We specialize in morbid obesity
We have developed a model of treatment, based on the notion that a positive change in lifestyle will lead to permanent weight loss.
Evjeklinikken is a rehabilitation institution which specializes in treating patients suffering from morbid obesity. The clinic was established in 2004, and the first patients started their treatment in 2005. We have since then treated more than 2500 patients.
Persons suffering from morbid obesity have always been our sole target and area of expertise. We have developed a model of treatment, based on the notion that a positive change in lifestyle will lead to permanent weight loss. The treatment consists of a combination of repeated admissions and close follow-up.
The basis for our assessments is always the current situation for each of our patients.
Our goal is to teach our patients how to help themselves. We do not wish to proclaim how they should live their lives, but rather to provide the knowledge, motivation and courage necessary for them to initiate the processes they have already decided on. The most important element is for us to follow our patients closely and provide the encouragement and guidance best suited for each individual patient.
We have developed a model of treatment, based on the notion that a positive change in lifestyle will lead to overall gains in health as well as prevent future plagues. A lasting gain in health is best achieved through fundamental changes in lifestyle, which for our patients will in addition often result in a slow and controlled weight loss. The main focus areas of our treatment are regular exercise, daily activities and diet. In order to maintain focus, many patients will need support and encouragement as well as positive experiences of achievement, which may open their eyes in regards to the many possibilities that are available for them. Many of our patients experience a feeling of guilt, which has to be overcome. They need to find a balance between what they can do and what they wish to do.
Food is one of our focus areas. The patients eat all their meals in our canteen. The menu consists of healthy dishes. During the five admissions, our patients will receive lots of knowledge and experiences in regards to diet and cooking. Our nutritionists teach what a healthy diet consists of, and also how to manage following a healthy diet. We also arrange group sessions in which the patients discuss different diet-related situations. In addition, the patients have private consultations with our nutritionists. We also arrange cooking classes, where the patients learn to cook different kinds of food, spanning from everyday meals and dinners to food suitable for hiking and trips. All the recipes are based on proper produce and ingredients, resulting in healthy dishes which are easy to cook at home. The cooking classes are led by our chefs, who provide tutoring and guidance, and have lots of useful tips to share.
Another focus area is regular exercise and daily activity. All workouts are conducted either in groups or as individually facilitated workouts. As a consequence of differences in physical function and fitness levels amongst the patients, the group sessions are usually divided into smaller groups supporting different levels of intensity. In the beginning of the treatment, most workouts will be conducted by several coaches, but as the treatment progresses and the patients’ skills improve, a single coach will be sufficient to conduct the workouts.
Some patients may find themselves in need of more extensive support regarding the individually facilitated workouts. In these cases, an extra coach will be assigned to assist the patient throughout the first few days, in order to develop a customized training program containing suitable exercises and workouts. Our goal is to help the patients become self-contained in regards to physical exercise, and also ensure that the fitness level is adjusted accordingly.
Our staff includes physiotherapists, instructors and a doctor with experience within the fields of physical medicine and rehabilitation. All exercises and activities are founded upon both professional experiences and feedback from our patients.
In addition to diet, regular exercise and daily activity, our treatment also focuses on the mental aspects that relate to changing lifestyle. This focus is maintained through several measures, including the patient’s individual consultations with our medical personnel, classes and lectures, group discussions and individual conversations, and also through the guidance each patient receives from his or her mentor.
Our patients form a little community during their admissions. They live together, and interact socially with each other. Also, a major part of the treatment is conducted in groups (classes, exercises and workouts, group discussions and teamwork).
Group therapy has proven positive, in that the patients meet other persons with similar challenges. They all find themselves going through a process of change, and their experience of personal motivation and achieving is strengthened by a common goal.
The group consists of patients who share a common denominator, and this helps to bind them together through a common motivation. The group remains together in every admission during the treatment.
Our treatment is adapted to suit both adults and children/families. The backgrounds of our patients are diverse, and the gap regarding their physical function is wide. It also varies a lot which goals the patients set for themselves regarding their treatment at our clinic. Our treatment is essentially facilitated for four different groups.
All our patients have two things in common: They have to wish to live a healthier life, and their degree of obesity has to be severe enough to meet the criteria for admission. For adults, the criteria are a body mass index of 40 or higher, or a body mass index of 35 or higher in addition to comorbidities like:
Associations between obesity and morbidity are highlighted in several studies. A Swedish study, following approximately 1300 obese persons over a period of six years, shows that obese persons had 77 % higher medical expenses than the control group. The consumption of diabetes medicine was nine times higher. Findings from the U.S. have shown that obese persons have a 37 % higher rate of admissions and doctors appointments than people with normal weight.
These findings, in addition to several similar findings in other studies, emphasize the need for patients with problems related to overweight and obesity to initiate the adequate treatment as soon as possible. Not least because this group has a highly elevated risk of long time sick leave and disability problems.
Cardiac arrest, stroke, diabetes type 2 and colorectal cancer are typical causes of death for persons with a high bodyweight. This is shown in Hans Th. Waalers previous analyses. He discovered that the mortality from type 2 diabetes increased three to four times following an increase in body mass index from 30 to 34.
