| Matthias Jung |
COLOGNE, Germany (dpa) – Christine Graf knows that eating in moderation isn’t always easy.
“Going without food is torture when you’re constantly bombarded with messages urging you to eat,” says Graf, a physician and professor at the German Sport University’s Institute for Kinesiology and Neuroscience in Cologne.
Graf treats children and adolescents who have failed at moderation plans and suffer from obesity, a disorder involving an excessive amount of body fat. She gives them exercise therapy to help them lead healthier lives.
“Only the desperate ones come to us,” Graf remarked.
Obesity is typically indicated by a body mass index (BMI) of 30 or greater. A person 180 centimetres tall and weighing about
130 kilogrammes has a BMI of 40, for example.
Obesity increases the chances of developing a number of potentially serious health conditions, including type 2 diabetes, cardiovascular problems and orthopaedic complaints.
Graf’s team takes what it calls a “multimodal” approach.
Because overweight people tend to exercise too little in addition to eating too much – and too many fatty foods – the young patients undergo an exercise programme along with a change in diet. They also receive psychological counselling.
Their exercise therapy takes place twice a week for 11 months. Every four weeks, their parents join in.
The parents “are a very important factor”, noted exercise therapist David Friesen. The more support they give their children, the more successful the children are in slimming down, he said.
At the beginning, the emphasis is put on endurance-type sports since there’s a quick sense of achievement as endurance improves, Friesen pointed said. Strength training and games are taught later.
It is important, Friesen said, that children and adolescents learn how sports “affect the body and what we can accomplish with them”.
At the conclusion of the therapy, the young participants are placed in sports clubs.
Sports clubs are out of the question for many of the patients in the care of Manuel Enzenhofer, a specialist in psychosomatic medicine and psychotherapy at Stuttgart’s Buerger Hospital. Enzenhofer treats obese adults, particularly the most difficult cases.
For them, outpatient treatment has either been unsuccessful or is simply not feasible. Enzenhofer says many obese people have serious emotional problems that manifest themselves in anxiety and eating disorders.
Like Graf, Enzenhofer has his patients use food logs and step counters in their battle against obesity, but such measures are insufficient. So he also works “psycho-dynamically”, inquiring into the deeper, emotional causes of the disorder during therapy.
When a patient no longer suppresses negative feelings by eating, underlying problems and conflicts often come to the surface, Enzenhofer said. This is desired, he pointed out, since it presents an opportunity to overcome them.
Because adults, in contrast to adolescents, often haven’t engaged in athletic activities in a long time, their weight-loss programme can begin with exercises done while sitting. More strenuous exercises can be done later, Enzenhofer said.
It’s not a matter of short-term weight loss, he stressed, but of losing weight and then keeping it off. “That’s a lifelong task,” he said.
Patients should set realistic goals. Studies cited by a German medical journal, Der Nervenarzt, have shown that behavioural therapy and lifestyle changes lead to a average weight loss of 10 per cent, although this can be increased with nutritional and exercise training.
In Graf’s view, “successful” therapy isn’t necessarily measured merely in weight loss or a lower BMI, however.
Improved physical fitness is also a plus, she argued. When an overweight person exercises more and thereby boosts the percentage of muscle mass in his or her body, that too is a success, she said.