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Background: The high prevalence of obesity (24% of the adult population) and its adverse effects on health call for effective prevention and treatment., Method: Pertinent articles were retrieved by a systematic literature search for the period 2005 to 2012. A total of 4495 abstracts were examined. 119 publications were analyzed, and recommendations were issued in a structured consensus procedure by an interdisciplinary committee with the participation of ten medical specialty societies., Results: Obesity (body-mass index [BMI] ge;30 kg/m2) is considered to be a chronic disease. Its prevention is especially important. For obese persons, it is recommended that a diet with an energy deficit of 500 kcal/day and a low energy density should be instituted for the purpose of weight loss and stabilization of a lower weight. The relative proportion of macronutrients is of secondary importance for weight loss. If the BMI exceeds 30 kg/m2, formula products can be used for a limited time. More physical exercise in everyday life and during leisure time promotes weight loss and improves risk factors and obesity-associated diseases. Behavior modification and behavioral therapy support changes in nutrition and exercise in everyday life. With respect to changes in lifestyle, there is no scientific evidence to support any particular order of the measures to be taken. Weight-loss programs whose efficacy has been scientifically evaluated are recommended. Surgical intervention is more effective than conservative treatment with respect to reduction of bodily fat, improvement of obesity-associated diseases, and lowering mortality. Controlled studies indicate that, within 1 to 2 years, a weight loss of ca. 4 to 6 kg can be achieved by dietary therapy, 2 to 3 kg by exercise therapy, and 20 to 40 kg by bariatric surgery., Conclusion: There is good scientific evidence for effective measures for the prevention and treatment of obesity.

Unlabelled: We assessed the effect of a weight management programme on body weight, body mass index (BMI), and fitness in obese children and adolescents. The study was designed as a longitudinal, non-randomised, clinical experience of a 3 and 6 month combined dietary-behavioural-exercise intervention. A total of 177 obese children (age 6-16 years) participated in the 3 month programme, of whom 65 completed the 6 month intervention. A group of 25 age- and maturity-matched obese children who did not participate in the structured programme served as controls. Body weight, BMI, and fitness were evaluated at baseline, and after the 3 and 6 months intervention. Body weight and BMI were significantly reduced ( P<0.05), and endurance time significantly increased ( P<0.0005) following the 3 months intervention. Obese children who continued the programme for 6 months maintained the decrease in BMI and further improved endurance time. In contrast, obese children who did not participate in the structured programme gained weight, increased their BMI, and improved fitness less significantly. Gender, pubertal status, and the degree of obesity had no influence on BMI changes. Children without parental overweight had significantly greater decreases in BMI compared to children of obese parents., Conclusion: a combined, structured multidisciplinary intervention for childhood obesity results in decreased body weight, decreased body mass index and improved fitness.

Objectives: Weight gain is a consistent sequela of smoking cessation. A successful intervention might attract smokers who fear weight gain. If the gain causes smoking relapse, such an intervention might reduce smoking relapse risk., Methods: Using a sample of 158 smokers who completed a 2-week smoking treatment program, we compared an innovative weight gain prevention intervention with both a nonspecific treatment and standard treatment. Subjects were assessed on weight and smoking behavior and followed for 1 year., Results: A disturbing, unexpected finding was that subjects in both the innovative and nonspecific conditions had a higher risk of smoking relapse than did standard treatment subjects. Some differences were observed between abstinent and smoking subjects in weight gain by treatment condition., Conclusions: Both active interventions may have been so complicated that they detracted from nonsmoking. Also, caloric restriction may increase the reinforcing value of nicotine, a psychoactive drug, thereby increasing smoking relapse risk. The magnitude of weight gain after smoking cessation may not merit interventions that increase smoking risk. Perhaps attitudinal modifications are the most appropriate.

This study evaluated the psychological effects of aerobic conditioning in 40 moderately obese, sedentary women participating in a 12-week behavioral weight loss program. Participants were randomly assigned to a no-exercise or moderate walking condition. Emotional impact of the treatment was assessed in two ways: (1) Subjects reported subjective mood prior to each eating episode and (2) the SCL-90-R was administered before and after the program. Exercisers lost more weight and body fat than non-exercisers. Both groups of subjects showed numerous improvements in mood as a result of participating in the weight loss program. Exercise had no specific differential effect on emotions as measured by daily mood ratings or the SCL-90-R. Exercise did not appear to add appreciably to the psychological benefits of losing weight in this sedentary obese population. Future studies utilizing longer periods of aerobic exercise training, larger sample size, and exercise specific measures are recommended.

The achievement of chronic blood pressure (BP) control in persons with mild hypertension is of central strategic concern in the prevention of hypertension-related morbidity and mortality. Epidemiologic and longitudinal studies suggest that regular participation in physical activity may be beneficial both in preventing hypertension and in lowering an already elevated BP. Moreover, preliminary analyses from our center suggest that cardiorespiratory fitness and, by inference, aerobic exercise may be of benefit in reducing mortality rates in hypertensive patients. When prescribing exercise with the intention of reducing an elevated BP and attenuating the risk for coronary artery disease, several factors must be considered to optimize the likelihood of a safe and effective response. These factors include specific safety aspects, and the type, frequency, intensity, and duration of exercise. In this respect, we recommend that aerobic exercise be performed at an intensity corresponding to 55 and 85% of the maximal heart rate and that the duration and frequency of training be modulated to achieve a weekly energy expenditure of between 14 and 20 kcal/kg of body weight. For those patients who require drug therapy, the interaction between the specific antihypertensive agent and exercise must also be considered.