Via practica 6/2009

Obesity management in ambulatory practice

Obesity is one of the most common non-communicable diseases of the developed countries and its prevalence has become at the end of the 20th century a world-wide epidemic. Obesity increases the risk of morbidity and mortality not only of coronary heart disease and type 2 diabetes mellitus, but it also increases the risk of cancer. The obesity treatment should be complex and it should be lead by medical doctors and other specialists. The aim of obesity management is not only to lose the body weight, but also the treatment of complications. The absolute natural parts of complex obesity management are diet intervention, physical activity and exercise, cognitive behavioural treatment, pharmacotherapy. Surgery is considered in most severe cases of so called morbid obesity with high grade health risks. There are several obesity management programs. Intensity of the weight loss treatment programs strongly depends on the obesity grade and also on the presence/absence of complications. Mild to moderate non-complicated overweight and obesity require general advice on lifestyle changes (KBT), together with diet intervention and physical activity program. Severe degrees of obesity and complications require more intensive lifestyle interventions (KBT), pharmacotherapy, very low-calorie diet (VLCD) or even surgical intervention. Complex obesity management is apart from a very few exceptions treated in out-patients clinics and departments.

Keywords: obesity, complex treatment, CMO, management in out-patient’s clinic, KBT, diet, physical activity