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Zusammenfassung

Das Übergewicht eines Menschen, welches zu gesundheitlichen Risiken führen kann, wird als Adi-positas definiert. So einfach die Blickdiagnostik des Symptoms auch ist, so unklar sind bis heute die eigentlichen Ursachen, die dieser »Störung« zugrunde liegen. Es stellt sich gar die Frage, ob die in den allermeisten Fällen vorliegende Form der »alimentären Adipositas« (abgesehen von Prader-Willi-Syndrom u. ä.) überhaupt eine Störung oder die — evolutionsbiologisch gewollte — Normalvariante darstellt, die sich nur unter den Bedingungen des allgegenwärtigen Nahrungsüberflusses, der seit etwa 5 Jahrzehnten in den Industrienationen besteht, zu einem Phänotypus mit Gesundheitsrisiko entwickeln konnte. Natürlich tangiert die Antwort auf diese Frage die therapeutischen Strategien, die Kognitionen von Therapeut und Patient über diese »Störung« sowie letztlich auch die Erfolgswahrscheinlichkeit der Therapie.

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Literatur

  1. Acheson, K. J., Schutz, Y., Bessard, T., Anatharaman, K., Flatt, J. P. & Jequier, E. (1988). Glycogen storage capacity and de novo lipogenesis during massive carbohydrate overfeeding in man. American Journal of Clinical Nutrition, 48, 240–247.PubMedGoogle Scholar
  2. Astrup, A. (1994). Macronutrient balance of obesity. International Monitor on Eating Pattern and Weight Control, 2, 2–5.Google Scholar
  3. Bennett, W. I. (1995). Beyond overeating. Editorial. New England Journal of Medicine, 332, 673–674.PubMedCrossRefGoogle Scholar
  4. Blair, S. N., Kohl, H. W. & Paffenbarger, R. S. jr. (1989). Physical fitness and all cause mortality. A prospektive study of healthy men and women. JAMA, 262, 2395–2401.PubMedCrossRefGoogle Scholar
  5. Blair, S. N. (1993). Evidence for success of exercise in weight loss and control. Annals of Internal Medicine, 119, 702–706.PubMedGoogle Scholar
  6. Blundell, J. F., Burley, V. J., Cotton, J. R. & Lawton, C. L. (1993). Dietary fat and the control of energy intake. Evaluating the effects of fat on meal size and postmeal satiety. American Journal of Clinical Nutrition, 57, 772 S.Google Scholar
  7. Bolton-Smith, C. & Woodward, M. (1994). Dietary composition and fat to sugar ratios in relation to obesity. International Journal of Obesity, 18, 820–828.PubMedGoogle Scholar
  8. Bouchard, C. & Perusse, L. (1988). Heredity and body fat. Annual Review of Nutrition, 8, 259–277.PubMedCrossRefGoogle Scholar
  9. Bouchard, C., Tremblay, A. & Despres, J.-P. (1990). The response to long-term overfeeding in identical twins. New England Journal of Medicine, 322, 1477–1482.PubMedCrossRefGoogle Scholar
  10. Bundesgesundheitsamt (1994). Die Gesundheit der Deutschen. SozEp, Heft4.Google Scholar
  11. Committee to Develop Criteria for Evaluating the Outcomes of Approaches to Prevent and Treat Obesity, Food and Nutrition Board, Institute of Medicine; Thomas, P. R., (Ed.) (1995). Weighing the Options — Criteria for Evaluating Weight-Management Programs. Washington DC: National Academy Press.Google Scholar
  12. Deutsche Adipositas-Gesellschaft (1996). Richtlinien zur Therapie der Adipositas. Deutsches Ärzteblatt, 36, B1751–B1753.Google Scholar
  13. Deutsche Gesellschaft für Ernährung (1980). Ernährungsbericht 1980. Druckerei Henrich, Frankfurt/Main.Google Scholar
