Obesitology is a field that focuses on obesity diagnosing and on its conservative, non-operative treatment. Conservative treatment takes place at our Out-patient Ward. Before the first examination with the obesitologist it is necessary to fill out several forms, for example an anamnesis form, form of your eating habits, graph of your weight history and list of your meals for the last seven days. These forms can be downloaded (http://www.iscare.cz/dotazniky.html) from the internet, or you can pick them up at our reception.

The treatment commences with a complex introductory internist examination that covers blood taking, detailed anamnesis aimed at eating habits, analysis of your weight history, evaluation of your meals for seven days, physical check-up, examination of your body fat tissue. This is done by measuring the thickness of skin folds by calipers and finding your weight by bioimpendance weighing-machine, and we also do ECG, if needed.

What Can an Obesitologist Do?

The goal of the treatment is a marked decline in weight, which should then be kept long-term – only then the health risks can be lowered. At the beginning, a realistic, achievable goal must be set; otherwise the patients lose their motivation. Naturally, we also treat the complications of obesity. The way of treatment is indicated according to the specific needs of the patient, in co-operation with other specialists who take part in the treatment of obesity. What follows are regular check-ups and adjustments in treatment in line with the decrease of weight.

The basis of a success is close co-operation of the patient who must realize that the treatment is long-term, in effect, life-long. The weight is lowered step by step, about 0.5–1 kg per week to prevent a yo-yo effect. If the long-term reduction regimen is chosen, we recommend a weigh loss of 1–2 kgs per month. Once the realistic goal is achieved the regimen is adjusted in such a way that the new, lower weight could be maintained.

The introductory examination by obesitologist, check-ups with physicians and dietitian, psychologist or surgical treatment is fully covered by health insurance companies together with the surgical treatment. Pharmacotherapy is covered partly by health insurance companies, depending on the specific case. The patients are asked to make their appointments for a specific time through our reception.

Diet

A diet is “tailor made” for each individual patient. Generally, we lower an energetic intake by about 500-600 kcal/day (2000-2500 kJ/day), trying to split the meals into 4-5 daily portions. It is necessary to keep a detailed list of everything that goes into the mouth. The diet should be varied, with a sufficient intake of quality proteins, all essential amino-acids, minerals, vitamins and micronutrients. When it comes to individual parts of our nutrition, it should consist of 55% carbohydrates, especially complex carbohydrates, such as bread, rice, pasta and potatoes. We try to avoid all kinds of simple sugar (beet root, sugar cane).

To satisfy the craving for a sweet taste, artificial sweeteners can be used, e.g. aspartame. Fats should constitute maximum 30% of the incoming energy where at least 2/3 of these fats will be of vegetable origin of from fish. We have to alert to the high content of fat in the so-called lean-meat sausages, meat and milk products! When it comes to meat, we usually choose from chicken, turkey, rabbit or fish meat. As for sausages, sometimes we can allow chicken or rabbit ham and avoid all the others – because of their high content of fat. Alternatively, soya meat can be used.

Another part of our nutrition are proteins, namely about 15%. Low-fat milk and meat products and legumens (especially soya) are sources of high quality proteins. It is wise to choose only low-fat milk products. An inseparable part of our nutrition is fiber, which is mostly found in vegetables, fruit and whole grain bread; 20-30 grams of fiber are recommended per day. Vegetables are low in energy, and thus we can eat it basically without any limit. However, it is better to choose fruit with lower content of sugar.

Water intake is also important. We should drink at least 2 liters of liquids per day, without sugar or with an artificial sweetener. We do not put limits on tea or coffee if the patient has no other reasons to avoid them.

Physical Activity

It is the physical activity that brings positive, pleasant experiences into our lives. And that’s why we put first emphasis on changes of physical activities when trying to change a life-style, of course, with a view to the possibilities of the patients and their health.

Adequate movement together with a healthy nutrition heightens the possibilities of the reduction regiment and helps alleviate the health-risks. Movement intensifies metabolism, breaks down the superfluous fat and prevents the loss of muscular matter that otherwise happens at reducing diet programs. It is important to intensify our every day physical activity in a nonviolent way. Thus, it is important to choose an activity that will be fun for you and will be suitable for you in every way. If you are not used to moving at all, begin slowly but do it regularly.

Each activity where energy expenditure is higher than energy input will have a positive effect. If it is not necessary, don’t drive to work, get off the bus 1 – 2 stops earlier and then walk the rest, walk upstairs instead of using a lift, have several minutes of a walk every day. Try to find a reason to move wherever you are. A more demanding physical activity should best be done three times a week.

A physical activity could be broken down into an AEROBIC exercise and STRENGTHENING.

Aerobic activities include cycling, stationary bicycle, spinning, swimming, tai-chi, roller-skating, golf, jogging, treadmill, tennis, squash, fast walk, tourism, skiing. During aerobic activities the fats are burned and, id done regularly and with sufficient intensity, there is a real weight loss. By strengthening the body is shaped and becomes firmer. In case of a significant weight loss skin folds are formed and that’s why exercise and namely strengthening plays an important part, so that the body doesn’t only lose weight but becomes firmer, as well. Thus, an ideal combination is strengthening together with aerobic exercises.

Exercise should become an important part of your life since it makes a big positive impact on our lives. We co-operate with physiotherapists in our centre in this field.