Modern nutritional therapy concepts for weight control
A successful reduction in bodyweight can only be achieved after a period of 2 to 5 years. The following table lists different options for modern nutritional therapy for weight control (Tab. 8). Up to a BMI of 30, nutritional, behavioural and movement therapy are the appropriate weight management therapies according to the “Best Practice” Program (Hauner et al., 1997). With a BMI above 30, with or without co-morbidity, additional medical therapy should also be considered. In the case of morbid obesity with BMI > 40, surgical treatment should be considered following unsuccessful conservative therapy (National Institute of Health Consensus Development Conference, 1992).
1. Nutritional Adjustment
- Reduction of fat intake to approx. 30 grams/day (see also fats)
- Calorie intake through carbohydrates (CH), in order to increase the burning of carbohydrates
- Adequate higher protein intake (60-80 grams/day), vitamin, mineral and trace-element supplements to prevent deficiencies and muscle decline.
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2. Behavioural Changes
- Recognition and correction of faults in eating habits and disturbed eating patterns (see also epidemiology and costs) by means of behavioural and psychotherapy.
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3. Medication
- Eating attacks can be successfully treated with medication (serotonin agonists)
- Lipase inhibitors (Orlistat, Xenical™) reduce fat absorption. The fatty stools side effect is avoided with a daily intake of 30-50 grams of fat.
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4. Increase in physical activity
- Each nutritional adjustment should be accompanied by a exercise program. Ideally 3 x 45 minutes per week with a heart rate, adjusted according to age, of 130 – 140 / minute. In this manner, the burning of fat can be increased by ca. 30 – 40 % and the probability of a renewed weight gain is reduced.
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| Tab. 8: Modern nutritional therapy |
