[Indications and results of an additional differentiated pharmacotherapy of obesity]

Despite frequently good early successes the several therapeutic methods of obesity show in general unsatisfactory long-term results with large numbers of recidivations. Considering non-existing causal-therapeutic possibilities in the present paper in reported on a complex and differentiated therapeutic programme in 549 obese persons. After an initial subtotal fasting cure of ca. 100 kcal/a day with gradual increase of diet in more than half the obese persons an additional differentiated pharmacotherapy was performed. The indications resulted above all from the frequent syntropy with diabetes mellitus (28%), arterial hypertension (23%) and hyperlipidaemia (14%). In 122 test persons (adipose patients with hyperlipoproteinaemia and extremely obese patients without essential factors of risk, respectively) a treatment with 2 x 50 microgram tri-iodothyronine--partly in combination with diuretics--was performed in intermittent and gradually decreasing dosage. Apart from a vast normalisation of the lipid parameters a reduction of weight from 32.6 +/- 14.8 kg could be achieved after 31 +/- 14 months. Of 131 adipose hypertensive patients 74 received additionally diuretics on account of increased water retention with also good long-term results concerning the reduction of weight and normalisation of blood pressure. The biguanides were a therapeutic enrichment particularly in the treatment of adipose elderly diabetics with obligatory diet. Apart from an improvement of the carbohydrate tolerance regularly a more intensive reduction of weight was obtained.