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Dutch obesity clinic offers unique long-term treatment

A Dutch obesity clinic recently launched a unique programme for people who are morbidly obese. People with a Body Mass Index (BMI) higher than 30 can now participate in a five-year-programme to lose weight.

The NOK clinic says its long-term treatment is comprehensive, multidisciplinary and integrative.

“Integrative means that all our specialists coordinate their therapy,” clinic spokesman Geert Kampschoer told the German Press Agency dpa.

People must be highly motivated to lose weight to participate, Kampschoer said.

The clinic offers its special services only in its branch in Leidschendam, near The Hague, forcing patients from out-of-town to travel. This is particularly demanding during the “extremely intensive” first phases of the 72-week programme.

After a consultation with a physician, a psychologist, a dietician and a physical therapist, the entire team determines the patient’s best possible therapy. Such coordinated discussions about the patient recur throughout the programme and are characteristic of what Kampschoer refers to as the NOK’s “integrated health care approach.”

During the first phase, the patient spends 16 hours per week at the clinic, divided over four days. In the next phase, the patient visits the clinic twice a week, four hours each time. This is gradually reduced in the following weeks to a frequency of once every three weeks.

Of the four hours spent at the clinic each time, part of that is spent on private consultations and the remainder on group sessions.

After the 72 weeks, the patient participates in a follow-up programme, consisting of less frequent meetings that continue for five years.

“Losing weight is not enough for people who are morbidly obese,” Kampschoer explains. “They should learn to adopt an entirely new lifestyle. We try to give them the tools to do so.”

Half of the Netherlands’ population is currently overweight while 10 per cent are defined as obese. Experts predict this will increase to 25 per cent by 2025.

The NOK is not the first clinic to provide long-term treatment options for morbidly obese people.

“Sweden and Australia have also experimented with this,” said Kampschoer, “but specialists there do not coordinate their therapy.”

“But if our psychologist is working on the patient’s cognitive behaviour, then our physical therapist will try to adjust his physical activity programme accordingly,” Kampschoer explains.

The recently launched programme builds upon the clinic’s experience as an obesity clinic since 1993. Each year, more than 1,000 patients are treated in one of its five branches located in various parts of the country. The regular programme takes 22 weeks, with a follow-up meeting 44 weeks later.

Asked about the success of its existing programme, Kampschoer said it was “mixed,” adding that “much depends on personal motivation.”

Two Dutch insurers have said they would reimburse patients for the NOK’s new treatment and the clinic said others are to follow in the next two months.

NOK says it expects to have welcomed at least 350 people by the end of this year. In 2010, the clinic hopes to treat more than 800 patients.

For patients whose BMI is higher than 40, or who have a BMI of more than 35 and have an underlying disease or suffer from diabetes, NOK also offers surgery. The number of people undergoing surgical procedures has increased substantially since Dutch health care insurers began to reimburse patients for these services in 2007.

“Seventy per cent of our regular programme patients undergo surgery,” Kampschoer said.

But even surgery does not offer a quick solution to obesity, he added. “A major lifestyle change remains necessary. Otherwise surgery will only result in complications.”