[Evidence based therapy of obesity]

For medical reasons, subjects with a BMI > or =30 kg/m(2) or a BMI > or =25 kg/m(2) and comorbidities such as type 2 diabetes mellitus should be considered for participation in a weight loss program. At present, there is a broad spectrum of measures to reduce body weight which have been validated in randomized controlled trials. The primary target of all intervention programs is to change lifestyle in order to establish an adequate calorie intake and an increase in physical activity. Other more aggressive options to escalate the efforts for reducing body weight include very low calorie diets, weight-lowering drugs and for the extreme forms of obesity surgical techniques. The treatment should be tailored to the "real world" and wishes of the individual patient. Patient empowerment is essential to achieve long-term self management of the weight problem. To effectively control the obesity epidemic it is of critical importance to establish preventive measures in the society. There is an urgent need to improve the structural prerequisites for a better treatment of people with overweight/obesity.