Conservative therapy of morbid obesity? Introduction
A therapy which is effective in the long term for morbid obesity (BMI > 40 Kg/m2 ) which does not involve surgery has not yet been found. Allof the scientific studies dealing with conservative therapy methods for morbid obesity (reduced calorie intake, behavioural therapy, drug therapy, increased physical activity) only show a success quotient of max. 10% in the long term. Weight is only reduced in the long term by 10%. Thus, conservative therapy for morbid obesity is considered to be unsatisfactory.
In most cases reduction diet, behavioural therapy and drug therapy achieve notable results in the short term but in the intermediate term and the long term the initial weight is put back on or often increased. For a therapy to be successful it must be adhered to over a lifetime without lapses.
Seen from a timeline perspective, the first phase of weight reduction by calorie reduction diets is a consolidation phase for the target weight. In this case a complete change of dietary habits and a qualitative diet which is tailored to daily calorie requirements are needed. In both cases regular medical consultation and checkups are required, in particular to change from a bad diet (vitamin deficiencies, protein deficiencies).
In most cases a ping-pong or yo-yo effect (see Regulation of body's energy balance) and repeated conservative therapy leads to increased frustration. This has a severe effect on the quality of life for the patient. On the one hand, time consuming and expensive measures are tried out, on the other they are not successful. The weight gain spiral continues with all its negative effects. Secondary disease and compromised physical integrity combine with feelings of guilt, fear of failure, feelings of shame, increased isolation in the patient’s private and professional life. Patients create a physical and psychic shield, become unattractive to others and lose their sexual drive. Unfortunately, the fact that no adequate conservative therapy exists is used by paramedic institutions and individuals to take advantage of the patient. Intensive advertising promises massive and long-term weight reduction but these promises are not kept though the patient’s cash is happily accepted.