Obesity can be viewed as a state in which a person is older than his or her age would indicate, because of elevated mortality. For example, Waaler calculated that a 50-54 year old man who is 175 cm tall and weighs 30 % more than his optimum weight (95 kg instead of 79 kg) has the same mortality as a man who is three years older. An equivalent calculation for a woman will result in a half to two years increase in age. A body mass index of 34 kg/m² will lead to a 30-40 % increase in mortality for men between 50-64 years of age, and will lead to a 20-30 % increase in mortality for women between 50-64 years of age, in reference to total mortality.
Our model of treatment is based on the notion that a positive change in lifestyle will lead to permanent weight loss, and will in addition lead to an overall gain in health as well as prevent future plagues. However, this presupposes that the patients truly wish to change their lifestyle and live a healthier life. For these persons, we can help convert this wish into actual change.
The fat mass is carefully and strictly regulated through a number of bodily mechanisms. Unfortunately, the negative effects of a modern and comfortable lifestyle can be even stronger than our body’s natural defense against obesity. Many obese persons may see themselves forced to try several different cures and diets in order to achieve a body they can feel satisfied with, and many of them will fail. We believe that our bodily mechanisms to achieve and maintain equilibrium are often underestimated. Succeeding in overcoming the bodily resistance against loss of fat mass will require extensive measures, particularly for persons who may have tried and failed in achieving this several times before. Changes in diet and activity levels are among the most common measures. However, several indicators seem to prove that counseling alone is insufficient to achieve this. Our strength lies in our abilities to make our patients try out new approaches and to view their old habits from a new perspective. In order to achieve this, we need to follow our patients closely, both during admissions, but especially in the periods between admissions. These periods are, after all, the time in which the patients strive to implement their new lifestyle in order for it to become permanent.
We wish for our patients to improve their lifestyle. However, this does not mean that we push our patients in order to reduce their weight even faster. The actual changes in everyday habits are what counts in the long run.
We have developed an interactive web portal, which all our patients are granted access to as part of their treatment. The purpose of this portal is to present a set of tools the patients can utilize, both during admissions and at home, in order to achieve their goals. This includes implementing measures which will lead to a heightened quality of life, discovering obstacles and barriers which may appear along the way, and to develop counterstrategies to prevent and overcome these obstacles.
The basis of the portal is a selection of calendars which the patients use for logging meals, physical activities and more. This is intended to help the patients getting an overview of which results were generated from certain measures. The more successes, albeit small, and the more times one makes the right decision, the easier it becomes to make it a habit. On the other hand, it is also possible to learn from the decisions one might regret, as they in retrospect prove hazardous to quality of life.
The portal is designed to enhance the patients’ focus and awareness. It also lets the clinic monitor the progress of each patient in order to being able to follow up and counsel the patients in a closer and more efficient manner.
Evjeklinikken Interactive is accessible from computers, tablets and smart phones.
Evjeklinikken is a rehabilitation institution which specializes in treating patients suffering from morbid obesity. We accept patients from all parts of Norway.
Norway has a long tradition of clinical rehabilitation. Our clinic was established in 2004, and the first patients started their treatment in 2005. Therefore, our history may seem shorter than other institutions. But in the field of treating obesity we hold a unique position in regard to the number of treated patients and treatment days. Due to this, we have gained extensive and solid experience in what is needed to create a properly functioning teamwork with our patients, in order to help them to implement and lead a healthier lifestyle.
Our clinic is based on four basic values:
We have developed a particular model of treatment. The model is based on the notion that a positive change in lifestyle will lead to an overall gain in health as well as prevent future plagues, and will in addition result in a slow and controlled weight loss. The treatment consists of a combination of repeated admissions and close follow-up.
Evjeklinikken is located in the southern part of Norway, more specifically in the county “Evje og Hornnes”. The clinic is situated in beautiful and scenic surroundings, and have suitable facilities for both exercise and recreation, outdoors as well as indoors.
Our buildings and facilities cover approximately 7000 m² in total, and consist of our administration building (containing our reception, the doctors’ office, the canteen, classrooms and more), our patient residential buildings, our gymnasium and more. We have access to an indoors pool suited for facilitated workouts for patients with reduced physical function.
In addition to our administrative staff, our health professional staff consists of the following positions:
Evjeklinikken was established.
Evjeklinikken receives our first patients.
The patient group consists of adult persons from the age of eighteen and upwards.
The initial model of treatment included one admission consisting of four weeks of treatment.
The initial model of treatment is revised, resulting in an expanded model consisting of eight weeks of treatment allocated over five admissions distributed over a year.
The model of treatment is revised, resulting in an expanded model consisting of twelve weeks of treatment allocated over five admissions distributed over a year.
In addition, we develop and implement the use of an interactive web portal (pilot version), which lets the patients plan, log and evaluate their own lifestyle, and also lets the clinic monitor the progress of each patient in order to being able to follow up and guide the patients in a closer and more efficient manner.
The pilot version of the interactive web portal is revised, resulting in a re-development of the entire web portal in order to improve the solution and safeguard the needs of both the patients and the clinic in a more appropriate, qualitative and efficient manner.
The model of treatment is revised, resulting in a re-structured model consisting of ten weeks of treatment allocated over four admissions distributed over the first year, and one admission consisting of two weeks of treatment located at the end of the second year.
In addition, the patients’ access to the interactive web portal is extended to five years in total.
Evjeklinikken has since the startup focused on research and development, and has participated in and contributed to several studies.