Bei Erwachsenen ist ein Erfolg in der Behandlung der Adipositas nur in ungefähr 10% der Fälle zu erwarten, sodass der Prävention und Therapie von Adipositas im Kindes- und Jugendalter eine hohe Bedeutung zukommen sollte. Zu den bekannten proximalen und distalen Risikofaktoren gehören eine hohe Kalorienaufnahme, körperliche Inaktivität, Übergewicht in der Familie, ein niedriger sozioökonomischer Status und Migrationshintergrund. Erfolgreiche Präventionsprogramme müssen psychosoziale Rahmenbedingungen mit einbeziehen und für diese gesellschaftlichen Gruppen spezifische Interventionen anbieten. Dies gilt auch für den Bereich der ambulanten und stationären Adipositastherapie bei Kindern und Jugendlichen. Auch wenn die kognitive Verhaltenstherapie einer alleinigen Lebensstiländerung überlegen ist und der Gewichtsverlust während der Behandlung höher ist, gilt eine langfristige Stabilisierung des Körpergewichts über den Therapiezeitraum hinaus als ungewiss. Dies weist darauf hin, dass die Rückkehr in ein Umfeld, das Adipositas fördert, als Risikofaktor angesehen werden muss. Nachhaltig erfolgreiche Behandlungsprogramme für Kinder und Jugendliche zielen deshalb auch auf die Verhaltensänderung von Eltern; in manchen Fällen wirkt sich sogar die alleinige Behandlung der Eltern vergleichbar positiv auf die Gewichtsreduktion der Kinder aus wie die gemeinsame Behandlung von Eltern und Kindern. Weitere übergewichtsfördernde Faktoren wie Fast Food, zuckerhaltige Limonaden, zu wenig Bewegung und ein hoher Fernseh- und Internetkonsum werden häufig ursächlich diskutiert. Inwiefern hier staatliche Regulierungen über Steuern bzw. Verbote erfolgreich sein könnten, gilt es noch zu untersuchen. Ein mangelndes Problembewusstsein innerhalb der Familie, an der Schule oder in anderen sozialen Gefügen würde diese Anstrengungen jedoch zunichtemachen, ebenso wie industrielle Kräfte, denen der wirtschaftliche Erfolg wichtiger ist als die Verantwortung für die Gesundheit der Gesellschaft.

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