Conservative Obesity Therapy

Conservative obesity therapy refers to all procedures that are non-surgical. This includes dietary therapy, medications, psychotherapy, and multimodal concepts.

Dietary Therapy

Dietary therapy or diet comes in various forms, such as food separation, eat less, low-carb, low-fat, no carbohydrates after eight, blood type diet, cabbage soup, and so on. The actual benefit of most diets is scientifically questionable, as they all aim to eliminate something and encourage the body to use reserves (fat). Unfortunately, we are evolutionarily conditioned to replenish these reserves once the shortage is over. Obese individuals are familiar with this as the yo-yo effect, which over time can lead the body to store even larger reserves of fat to better survive the next period of scarcity. Effective dietary therapy should therefore not induce weight loss through nutrient deficiency, but rather through targeted changes in eating behavior based on nutritional guidelines. The true meaning of the word "diet" from the Greek word díaita translates to lifestyle or way of life that needs to be changed. Hence, it's already implied that temporarily eliminating certain foods won't achieve the goal. Dietetics as a science is concerned not only with weight reduction measures but rather with treating diseases through specific diets. Improper use of the term "diet" can lead to the development of fat metabolism disorders due to frequent diets, which can in turn contribute to obesity.

Medicinal Therapy

Medicinal therapy is only considered for individuals with obesity if prescribed by a physician. It's best to inquire about this with your primary care physician. Weight-loss medications ordered from the internet are usually ineffective and should not be taken. In a few cases where obesity is caused by chemotherapy or hormone therapy, targeted changes in medication can lead to improvement. However, this does not apply to the vast majority of individuals with obesity, whose weight issues are due to their lifestyle.

Psychotherapy

Unlike eating disorders such as binge eating and anorexia, which are recognized as mental illnesses, obesity, or pathological obesity, is not viewed as such. In some cases, obesity or the behaviors leading to obesity may be caused by a mental illness such as depression. In such cases, therapy conducted by a psychotherapist can address the underlying cause and thereby lead to weight reduction. However, such therapy should always be accompanied by interdisciplinary coordination among treating physicians, as it should be conducted alongside dietary and exercise therapies.

Multimodal Concepts – MMK

Today, multimodal concepts form the basis of weight reduction therapy, partly because health insurance companies require the concurrent implementation of such a concept for covering bariatric surgery costs. Moreover, only the combination of different therapies ensures sustainable success.

The multimodal concept combines the following three areas:

Diet

Under the guidance of a dietitian or nutritionist, there is a targeted change in eating behavior and a long-term change in diet. This can be done in group therapy as well as individually with the respective individual; the important thing is the permanent change in diet.

Exercise

Based on the individual's capabilities, an exercise program is developed to increase physical activity. This is not about completing a marathon, but rather about burning more energy in everyday life by using stairs instead of elevators, walking children to school, and exercising regularly. Sports that are particularly suitable include Nordic walking, cycling, swimming, or water aerobics. Swimming 1000 meters burns several hundred calories, and with 2 x 1000 meters per day, you can lose up to 800g of body weight per week. Exercise has other important effects: muscles burn fat, and more muscles burn more fat. In addition, muscles support heavily loaded joints. It is important to always train within your own limits, and if at the beginning you can only do 5 or 10 minutes of Nordic walking, that's a start. You will see that after a few weeks, you can walk longer distances, and the more you train, the more energy your body can consume. A proven concept here are training groups with people at the same performance level and the supervision of the training by a physiotherapist or sports therapist or a fitness trainer.

Behavior

Behavioral therapy aims to help individuals with obesity to break and change deeply rooted behavioral patterns so that exercise therapy and dietary therapy can take effect. It is important to understand that people's behavior is deeply rooted in the subconscious and requires effort to change. Anyone who has tried to quit smoking or another bad habit can understand what it means to change their lifestyle in the long term.

Medical Care

Last but not least, medical care is the fourth essential therapy unit in the multimodal concept. At the center of this is the interdisciplinary exchange of the participating medical disciplines. Changing diet and adjusting nutrient intake to changed exercise behavior requires precise control; otherwise, fat metabolism disorders that lead to obesity will be exacerbated. Therefore, comprehensive medical supervision throughout the process is essential.

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