  14. Deutsche Gesellschaft für Ernährung (1992). Ernährungsbericht 1992. Druckerei Henrich, Frankfurt/Main.Google Scholar
  15. Drent, M. L., Zelissen, P. M. J. et al. (1995). The effect of dexfenfluramine on eating habits in a Dutch ambulatory android overweight population with an overconsump-tion of snacks. International Journal of Obesity, 19, 299–304.PubMedGoogle Scholar
  16. Edwards, L. E., Hellerstedt, W. L., Alton, I. R., Story, M. & Himes, J. H. (1996). Pregnancy complications and birth outcomes in obese and normal-weight women. Effects of gestational weight change. Obstetrics and Gynecology, 87(3), 389–294.PubMedCrossRefGoogle Scholar
  17. Ellrott, T., Pudel, V. & Westenhöfer, J. (1995). Fettreduzierte Lebensmittel ad libitum, eine geeignete Strategie zur Gewichtsabnahme? Aktuelle Ernährungsmedizin, 6, 293–303.Google Scholar
  18. Ellrott, T. & Pudel, V. (1996). Perspektiven der Adipositas-therapie. Aktuelle Ernährungsmedizin, 21, 73–80.Google Scholar
  19. Ellrott, T. & Pudel, V. (1998). Adipositastherapie. Aktuelle Perspektiven (2. Aufl.). Stuttgart: Thieme.Google Scholar
  20. Fairburn, C. G. & Cooper, Z. (1996). New perspectives on dietary and behavioural treatments for obesity. International Journal of Obesity, 20 (Suppl. 1), S9–S13.PubMedGoogle Scholar
  21. Flatt, J.-P. (1995). Use and storage of carbohydrate and fat. American Journal of Clinical Nutrition, 61, 952S–959S.PubMedGoogle Scholar
  22. Flegal, K. M. et al. (1996). NAASO-Kongress. Breckenridge.Google Scholar
  23. Gatenby, S. J., Aaron, J. I., Morton, G. M. & Mela, D. J. (1995). Nutritional implications of reduced-fat use by free living consumers. Appetite25, 241–252.PubMedCrossRefGoogle Scholar
  24. Grilo, C. N., Brownell, K. D. & Stunkard, A. J. (1993). The metabolic and psychological importance of exercise in weight control. In A. J. Stunkard & T. A. Wadden (Eds.), Obesity. Theory and therapy (2nd edn.). New York: Raven Press.Google Scholar
  25. Hauptman, J. B., Jeunet, F. S. & Hartmann, D. (1992). Initial studies in humans with the novel gastrointestinal lipase inhibitor Ro 18–0647 (Tetrahydrolipostatin). American Journal of Clinical Nutrition,55, 309S–313S.PubMedGoogle Scholar
  26. Hebebrand, J. & Remschmidt, H. (1995). Genetische Aspekte der Adipositas. Adipositas, 9, 20–24.Google Scholar
  27. Heitmann, B. L. & Lissner, L. (1995). Dietary underreporting by obese individuals — is it specific or non specific? British Medical Journal, 311, 986–989.PubMedCrossRefGoogle Scholar
  28. Helmrich, S. P., Ragland, D. R., Leung, R. W. & Paffenbarger, R. S. jr. (1991). Physical activity and reduced occurrence of non-insulin-dependent diabetes. New England Journal of Medicine, 325, 147–152.PubMedCrossRefGoogle Scholar
  29. Herman, C. P. & Mack, D. (1975). Restrained and unrestrained eating. Journal of Personality, 43, 647–660.PubMedCrossRefGoogle Scholar
  30. Herman, C. P. & Polivy, J. (1975). Anxiety, restraint, and eating behavior. Journal of Abnormal Psychology, 84, 666–672.CrossRefGoogle Scholar
  31. Herman, C. P. & Polivy, J. (1980). Restrained eating. In A. J. Stunkard (Ed.), Obesity (pp. 208–225). Philadelphia: Saunders.Google Scholar
  32. Herman, C. P. & Polivy, J. (1984). A boundary model for the regulation of eating. In A. J. Stunkard & E. Stellar (Eds.), Eating and Its Disorders (pp. 141–156). New York: Raven Press.Google Scholar
