[Dietary approach to obesity]

Dietetic treatment of overweight has its limits in cases with morbid obesity (BMI > 40 kg/m2) or with disturbed eating habits (compulsive eating). In these cases surgery and cognitive treatment may play a role. Dietetic treatment is often sufficient in patients with moderate to severe overweight (BMI > 27 to 39 kg/m3). This includes in the first place identification of bad habits by evaluation of nutritional behaviour over 3 or 7 days. The most frequent mistakes are the jumping of a meal (mostly breakfast) and nibbling of snacks rich in fat between meals and omission of hypocaloric and voluminous food like fruit and vegetables. The lacking sensation of saturation which is fostered by rapid and automatic food intake, may also contribute to the maintenance of overweight. The first dietetic rules to be observed consist in a regular schedule for meals and-if necessary-snacks in between and the selection of a lipid-poor diet with particular attention to hidden fat. The meal should be turned into an enjoyable experience whenever possible without other concurrent activities.