M.O.B.I.L.I.S.: A nationwide program helps to lose weight

In the one-year M.O.B.I.L.I.S.-program the focus is on physical activities.

Foto: ddp/ Sascha Schürmann

People with obesity find counseling and treatment services in the IFB Adiposity outpatient clinic at the University Hospital Leipzig. Adults with a body mass index (BMI) bigger than 35 kg / m²  can consult this specialized outpatient care unit. Yet, many people with a lower BMI want to lose weight and need support. Therefore, the IFB is cooperating with M.O.B.I.L.I.S., a special weight- loss-program for groups of people with a BMI of 30 to 40 kg / m². In this report Andreas Berg presents M.O.B.I.L.I.S.:

The origin and targets of M.O.B.I.L.I.S.

The M.O.B.I.L.I.S.-program implements the findings about effective weight reduction, which makes a combination of more physical activity, of a changed eating behavior and thus an altered behavior altogether necessary. This is also lined out as a basic of any weight management in the treatment guidelines of the German Obesity Society (DAG): a multimodal base program with the three pillars of nutrition, behavior, and exercise, as well as medical monitoring.

This training program was initiated in 2002 by the Department of Rehabilitative and Preventive Sports Medicine, University of Freiburg and the Institute for Cardiovascular Research and Sports Medicine, German Sports University Cologne. Renowned scientists developed it on the basis of accepted guidelines. The program is offered in cities nationwide and is organized centrally from the nonprofit organization M.O.B.I.L.I.S. in Freiburg. Currently two active groups exist in Leipzig. For spring to summer it was planned to start another group in close cooperation with the Institute for Health Sports and Public Health and the REHASPORT Leipzig.

The target of M.O.B.I.L.I.S. is to enable the participants to a health conscious lifestyle in personal responsibility.  Under professional guidance, participants will learn to influence their physical and nutritional behavior positively and achieve the desired health effects, like weight loss, and in the long run a reduced risk of obesity-associated diseases.

Content and costs

Knowledge and skills in the fields of exercise, psychology, education and nutrition are taught in 40 practical and in 20 theoretical units. Three medical examinations belong to the standardized group concept. Participation is open to adults with an initial BMI of 30 to 40 kg / m² and at least one obesity-associated risk factor (e.g. hypertension, lipid metabolism disorder, etc.)
There is no basic age limit - however, the participants should be able to do sporting activities, for example Nordic Walking. Therefore, diseases that make a physical movement impossible are an exclusion criterion. No participation is possible for patients with type-1-diabetes, severe liver and kidney damage, as well as psychiatric or eating disorders (bulimia, binge eating). A stomach stapling operation and malignant tumor in the last five years are also defined as a contra-indication.

The costs for the 12-month program amount to 785 Euros per participant. Due to a framework agreement with the Barmer GEK and further health insurers a general reimbursement up to the amount of 685 Euros is possible. Thus, the participant would only pay 100 Euros him- or herself.

Since December 2004 experts of the four M.O.B.I.L.I.S. competence areas have been training complete treatment teams in M.O.B.I.L.I.S. These teams consist of a sports teacher or sports scientist, a psychologist or educator, a certified dietician or nutritional scientist, and a physician. M.O.B.I.L.I.S. is supported by high-ranking politicians of the German Bundestag, the European Parliament, and various Bundesland-governments and mayors in form of local sponsorships.

Evaluation of M.O.B.I.L.I.S. program

M.O.B.I.L.I.S. has been scientifically monitored and evaluated since the launch of the project. The success of this program is shown for example by evaluations of all groups concluded till 31.01.2012: 4,336 of a total of 5,025 patients participated for one year. 43 percent reached the target of at least 5 percent weight loss and 19 percent the goal of a 10 percent weight loss. The average reduction in body weight by 6 kg, 2.1 points on the BMI-scale and 6.6 cm of the waist circumference also points out that the participants were able to reduce the harmful visceral fat significantly. At the same time the participants achieved a significant increase in their physical activity. At the beginning they started with sports for about 1.3 hours per week. After one year the activity rose over 2.6 hours per week.

Two dissertations from 2011 and 2013 at the University of Freiburg examined the effectivity of the concept as well as a long-term study of the University of Konstanz in the cost-effectiveness of the program.

Andreas Berg, Executive Director of M.O.B.I.L.I.S. e.V.