[Therapeutic approaches for obesity and comorbidities in young immigrants]

The prevalence of overweight and obesity is higher in children and adolescents with a migrational background. However, if the country of origin is taken into account, the picture of these differences becomes more complex and more heterogeneous. Predictors for obesity and the ethnic differences are manifold and can be roughly differentiated into cultural, social and individual causes as well as into causes related to the process of acculturation. There are special problems in the long-term health care of obese adolescents with a migrational background. The most important are (1) treatment delay, (2) different concepts of a healthy (problematic) body weight, (3) barriers in diagnostics and treatment of rare secondary disorders and (4) puberty-related changes in lifestyle (increased media use, decreased physical activity and unfavourable daily routines). Therapeutic approaches are only sustainable and effective when the underlying concepts are multiprofessional and multimodal, and are embedded into the family and cultural contexts. Adolescents with a migrational background need culture-adapted nutrition, exercise and media consumption counselling. Such offers have to be (further) developed in accordance with family background, with youth culture and adolescent stage of development.