Objective: To investigate the impact of current mental disorders on weight loss with special consideration of depressive and/or anxiety disorders as well as binge eating behavior in obese individuals undergoing different weight loss treatments. Methods: Three different samples of obese individuals were investigated in a prospective, longitudinal study: participants in a conventional weight loss treatment program (CONV TREAT; n = 250), obesity surgery patients (OBES SURG; n = 153), and obese control individuals (OC; n = 128). Current mental disorders and BMI were assessed at baseline and at 4-year follow-up. Results: OBES SURG patients with a depressive and/or anxiety disorder lost significantly less weight compared with those without a comorbid mental diagnosis. This result was not detected for CONV TREAT participants. A trend to gain weight was seen in OC participants with a depressive and/or anxiety disorder, whereas OC participants without current mental disorders at baseline lost some weight. Binge eating behavior at baseline did not predict weight loss at 4-year followup. Conclusions: These results underline the importance of addressing current depressive and anxiety disorders in obese patients, especially when such patients are undergoing obesity surgery.

Various components of body image were measured to assess body image disturbances in patients with obesity. To overcome limitations of previous studies, a photo distortion technique and a biological motion distortion device were included to assess static and dynamic aspects of body image. Questionnaires assessed cognitive-affective aspects, bodily attitudes, and eating behavior. Patients with obesity and a binge eating disorder (OBE, n = 15) were compared with patients with obesity only (ONB; n = 15), to determine the nature of any differences in body image disturbances. Both groups had high levels of body image disturbances with cognitive-affective deficits. Binge eating disorder (BED) participants also had perceptual difficulties (static only). Both groups reported high importance of weight and shape for self-esteem. There were some significant differences between the groups suggesting that a comorbid BED causes further aggravation. Body image interventions in obesity treatment may be warranted.

Morbid obesity is associated with depressive symptoms and low self-acceptance. Gastric banding results in both long-term weight loss and improvement in depression and self-acceptance.

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A sub-study evaluated 698 younger (54.5 +/- 6.9 years) type 2 diabetics of the KID Study participants to establish the prevalence of diabetic complications and associated diseases and their correlation with body mass index (BMI), duration of disease and to C-peptide levels. Only 19.8% of the type 2 diabetics had a normal weight. In all weight subgroups, the average age of diabetes manifestation were around age 45. In 46.6% of all type 2 diabetics we could already demonstrate microangiopathic complications. Strikingly, 15.9% of the patients already had proliferative retinopathies and 12.6% had albuminuria of more than 1000 mg/dl. 74.7% of our type 2 diabetics presented with the well-known risk cluster of the metabolic syndrome: In every other patient, we found hypertension and/or hyperlipoproteinaemia. Accordingly, the prevalence of the macroangiopathic diabetic complications, coronary artery disease and peripheral vascular disease was 17.8%, which is high for a relatively young population with a mean age of 53.9 years and goes conform with recent literature (Lowel et al., 1999). An increase in BMI correlated significantly with deterioration of HbA1, a decrease in HDL cholesterol, an increase in triglycerides and with a higher prevalence of hypertension. The frequency of nephropathy increase significantly up to a BMI of 30-35 kg/m2. Retinopathies and polyneuropathies were associated with BMI but increased significantly with the duration of the diabetic state. In contrast to microangiopathic diabetic complications, there was already a high prevalence of nephropathy after a comparatively short duration of disease. The prevalence of hyperlipoproteinaemia and hypertension did not depend from the duration of diabetes. These concomitant diseases already were frequent early in the disease and did not increase with the duration of disease. However, there was a strong correlation between increasing hyperlipoproteinaemia and hypertension and higher C-peptide levels. We found no coincidence between C-peptide levels and microangiopathic diabetic complications.

In Germany every citizen must acquire either public or private health insurance from companies which then cover the expenses for psychotherapeutic in-patient and out-patient treatments within a given set of regulations. Since the commencement of the Psychotherapists' Law in 1999, psychological psychotherapists and child and adolescent psychotherapists are permitted to diagnose and treat mental disorders with psychotherapy under their own responsibility as a legally defined healing profession. Psychotherapists have to use scientifically approved psychotherapeutic approaches for treatment. The qualification and licensure of psychotherapists are highly regulated by the Psychotherapists' Law, which is currently undergoing a process of change. 2.86 million patients are in outpatient or inpatient psychotherapeutic care per year in Germany, tendency rising. Psychotherapeutic care is highly regulated, only scientifically approved approaches are admitted. Psychological and child and adolescent psychotherapists treat patients under their own responsibility. Future courses of study and advanced training for psychotherapists will be similarly structured to those of the medical profession. 2.86 million patients are in outpatient or inpatient psychotherapeutic care per year in Germany, tendency rising. Psychotherapeutic care is highly regulated, only scientifically approved approaches are admitted. Psychological and child and adolescent psychotherapists treat patients under their own responsibility. Future courses of study and advanced training for psychotherapists will be similarly structured to those of the medical profession.

Zusammenfassung Einleitung Sexuelle Funktionsstörungen gelten als häufig. Gleichzeitig fehlen epidemiologische Daten zur Behandlungsprävalenz sexueller Funktionsstörungen in der ambulanten Psychotherapie. Im Rahmen eines Projekts zur Koordination der Datenerhebung an den deutschen Hochschulambulanzen für Psychotherapie wird erstmals eine Schätzung für dieses Behandlungssegment möglich. Forschungsziele Das Ziel dieser Studie ist die Darstellung der festgestellten F52-Diagnosen an deutschen Hochschulambulanzen für Psychotherapie an psychologischen Instituten. Methoden 16 Hochschulambulanzen für Erwachsene übermittelten ausgewählte Daten zur Eingangsdiagnostik ihrer Patient_innen (N = 4 504; M Alter = 37.87; SD = 13.47; Altersbereich = 15 bis 86 Jahre; 65.3 % weiblich) aus dem Jahr 2016. In der hier vorgestellten Studie wird spezifisch die Häufigkeit der Vergabe von Diagnosen aus dem ICD-Kapitel F52 analysiert. Ergebnisse Insgesamt wurde in 32 Fällen (0.7 %) die Diagnose einer sexuellen Funktionsstörung vergeben, in acht Fällen (0.2 %) als Hauptdiagnose. In 31 Fällen (96.9 %) waren auch komorbide Störungen gegeben, hauptsächlich Angststörungen (34.4 %) und affektive Störungen (53.1 %). Unter den Hauptdiagnosen war der nichtorganische Vaginismus (n = 3) der häufigste Grund, eine psychotherapeutische Hochschulambulanz eines psychologischen Instituts aufzusuchen. Die Häufigkeit von F52-Diagnosen in den 16 Ambulanzen schwankte zwischen 0 % und 1.2 %, und acht der 16 Ambulanzen vergaben überhaupt keine F52-Diagnosen. Schlussfolgerung Die Werte in der vorliegenden Behandlungsstichprobe erscheinen vor dem Hintergrund der Prävalenzdaten aus Bevölkerungsstudien als auffällig niedrig. Hierfür können neben methodischen und studienspezifischen Gründen auch Aspekte der psychotherapeutischen Versorgung sowie Beurteilungsfehler bei der Diagnosevergabe verantwortlich sein.