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Psychotherapie und Adipositas

Strategien, Herausforderungen und Chancen

Psychotherapy and obesity

Strategies, challenges and possibilities

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Zusammenfassung

Ein Fünftel der deutschen Bevölkerung ist von Adipositas betroffen, und die Prävalenz nimmt weiter zu. In Gewichtsreduktionsprogrammen spielt Psychotherapie eine wichtige Rolle. Vor allem verhaltenstherapeutische Strategien zur Veränderung des Lebensstils – das Bewegungs- und Ernährungsverhalten betreffend – sind etabliert und evidenzbasiert. Von besonderer Bedeutung ist Psychotherapie bei Motivationsproblemen, fehlender Gewichtsabnahme, Gewichtssteigerung oder psychischer Komorbidität. Liegt neben der Adipositas eine Binge-Eating-Störung vor, sollte primär die Essstörung im Behandlungsfokus stehen. Besonders wichtige Phasen der Therapie stellen die Phase der Initialisierung und Verstärkung der Motivation sowie die Phase der Aufrechterhaltung des Gewichtsverlusts dar. Neben klassischen Einzel- und Gruppentherapiesettings werden zunehmend internetbasierte Ansätze wichtig.

Summary

One fifth of the German population is obese with increasing prevalence. Psychotherapy plays an important role in weight loss programmes. Cognitive behaviour therapy, targeting lifestyle changes, including exercise and eating behaviour, is the evidence-based treatment of choice. Especially the lack of motivation or absence of weight loss, further weight gain or psychosocial burden makes psychotherapy essential. The treatment of a comorbid binge eating disorder should be initiated prior to focusing on weight loss. Remarkably difficult stages in the treatment of obesity are the initiation of changes as well as the maintenance of the achieved weight loss. Internet-based attempts will become increasingly important.

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Literatur

  1. Agras WS, Telch CF, Arnow B, Eldredge K et al (1995) Does interpersonal therapy help patients with binge eating disorder who fail to respond to cognitive-behavioral therapy? J Consult Clin Psychol 63(3):356–360

    Article  PubMed  CAS  Google Scholar 

  2. Allison DB, Faith MS (1996) Hypnosis as an adjunct to cognitive-behavioural psychotherapy for obesity: a meta-analytic reappraisal. J Consult Clin Psychol 64:513–516

    Article  PubMed  CAS  Google Scholar 

  3. Anderson JW, Konz EC, Frederich RC, Wood CL (2001) Long-term weight-loss maintenance:a meta-analysis of US studies. Am J Clin Nutr 74(5):579–584

    PubMed  CAS  Google Scholar 

  4. Arem H, Irwin M (2010) A Review of web-based weight loss interventions in adults. Obes Rev 12:236–243

    Article  Google Scholar 

  5. Becker S, Nieß A, Hipp A, Fritsche A et al (2006) Adipositas – eine interdisziplinäre Aufgabe. Ther Umsch 63(8):509–514

    Article  PubMed  CAS  Google Scholar 

  6. Becker S, Rapps N, Zipfel S (2007) Psychotherapie bei Adipositas – ein systematischer Review. Psychother Psychosom Med Psychol 57(11):420–427

    Article  PubMed  Google Scholar 

  7. Benecke A, Vogel H (2003) Gesundheitsberichterstattung des Bundes – Übergewicht und Adipositas. Robert Koch-Institut, Berlin

  8. Beutel M, Thiede R, Wiltink J, Sobez I (2001) Effectiveness of behavioral and psychodynamic in-patient treatment of severe obesity – first results from a randomized study. Int J Obes Relat Metab Disord 25(Suppl 1):96–98

    Article  Google Scholar 

  9. Brownley KA, Berkman ND, Seway JA, Lohr KN (2007) Binge eating disorder treatment: a systematic review of randomized controlled trials. Int J Eat Disord 40:337–348

    Article  PubMed  Google Scholar 

  10. Burke LE, Wang J, Sevick MA (2011) Self-monitoring in weight loss: a systematic review of the literature. J Am Diet Assoc 111(1):92–102

    Article  PubMed  Google Scholar 

  11. Carels RA, Darby L, Cacciapaglia HM, Konrad K et al (2007) Using motivational interviewing as a supplement to obesity treatment: a strepped-care approach. Health Psychol 26(3):369–374

