The outpatient day clinic therapy program for 8 weeks includes:

• On average, 6 therapeutic hours per week (group and individual psychotherapy, occupational therapy)
• Physiotherapy and sports therapy, both individually and in groups, 4 hours weekly
• Progressive muscle relaxation training according to Jacobson
• Self-assertiveness training according to Ullrich (learning to express desires and needs, setting boundaries) 1 hour weekly
• Computer-based training methods 1 hour weekly to objectify cognitive deficits

We place special emphasis on:

• Weight loss (700g per week), otherwise increased physical activity as part of sports therapy
• Keeping food logs and weight monitoring, but no dieting
• Building adequate social behavior in the group
• Video confrontations (alteration of body image distortions)
• Exposure exercises (eating in a restaurant) and attempts to regulate eating behavior through food logs and rhythmization
• Significant increase in daily physical activity habits
• Initiating social medical measures (changing work situation, more movement, altering exercise habits through long-term goals)

If indicated, pharmacological treatments, e.g., with Xenical/Reductil, may be used, in consultation with the treating physicians. Consultative advice regarding gastric banding may also be arranged upon discussion.

Individual Therapy Offer

Weight management program and individual therapy as needed.

• Initiating weight loss until the defined target weight is reached
• Prevention of sequelae through continuous medical treatment (ECG, lab tests, weight measurements)
• Motivation for a deeper understanding of the causes of obesity

To this end, we first work in an initial process phase:

• On therapy motivation
• On compliance (keeping food logs, seeking alternative reinforcers)
• On a deeper understanding of the problem and disease connections
• On access to physical experience through sports and physiotherapy

This first process phase can extend over a longer period, often throughout the entire 8-week duration. This means that symptom freedom may not be achieved, but awareness for further therapeutic steps will have been established.

Depending on the personality structure and cognitive abilities, work may also be done on introspection ability, confrontational ability, and conflict resolution skills.

Scientifically Expected Success Rate

According to strict criteria (weight loss over 1 year) in outpatient treatments for obesity (Focus), the following results have been observed:

• Behavioral medical treatments for obesity (Comprehensive lifestyle therapies) lead to an average weight loss of 8kg over 1 year, with a weight gain of 2-4 kg in the following year (Hensrud, D., 2001).
• Weight programs involving partners are more effective than individual programs in reducing weight (Black et al., 1990)
• Diets result in an average weight gain of 1kg after 1 year (yo-yo effect), but they reduce triglyceride and cholesterol levels (Klein, 2001).
• Adipex reduces weight by 7.9kg, Reductil by 4.3kg, and Xenical by 3.4kg after 1 year (Glazer, 2001).
• Gastric bypass leads to an average weight loss of 27kg, although the long-term consequences are still unclear, and complications occur in about 30% of patients (Dixon and O’Brian, 2002).
• Intragastric balloons lead to an average weight loss of 15kg after 7 months (Evans, 2001).