[Closing the gap in conservative obesity therapy: a fully health insurance-financed obesity program - Prospective analysis of clinical real world data]. / Ausweg aus der Versorgungslücke: Voll Krankenkassen-finanzierte konservative Adipositas-Therapie.

BACKGROUND: The obesity treatment program "Leipziger Adipositasmanagement" is a long-term (i. e., four years long) conservative treatment program which is completely covered by a public health insurance company for patients with obesity grades 2 and 3 (i. e., body mass index > 35 kg/m2). Here we evaluate the effectiveness of the first part of the program which was on average 72 weeks long. METHODS: Body weight, body circumferences, metabolic and psychological parameters were collected prior to the start (t0) and after completion of the first part (t1). The whole first treatment part was completed by 243 persons. The analysis design was a prospective evaluation of clinical real world data. RESULTS: Treatment costs per patient were 2,022 € on average. There were significant clinically meaningful improvements from t0 to t1. On average, patients lost 5 kg (95 % confidence interval, KI 3.8 to 6.2 kg) or 4 % (KI 3.1 to 4.9 %) of their initial body weight. The hemoglobin A1c value decreased from 5.9 % to 5.6 % in all patients and from 6.7 % to 6.2 % in diabetic patients. Further metabolic (e. g., low density lipoprotein and total cholesterol) and psychological (e. g., quality of life) parameters improved significantly as well. CONCLUSIONS: The available real world data show, that an obesity treatment program, which is completely covered by a public health insurance company, can reach a clinically significant weight loss with metabolic improvements. The treatment program "Leipziger Adipositasmanagement" contributes to improving long-term treatment of obesity in Germany.

[Evaluation of the One-Year Multimodal Weight Loss Program DOC WEIGHT® 1.0 for Obesity Class II and III]. / Evaluation des einjährigen multimodalen Therapieprogramms DOC WEIGHT® 1.0 zur Gewichtsreduktion bei Patienten mit Adipositas Grad II und III.

According to treatment guidelines, treatment for obesity (body mass index [BMI]≥30.0 kg/m(2)) comprises nutritional, physical, and behavioral interventions. However, evidence-based programs for the treatment of severe obesity are rare. In an uncontrolled study, a total of 190 participants (BMI≥35.0 kg/m(2)) of the one-year multimodal treatment program DOC WEIGHT(®) 1.0 were assessed at pre- (t0) and post-intervention (t1) as well as at 1-year follow-up (t2). Results revealed significant improvements from t0 to t1 in body weight, waist circumference, eating disorder psychopathology, and quality of life that persisted to t2. Long-term multimodal outpatient treatment for severe obesity focusing on behavior modification is promising, however, high rates of loss to follow-up limit explanatory power. To improve evidence, consecutive evaluation is intended.