Versorgungskonzepte für Kinder und Jugendliche mit extremer und/oder genetischer Adipositas

Zusammenfassung

Kinder und Jugendliche mit extremer und/oder genetischer Adipositas benötigen aufgrund des chronisch-rezidivierenden und progressiven Charakters der Adipositas eine langfristige und kontinuierliche Betreuung und Behandlung. Ziel dieser Arbeit ist es, ein strukturiertes Versorgungs- und Behandlungskonzept für Kinder und Jugendliche mit extremer und/oder genetischer Adipositas vorzustellen, welches den speziellen Anforderungen und Bedürfnissen dieser Patientengruppe entspricht. Kinder und Jugendliche mit extremer und/oder genetischer Adipositas sollten strukturiert und kontinuierlich nach dem „Chronic Care Model“ in spezialisierten Behandlungszentren in enger Zusammenarbeit mit niedergelassenen Arztpraxen versorgt und behandelt werden. Das Wissen über die zugrundeliegenden molekularbiologischen Mechanismen der Regulation von Hunger und Sättigung, des Körpergewichts und letztlich der Entstehung der Adipositas ermöglichen einen personalisierten Behandlungsansatz. Individualisierte, multimodale Behandlungsansätze sind die Grundlage für eine langfristige und effektive Behandlung der Adipositas bei Kindern und Jugendlichen mit extremer und/oder genetischer Adipositas. Neue pharmakologische Therapiemöglichkeiten, wie Inkretin-basierte Medikamente für Jugendliche mit extremer Adipositas oder speziell entwickelte Mechanismus-basierte Medikamente für Personen mit genetischer Adipositas, stellen einen bedeutenden Fortschritt im chronischen Gewichtsmanagement und eine effektive Ergänzung zu individuellen, multimodalen Lebensstilinterventionen dar.

Abstract

Children and adolescents with severe and/or genetic obesity require long-term and continuous care and treatment due to the chronic, recurrent, and progressive character of obesity. The aim of this article is to present a structured care and treatment concept for patients with extreme and/or genetic obesity that meets the special requirements and needs of this patient group. Structured care for these patients should be provided according to the “chronic care model” in specialized treatment centres and in close cooperation with local paediatricians. Knowledge about the underlying molecular biological mechanisms of the regulation of hunger and satiety, body weight and ultimately the development of obesity enables an individualised treatment approach. Individualized, multimodal treatment approaches are therefore the basis of a long-term and effective obesity treatment in children and adolescents with extreme and/or genetic obesity. New pharmacological treatments, as incretin-based drugs for adolescents with extreme obesity or mechanism-based drugs for patients with genetic obesity, represent a significant advance in chronic weight management and are an effective complement to individualised, multimodal lifestyle interventions.

Schlüsselwörter

extreme Adipositas - genetische Adipositas - strukturierte Versorgung und Behandlung - Kinder und Jugendliche

Keywords

severe obesity - genetic obesity - structured care and treatment - children and adolescents

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