  33. Herman, C. P. & Polivy, J. (1988). Restraint and excess in dieters and bulimics. In K. M. Pirke, W. Vandereycken & D. Ploog (Eds.), The Psychobiology of Bulimia Nervosa (pp. 33–41). Berlin: Springer.CrossRefGoogle Scholar
  34. Herman, C. P. & Polivy, J. (1990). From dietary restraint to binge eating. Attaching causes to effects. Appetite, 14, 123–125.PubMedCrossRefGoogle Scholar
  35. Horton, T. J., Drougas, H., Brachey, A., Reed, G. W., Peters, J. C. & Hill, J. O. (1995). Fat and carbohydrate overfeeding in humans. Different effects on energy storage. American Journal of Clinical Nutrition,62, 19–29.PubMedGoogle Scholar
  36. Jakicic, J. M., Wing, R. R., et al. (1995). Prescribing exercise in multiple short bouts versus one continous bout effects on adherence, cardiorespiratory fitness, and weight loss in overweight women. International Journal of Obesity, 19, 893–901.PubMedGoogle Scholar
  37. Jones, S. P., Smith, I. G., Kelly, F. & Gray, J. A. (1995). Long term weight loss with sibutramine. International Journal of Obesity, 19, 41 S.Google Scholar
  38. Kendall, A., Levitzky, D. A., Strupp, D. J. & Lissner, L. (1992). Weight loss on low-fat diet. Consequences of the impression of the control of food intake in humans. American Journal of Clinical Nutrition, 53, 1124–1129.Google Scholar
  39. Kohl, H. W., Powell, K. E., Gordon, N. F. et al. (1992). Physical activity, physical fitness, and sudden cardiac death. Epidemiologic Reviews, 14, 37–58.PubMedGoogle Scholar
  40. Kuczmarski, R. J., Flegal, K. M., Campbell, S. M. & Johnson, C. L. (1994). Increasing prevalence of overweight among US adults. The National Health and Nutrition Examination Surveys, 1961 to 1991. JAMA, 272, 205–211.PubMedCrossRefGoogle Scholar
  41. Leibel, R. L., Rosenbaum, M. & Hirsch, J. (1995). Changes in energy expenditure resulting from altered body weight. New England Journal of Medicine, 332, 621–628.PubMedCrossRefGoogle Scholar
  42. Lissner, L., Levitzky, D. A., Strupp, B. J., Kalkwarf, H. J. & Roe, D. A. (1987). Dietary fat and the regulation of energy intake in human subjects. American Journal of Clinical Nutrition, 46, 886–892.PubMedGoogle Scholar
  43. Manson, J. E., Rimm, E. B., Stampfer, M. J. et al. (1991). Physical activity and incidence of non-insulin dependent diabetes mellitus in women. Lancet, 338, 774–778.PubMedCrossRefGoogle Scholar
  44. Morris, J. N., Phillips, J. F., Jordan, J. W. et al. (1990). Exercise in leisure time. Coronary attack and death rates. British Heart Journal, 63, 325–334.PubMedCrossRefGoogle Scholar
  45. Noack, R. (1995). Energiehaushalt. In H.-K. Biesalski, P. Fürst, H. Kasper, R. Kluthe, W. Pölert, W. Puchstein, H. B. Stähelin (Eds.), Ernährungsmedizin. Stuttgart: Thieme.Google Scholar
  46. Olschewski, P., Ellrott, T., Jalkanen, J., Pudel, V., Schölten, T., Heisterkamp, F. & Siebeneick, S. (1997). Langzeiterfolg eines multidisziplinären Gewichtsmanagement-Programms. Münchener Medizinische Wochenschrift, 139, 245–250.Google Scholar
  47. Pelleymounter, M. A., Cullen, M. J. et al. (1995). Effects of the obese Gene Product on Body Weight Regulation in ob/ob Mice. Science, 269, 540–543.PubMedCrossRefGoogle Scholar
  48. Prentice, A. M. & Jebb, S. A. (1995). Obesity in Britain. British Medical Journal, 311, 437–439.PubMedCrossRefGoogle Scholar
  49. Pudel, V., Metzdorff, M. & Oetting, M. (1975). Zur Persönlichkeit Adipöser in psychologischen Tests unter Berücksichtigung latent Fettsüchtiger. Zeitschrift für Psychosomatische Medizin und Psychoanalyse, 21, 345–361.PubMedGoogle Scholar
