[Obesity - clinical impact and therapeutic strategies]

Over the last 30 years the prevalence of overweight and obesity has sharply increased in western industrialized countries. Accordingly, in Germany 15% of the adult population can be regarded as obese. The association between adiposity and increased morbidity and mortality has been well established but the individual metabolic risk is mainly dependent on the distribution of adipose depots. During the last two decades knowledge of the pathophysiology of obesity has increased substantially. However, current therapeutic options including life-style modifications and a few anti-obesity drugs show overall disappointing results in long-term body weight control indicating the need for therapeutic improvements. For patients with morbid obesity surgical therapies (bariatric surgery) can be considered. While long-lasting weight control and decrease of adiposity-related morbidity and mortality has been demonstrated only for these procedures, after bariatric surgery patients also require long-term follow up and treatment.