    Article  PubMed  Google Scholar 

  12. Cooper Z, Doll HA, Hawker DM, Byrne S et al (2010) Testing a new cognitive behavioural treatment for obesity: a randomized controlled trial with three-year follow-up. Behav Res Ther 48(8):706–713

    Article  PubMed  Google Scholar 

  13. De Zwaan M, Friederich HC (2006) Binge-Eating-Störung. Ther Umsch 63:529–533

    Article  Google Scholar 

  14. Deutsche Adipositas-Gesellschaft, Deutsche Gesellschaft für Psychosomatische Medizin und Psychotherapie, Deutsche Gesellschaft für Ernährungsmedizin (2010) S3-Leitlinie Chirurgie der Adipositas. www.adipositas-gesellschaft.de/daten/ADIP-6–2010.pdf

  15. Deutsche Gesellschaft für Ernährung (2008) Ernährungsbericht. DGE

  16. DiMarco ID, Klein DA, Clark VL, Wilson GT (2009) The use of motivational interviewing techniques to enhance the efficacy of guided self-help behavioral weight loss treatment. Eat Behav 10(2):134–136

    Article  PubMed  Google Scholar 

  17. Douketis JD, Macie C, Thabane L, Williamson DF (2005) Systematic review of long-term weight loss studies in obese adults: clinical significance and applicability to clinical practice. Int J Obes 29:1153–1167

    Article  CAS  Google Scholar 

  18. Elliott CA, Tanofsky-Kraff M, Shomaker LB, Columbo KM et al (2010) An examination of the interpersonal model of loss of control eating in children and adolescents. Behav Res Ther 48(5):424–428

    Article  PubMed  Google Scholar 

  19. Frankenburg FR, Zanarini MC (2006) Obesity and obesity-related illnesses in borderline patients. J Pers Disord 20(1):71–80

    Article  PubMed  Google Scholar 

  20. Hauner H, Buchholz G, Hamann A et al (2007) Prävention und Therapie der Adipositas – Evidenzbasierte Leitlinie Adipositas der Deutschen Adipositas Gesellschaft, Deutschen Diabetes Gesellschaft und der Deutschen Gesellschaft für Ernährung. www.adipositas-gesellschaft.de/daten/Adipositas-Leitlinie-2007.pdf

  21. Herpertz S, Zipfel S, Zwaan M de (Hrsg) (2008) Handbuch Essstörungen und Adipositas. Springer, Heidelberg

  22. Katzer L, Bradshaw AJ, Horwath CC, Gray AR et al (2008) Evaluation of a „nondieting“ stress reduction program for overweight women: a randomized trial. Am J Health Promot 22(4):264–274

    Article  PubMed  Google Scholar 

  23. Kitzman-Ulrich H, Wilson DK, St George SM, Lawman H et al (2010) The integration of a family systems approach for understanding youth obesity, physical activity, and dietary programs. Clin Child Fam Psychol Rev 13(3):231–253

    Article  PubMed  Google Scholar 

  24. Kristal AR, Littman AJ, Benitez D, White E (2005) Yoga practice is associated with attenuated weight gain in healthy, middle-aged men and women. Altern Ther Health Med 11:28–33

    PubMed  Google Scholar 

  25. Miller WR, Benefield RG, Tonigan JS (1993) Enhancing motivation for change in problem drinking: a controlled comparison of two therapist styles. J Consult Clin Psychol 61(3):455–461

    Article  PubMed  CAS  Google Scholar 

  26. Pawlow LA, O’Neil PM, Malcolm RJ (2003) Night eating syndrome: effects of brief relaxation training on stress, mood, hunger, and eating patterns. Int J Obes Relat Metab Disord 27:970–978

    Article  PubMed  CAS  Google Scholar 

  27. Rand CS, Stunkard AJ (1983) Obesity and psychoanalysis: treatment and four-year follow-up. Am J Psychiatry 140(9):1140–1144

    PubMed  CAS  Google Scholar 

  28. Rieber N, Hilbert A, Teufel M, Giel KE et al (2010) Gewichtsstabilisierung nach Gewichtsreduktion: Eine kritische Bestandsaufnahme zu Prädiktion und Intervention. Adipositas 3:115–124

    Google Scholar 

  29. Saver DL, Robinson AH, Jo B (2010) Outcome from a randomized controlled trial of group therapy for binge eating disorder: comparing dialectical behavior therapy adapted for binge eating to an active comparison group therapy. Behav Ther 41(1):106–120

    Article  Google Scholar 

  30. Shaw K, O Rourke P, Mar C, Kenardy J (2009) Psychological interventions for overweight or obesity. The Cochrane Library 1

