Mühlig Yvonne, Remy Miriam, Holle Rolf, Scherag André, Wabitsch Martin, Hebebrand Johannes
Klinik für Psychiatrie, Psychosomatik und Psychotherapie des Kindes- und Jugendalters, LVR-Klinikum Essen, Universität Duisburg-Essen.
Institut für Gesundheitsökonomie und Management im Gesundheitswesen, Helmholtz Zentrum München Deutsches Forschungszentrum fur Umwelt und Gesundheit, Neuherberg.
Psychother Psychosom Med Psychol. 2019 Dec;69(12):490-498. doi: 10.1055/a-0829-1995. Epub 2019 Apr 3.
In clinical care, unemployed youths have limited access to available obesity treatments including obesity surgery. With the implementation of a specialized obesity outpatient unit in cooperation with five German job-centers we aim to prove whether unemployed youths are interested in obesity treatment and how they adhere to a multilevel obesity treatment in terms of participation rates.
Youths (aged 15.0-24.9 years) with a body-mass-index (BMI) ≥30 kg/m were initially offered an individualized patient information concerning obesity treatment on the premises of the job-center. If interested, youths were included in the multicomponent treatment program (6 sessions). Those who participated in a minimum of 5 out of 6 treatment sessions were offered access to a preparation course (4 sessions) and an individualized evaluation of the indication for obesity surgery.
Between 2012 and 2017, 83 youths (mean age 21.1 years, BMI 48.1 kg/m, BMI 35.0-39.9 kg/m: N=7, ≥40 kg/m: N=71) were enrolled in the treatment program. 34 participated in ≥5/6 sessions in the multicomponent obesity treatment and 20 expressed an interest in obesity surgery. To date, 11 adolescents underwent obesity surgery with a mean BMI reduction of 14.3 kg/m between 3 and 36 months after obesity surgery (excess weight loss 27.3%) vs. 3.8 kg/m between 6 and 48 months after treatment initiation in the group of youths who did not receive obesity surgery. 13 youths were integrated in the primary labor market.
Several unemployed youths accepted our treatment program and improved their health and vocational status in the course of their participation.
The implementation of a specialized obesity outpatient unit within German job-centers is a successful strategy to characterize this high-risk-group and to determine their individual treatment needs. This finding must be confirmed with a larger sample size and by evaluating the long-term course of treatment.
在临床护理中，失业青年获得包括肥胖症手术在内的现有肥胖症治疗的机会有限。通过与五个德国就业中心合作设立一个专门的肥胖症门诊单元，我们旨在证明失业青年是否对肥胖症治疗感兴趣，以及他们在参与率方面如何坚持多层次肥胖症治疗。
体重指数（BMI）≥30 kg/m²的15.0至24.9岁青年最初在就业中心的场所获得有关肥胖症治疗的个性化患者信息。如有兴趣，青年将被纳入多组分治疗计划（6次疗程）。在6次治疗疗程中至少参加5次的青年将获得参加预备课程（4次疗程）的机会以及对肥胖症手术适应症的个性化评估。
2012年至2017年期间，83名青年（平均年龄21.1岁，BMI 48.1 kg/m²，BMI 35.0 - 39.9 kg/m²：N = 7，≥40 kg/m²：N = 71）参加了治疗计划。34人参加了多组分肥胖症治疗的≥5/6次疗程，20人表示对肥胖症手术感兴趣。迄今为止，11名青少年接受了肥胖症手术，肥胖症手术后3至36个月平均BMI降低14.3 kg/m²（超重减轻27.3%），而未接受肥胖症手术的青年组在治疗开始后6至48个月平均BMI降低3.8 kg/m²。13名青年融入了初级劳动力市场。
一些失业青年接受了我们的治疗计划，并在参与过程中改善了他们的健康和职业状况。
在德国就业中心设立专门的肥胖症门诊单元是一种成功的策略，可对这一高风险群体进行特征描述并确定他们的个体治疗需求。这一发现必须通过更大的样本量以及评估长期治疗过程来加以证实。
