Adipositas: State of the Art

According to WHO criteria obesity is defined as a BMI of >= 30 kg/m(2). In Germany the prevalence of obesity has increased over the last decades, affecting about 24% of the population. A genetic vulnerability combined with easy access to high calorie food and low levels of physical activity are seen as main reasons for this increase in prevalence rates in affluent societies. Weight loss programs should include the following components: nutrition, physical activity, and behavior modification. Overall, treatment goals should be realistic and should be adjusted to the individual's needs. Comorbidities, risks, expectancies, and resources of the individual should be considered; treatment should not only focus on weight loss. Long-term weight maintenance is still difficult to achieve. For severely obese individuals bariatric surgery is an effective treatment strategy. Individuals with obesity have an increased risk of mental comorbidity; this could be found in population-based as well as clinical samples. This includes affective disorders, anxiety disorders, and eating disorders (especially binge eating disorder). Also ADHD is associated with obesity in children, adolescents as well as in adults. In our society obesity is more stigmatized than other mental or somatic disorders.