  31. Svetkey LP, Stevens VJ, Brantley PJ, Appel LJ (2008) Comparison of strategies for sustaining weight loss: the weight loss maintenance randomized controlled trial. JAMA 299(10):1139–1148

    Article  PubMed  CAS  Google Scholar 

  32. Tanofsky-Kraff M, Wilfley DE, Young JF, Mufson L et al (2010) A pilot study of interpersonal psychotherapy for preventing excess weight gain in adolescent girls at-risk for obesity. Int J Eat Disord 43(8):701–706

    Article  PubMed  Google Scholar 

  33. Tate DF, Wing RR, Winnett RA (2001) Using internet technology to deliver a behavioural weight loss program. JAMA 285:1172–1177

    Article  PubMed  CAS  Google Scholar 

  34. Telch CF, Agras WS, Linehan MM (2001) Dialectical behavior therapy for binge eating disorder. J Conslut Clin Psychol 69(6):1061–1065

    Article  CAS  Google Scholar 

  35. Teufel M, Giel KE, Zipfel S (2009) Telemedizin und Psychotherapie – Empathie durch das ferne Cyberspace? Psychother Psychosom Med Psychol 59(8):289–290

    Article  PubMed  Google Scholar 

  36. Teufel M, Schäffeler N, Zwaan M de, Graap H et al (2011) Internet use among patients with psychosomatic disorders: What are the health-related demands and needs? J Health Psychol (in press)

  37. Thomas D, Vydelingum V, Lawrence J (2011) E-mail contact as an effective strategy in the maintenance of weight loss in adults. J Hum Nutr Diet 24(1):32–38

    Article  PubMed  CAS  Google Scholar 

  38. Vocks S, Tuschen-Caffier B, Pietrowsky R, Rustenbach SJ et al (2010) Meta-analysis of the effectiveness of psychological and pharmacological treatments for binge eating disorder. Int J Eat Disord 43:205–217

    PubMed  Google Scholar 

  39. Wadden TA, Butryn ML (2003) Behavioral treatment of obesity. Endocrinol Metab Clin North Am 32(4):981–1003

    Article  PubMed  Google Scholar 

  40. WHO (2000) Obesity: preventing and managing the global epidemic Report of a WHO consultation. World Health Organ Tech Rep Ser 894 (i–xii):1–253

  41. Wilfley DE, Welch RR, Stein RI, Spurrell EB et al (2002) A randomized comparison of group interpersonal psychotherapy fort he treatment of overweight individuals with binge eating disorder. Arch Gen Psychiatry 59(8):713–721

    Article  PubMed  Google Scholar 

  42. Wiltink J, Dippel A, Szczepanski M, Thiede R et al (2007) Long-term weight loss maintenance after inpatient psychotherapy of severely obese patients based on a randomized study: predictors and maintaining factors of health behavior. J Psychosom Res 62(6):691–698

    Article  PubMed  Google Scholar 

  43. Wing RR, Phelan S (2005) Long-term weight loss maintenance. Am J Clin Nutr 82(Suppl 1):222–225

    Google Scholar 

  44. Wing RR, Tate DF, Gorin AA, Raynor HA et al (2006) A self-regulation program for maintenance of weight loss. N Engl J Med 355(15):1563–1571

    Article  PubMed  CAS  Google Scholar 

  45. Wiser S, Telch CF (1999) Dialectical behaviour therapy for binge eating disorder. J Clin Psychol 55(6):755–768

    Article  PubMed  CAS  Google Scholar 

  46. Wu T, Gao X, Chen M, Dam RM van (2009) Long-term effectiveness of diet-plus-exercise interventions vs diet-only interventions for weight loss: a meta-analysis. Obes Rev 10:313–323

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Medizinische Klinik VI, Psychosomatische Medizin und Psychotherapie, Universitätsklinikum Tübingen, Osianderstr. 5, 72070, Tübingen, Deutschland

    M. Teufel, S. Becker, N. Rieber, K. Stephan & S. Zipfel

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  1. M. Teufel
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  2. S. Becker
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  3. N. Rieber
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  4. K. Stephan
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  5. S. Zipfel
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Correspondence to M. Teufel.

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Teufel, M., Becker, S., Rieber, N. et al. Psychotherapie und Adipositas. Nervenarzt 82, 1133–1139 (2011). https://doi.org/10.1007/s00115-010-3230-2

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