  50. Pudel, V. & Westenhöfer, J. (1992). Dietary and behavioural principles in the treatment of obesity. International Monitor on Eating Pattern and Weight Control, 1 (2), 2–7.Google Scholar
  51. Pudel, V. & Westenhöfer, J. (1997). Ernährungspsychologie — Eine Einführung (2. Aufl.) Göttingen: Hogrefe.Google Scholar
  52. Pudel, V. & Westenhöfer, J. (1989). Fragebogen zum Eßverhalten (FEV) — Handanweisung. Göttingen: Hogrefe.Google Scholar
  53. Pudel, V. (1994). Ernährungsberatung als Risikofaktor für Ernährungsverhalten? Ernährungs-Umschau41, 81–85.Google Scholar
  54. Rand, C. & Macgregor, A. (1991) Successful weight loss following obesity surgery and the perceived liability of morbid obesity. International Journal of Obesity,15, 577–579.PubMedGoogle Scholar
  55. Rössner, S. (1992). Factors determining the long term outcome of obesity treatment. In P. Björntorp & B. N. Brodoff (Eds.), Obesity (pp. 712–719). Philadelphia: J.B. Lippincott.Google Scholar
  56. Ryan, D. H. (1995). Sibutramine. Obesity Research, 3, 317 S.CrossRefGoogle Scholar
  57. Sarlio-Lähteenkorva, S., Stunkard, A. J. & Rissanen, A. (1995). Psychosocial factors and quality of life in obesity. International Journal of Obesity, 19 (Suppl. 6), S1–S5.PubMedGoogle Scholar
  58. Schlundt, D., Hill, J., Pope-Cordle, J., Arnold, D., Virts, K. & Kathan, M. (1993). Randomized evaluation of a low fat ad libitum carbohydrate diet for weight reduction. International Journal of Obesity, 17, 623–629.PubMedGoogle Scholar
  59. Schneider, R. (1996). Relevanz und Kosten der Adipositas in Deutschland. Ernährungs-Umschau, 43, 369–374.Google Scholar
  60. Seidell, J.C. Obesity in Europe. Scaling an epidemic. International Journal of Obesity, 19, S1–S4.PubMedGoogle Scholar
  61. Shah, M., McGovern, P., French, S. & Baxter, J. Comparison of low fat, ad libitum complex-carbohydrate diet with a low-energy diet in moderately obese women. American Journal of Clinical Nutrition 59, 980–984.PubMedGoogle Scholar
  62. Skender, A et al. (1996). Comparison of two-year weight loss trends in behavioural treatments of Obesity. Diet, exercise and combination interventions. Journal of the American Dietetic Association, 96, 342–346.PubMedCrossRefGoogle Scholar
  63. Stern, J. S., Hirsch, J., Blair, S. N., Foreyt, J. P., Frank, A., Kumanyika, S. K., Madans, J. H., Marlatt, G. A., St. Jeor, S. T. & Stunkard, A. J. (1995). Weighing the options. Criteria for evaluating weight-management programs. The Committee to Develop Criteria for Evaluating the Outcomes of Approaches to Prevent and Treat Obesity. Obesity Research, 3, 591–604.PubMedCrossRefGoogle Scholar
  64. Stunkard, A. J., Harris J. R., Pedersen, N. L. & McClearn, G. E. (1990). The bodymass index of two twins who have been reared apart. New England Journal of Medicine, 322, 1483–1487.PubMedCrossRefGoogle Scholar
  65. Stunkard, A. J. & Messick, S. (1985). The three-factor eating questionnaire to measure dietary restraint, disinhibition and hunger. Journal of Psychosomatic Research, 29, 71–83.PubMedCrossRefGoogle Scholar
  66. Stunkard, A. J. & Pudel, V. (1989). Adipositas. In Th. v. Uexküll (Hrsg.), Psychosomatische Medizin (4. Aufl.). München: Urban & Schwarzenberg.Google Scholar
  67. Swinburn, B. & Ravussin, E. (1993). Energy balance or fat balance? American Journal of Clinical Nutrition, 57, 766–771.Google Scholar
