Overweight or obesity is the expression of a genuine and serious illness, a demonstrable effect of shortening the life span. Obesity has the same causes as all the diseases of civilization and, therefore, usually occurs with them together. The frequent combination of obesity with diabetes, musculoskeletal diseases, such as joints, muscles and spine, gallstone formation and thrombosis are some examples given. According to the statistics, an excess of 9 kilos of weight increases the mortality rate by 18%, while an additional increase of 27 kilograms in weight will increase the mortality rate by 67%. As per definition of obesity (BMI> ~ 30), there are 8.5% of obese Austrians, with 48% men and 42% of women covered. The census survey indicates that 14.5% of the Austrian population in general (60% men, 40% women) were overweight, where the Body Mass Index (BMI) reference range of 27.0 to 29.9 as the criterion for overweight is used. Even if one considers the international guidelines for assessment where the overweight BMI is between 25.0 and 29.9, about 42% of all Austrians are overweight. What is the Body Mass Index (BMI)? The standards for assessment of obesity were established for some years. BMI is calculated by dividing body weight in kilograms by the square of person’s height in meters. Applying the formula for a 92 kilogram person whose height is 1.78 meters, the BMI is calculated by the formula 92 / (1.78 x 1.78). The BMI thus calculated will come to 29.94, which falls in the overweight range of 25-30. The standard ranges are: BMI 20-25 – normal; BMI 25-30 – overweight; and BMI 30 and above – morbid obesity. Like the Stone Age man, the modern man’s metabolism requires lot of fat to absorb and store it in order to survive. Many diet forms and programs such as macro-biotics, Fit for Life, etc., are not recommended. On the other hand, any reduction diets, such as calorie-reduced-fat formula diet combinations would be meaningful in the case of obesity, the intake of energy from energy-rich consumption. On the other hand, there are two other options: eat less or exercise more. Both options, however, depend on behavioral pattern, and may prove to be ineffective. The body fat percentage, as different from BMI, increases with age. This is not a problem of age, but of a declining physical activity. One might, therefore, speak of movement behavior disorder as an eating disorder. Movement has insulin-like effect; moderate movements such as running 45 minutes twice a week and walking for 30 minutes per day will suffice. This results in a calorie deficit of 265 kcal per day, 9000 kcals in 34 days, which is a deficit of one kilogram of fat or ten kilograms in a year, without changing food habits.
When weight loss and exercise do not help, medications are indicted. Orlistat in a dose of 120mg daily 3x has a massive metabolic effect and leads to a significant reduction of oral anti-diabetics. Sibutramine, a substance with a very favorable side effect profile, may be included in a multidisciplinary treatment approach.