behandlungspfad zur Therapie von Personen mit massiver Adipositas entwickelt.
Increasing adiposity and its subsequent diseases, especially Type 2 diabetes, makes
it necessary to intensify all the well-known preventive and therapeutic measures.
These include, in case of grade 3 adiposity, not only the conservative programmes
but also whenever necessary bariatric surgery (adipose patient surgery). This will
super-proportionally benefit Type 2 diabetics, since there is an immediate dramatic
improvement in the metabolic condition of the patients especially subsequent to malabsorption
surgery, independent of the weight loss. The persistently positive effect of bariatric
surgery has been established with regard to weight loss, adiposity-associated diseases
and mortality, by means of long-term studies with a follow-up of up to 15 years. A
guideline for the treatment of highly adipose patients has been compiled by the Federal
German Association of Physicians Engaged in Nutritional Medicine.
Key words
Diabetes mellitus - massive adiposity - bariatric surgery
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Korrespondenz
Dr. med. Winfried Keuthage
Diabetologische Schwerpunkt-praxis Schwerpunktpraxis Ernährungsmedizin
Düesbergweg 128
48153 Münster
eMail: dr@keuthage.de