  68. Toubro, S. & Astrup, A. (1997). Randomised comparison of diets for maintaining obese subjects weight after major weight loss. Ad lib, low fat, high carbohydrate diet versus fixed energy intake. British Medical Journal,314,29–33.PubMedCrossRefGoogle Scholar
  69. Tremblay, A., Desprès, J.-R, Maheux, J. et al. (1991). Normalization of the metabolic profile in obese women by exercise and a low fat diet. Medicine and Science in Sports and Exercise, 23, 1326–1331.PubMedCrossRefGoogle Scholar
  70. Troiano, R. P., Flegal, K. M. et al. (1995). Overweight prevalence and trends for children and adolescents. Archives of Pediatrics and Adolescent Medicine, 149, 1085–1091.PubMedCrossRefGoogle Scholar
  71. Tucker, L. A. & Kano, M. J. (1992). Dietary fat and body fat. A multivariate study of 205 adult females. American Journal of Clinical Nutrition, 56, 616–622.PubMedGoogle Scholar
  72. U.S. Department of Health and Human Services and U.S. Department of Agriculture (1995). Dietary Guidelines for Americans 1995 (4th edn.). Washington.Google Scholar
  73. Wadden, T. A. (1993). The treatment of obesity. An overview. In Stunkard, A. J., Wadden, T. A. (Eds.), Obesity. Theory and therapy (2nd edn.). New York: Raven Press.Google Scholar
  74. Westenhöfer, J. (1992). Gezügeltes Essen und Störbarkeit des Eßverhaltens. Göttingen: Hogrefe.Google Scholar
  75. Westerterp, K. R., Verboeketvan de Venne, W. P. H. G., Westerterp-Plantenga, M. S., Velthuis-te Wierik, E. J. M., de Graaf, C. & Weststrate, J. A. (1996). Dietary fat and body fat. An intervention study. International Journal of Obesity, 20, 1022–1026.PubMedGoogle Scholar
  76. Weststrate, J. A. (1992). Effect of nutrients on the regulation of food intake. Unilever Research Laboratorium Vlaar-dingen. Unilever Information Material, Vlaardingen.Google Scholar
  77. Wirth, A. (1997). Adipositas — Epidemiologie, Ätiologie, Folgekrankheiten, Therapie. Berlin: Springer.Google Scholar
  78. Wolf, A. M., Colditz, G. A. (1996). Social and economic effects of body weight in the United States. American Journal of Clinical Nutrition, 63, 466S–469S.PubMedGoogle Scholar
  79. Young, T., Palta, M., Dempsey, J., Skatrud, J., Weber, S. & Badr, S. (1993). The occurence of sleep disordered breathing among middle aged adults. New England Journal of Medicine, 328, 1230–1235.PubMedCrossRefGoogle Scholar
  80. Zhang, Y., Proenca, R., Maffei, M., Barone, M., Leopold, L. & Friedman, J. M. (1994). Positional cloning of the mouse obese gene and its human homologue. Nature, 372, 425–432.PubMedCrossRefGoogle Scholar

Weiterführende Literatur

  1. Ellrott, T. & Pudel, V. (1998). Adipositastherapie. Aktuelle Perspektiven (2. Aufl.). Stuttgart: Thieme.Google Scholar
  2. Pudel, V., & Westenhöfer, J. (1997). Ernährungspsychologie — Eine Einführung (2. Aufl.). Göttingen: Hogrefe.Google Scholar
  3. Stunkard, A. J., & Wadden, T. A. (Eds.) (1993). Obesity.Theory and therapy (2nd edn.). New York: Raven Press.Google Scholar
  4. Westenhöfer, J. (1992). Gezügeltes Essen und Störbarkeit des Eßverhaltens. Göttingen: Hogrefe.Google Scholar
  5. Wirth, A. (1997). Adipositas — Epidemiologie, Ätiologie, Folgekrankheiten, Therapie. Berlin: Springer.Google Scholar

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© Springer-Verlag Berlin Heidelberg 2000

Authors and Affiliations

  • Volker Pudel

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