Medical weight loss in obesity in Clinic Limberger

About the department

The Department for Obesity Treatment at the Clinic Limberger offers effective programs for people with morbid obesity, which is associated with numerous health risks and may lead to a reduction in life expectancy and a decrease in its quality. The weight loss programs are provided both on an inpatient and outpatient basis. These are based on the following three main principles: nutrition correction, physical activity, and the rejection of negative behavioral habits (the development of self-discipline and self-confidence). Standard treatment programs include counseling, a comprehensive medical check-up, a customized exercise program, a customized nutrition plan, psychological group therapy, and other weight loss measures. In complex cases, the department's patients are recommended for a bariatric intervention, for example, intragastric balloon placement or gastric banding. The department's patients are treated in close cooperation with colleagues from the specialized Obesity Center Süd-West at the Schwarzwald-Baar Hospital. At every stage of the patient's struggle for a slim and healthy body, he receives the necessary support and psychological assistance, which is also an integral part of a successful therapeutic process. The department is headed by Prof. Dr. med. Stefan Beckert.

All outpatient and inpatient obesity treatment programs offered in the department have specific goals. The priority task is long-term lifestyle modification. In the first stages of therapy, a patient should lose at least 1 kg per week. After the beginning of weight loss, the patient's general health improves, the symptoms of concomitant diseases regress, the physical condition and psycho-emotional state improve, the quality of life increases, etc. Particular attention is paid to the preservation of the results obtained and the patient's mood for further adherence to a healthy lifestyle.

The department's outpatient programs include the specialized M.O.B.I.L.I.S. program for patients with morbid obesity and a body mass index of 30 to 40 kg/m2 (in collaboration with the University of Freiburg), as well as the BALANCIA weight loss program developed for people with low overweight (a body mass index of up to 30 kg/m2), which is being implemented in collaboration with the ADTV Dance School of Christian Seidel.

All therapeutic measures meet the criteria of the German Obesity Society. Morbid obesity is a rather complex pathological condition that requires an individual approach and interdisciplinary treatment. Any treatment program is implemented with the participation of nutritionists, psychotherapists, physiotherapists, and professional sports trainers. When treating patients with comorbidities, specialists from related disciplines are also involved, for example, endocrinologists, cardiologists, orthopedists, etc.

An integral part of therapy is a preliminary comprehensive check-up. The department's patients undergo electrocardiography, including a stress test, laboratory tests, 24-hour blood pressure measurement, and ultrasound and X-ray scans. With appropriate clinical indications, echocardiography, Doppler ultrasonography of the blood vessels, obstructive sleep apnea screening, and other tests are carried out. Diagnostic procedures allow doctors to assess the patient's general health, detect concomitant diseases, and develop optimal tactics for the safe fight against excess weight.

Nutrition plays a key role in the treatment of morbid obesity. The department employs experienced nutritionists who make sure that each patient follows an individually developed diet. The medical facility has training kitchens where practical cooking classes are held. In addition, patients are taught to keep a "food diary" and receive training on reasonable food purchasing.

Eating a healthy diet is accompanied by regular physical activity, such as training in modern gyms, swimming in the pool, walking in the fresh air, cycling, etc. A complex of physical exercises is also selected individually based on the patient's indicators of their general health condition and stamina. Performing physical exercises takes place in groups for several hours a day under the supervision of a specialist.

Twice a week, the department's patients attend group sessions with a psychologist. The task of the psychologist is to motivate patients to change their lifestyles, follow a diet, and exercise in the gym. In addition, it is important for a specialist to develop self-discipline in the patient so that, after completing the course of treatment and achieving a good result, he does not return to his former way of life. Psychologists often strive to help the patient solve the problem of complexes and self-doubt due to excess weight. Some patients with morbid obesity suffer from depression and anxiety disorders. In such cases, a psychologist works with the patient individually. Twice a week, patients practice relaxation therapy: autogenic training and Jacobson's progressive muscle relaxation.

A decisive factor in achieving a successful outcome is the patient's motivation. Upon admission to the department, the patient fills out a written form in which he undertakes to follow all the rules and stages of treatment. If the rules are not followed, cooperation with the patient will be terminated. The goal of therapy, the treatment plan, and the diagnosis are discussed in detail with the patient and recorded in writing. The treatment's success is confirmed by regular weight control and an assessment of the physical condition.

Inpatient obesity treatment is indicated for patients in the following clinical cases:

• Patients who failed to achieve the desired results with outpatient treatment and who require urgent weight loss
• Patients whose obesity has led to the development of somatic complications
• Patients who experience mental disorders due to their overweight (for example, problems with self-esteem, problems with interpersonal relationships, social isolation, or depression)
• Patients who need psychological care to change eating behavior and normalize weight (the detection of causal factors and behavioral situations and the development of strategies to overcome them)
• Patients who require bariatric surgery
• Patients after bariatric surgery
• Other clinical cases

A standard inpatient obesity treatment program includes the following fundamental principles:

• Lifestyle modification (group therapy with a psychologist twice a week)
  • Changing eating habits and increasing physical activity
  • Eating behavior analysis
  • Mutual motivation of group members, self-esteem improvement, and establishment of social contacts
  • Self-discipline improvement
  • Individual conversations for treating concomitant mental disorders, such as depression and anxiety disorders (if necessary)
  • Autogenic trainings
• Diet therapy (balanced diet with three meals a day – 1,200 kcal per day)
  • Nutrition classes, in which the patient receives information about the proper foods (4 hours during the entire period of the inpatient program)
  • Training in a special kitchen that allows patients to maintain a proper diet after returning home (8 hours during the entire period of the inpatient program)
  • Training to purchase food (3 hours during the entire period of the inpatient program)
  • Nutrition control training
  • Individual counseling with a nutritionist (if necessary)
• Physical therapy (development of motivation for constant physical activities in patients)
  • Daily group training to develop stamina of at least two and a half hours (the intensity of sports therapy depends on the patient's ability to exercise previously determined with ergometry), including cycling, hiking, walking, swimming, general gymnastics, and water aerobics
  • Special back training (1 time per week)
  • Theoretical classes on physical exercise (1 time per week)
  • Pilates, spinal gymnastics, breathing exercises, Nordic walking, fitness, and gymnastics with music and outdoor games (optional and with appropriate indications)
• Follow-up care and control of the results obtained