The
long-term weight reduction and improvement of obesity-related concomitant
diseases through bariatric surgery have been well documented in numerous
studies. Obesity and metabolic surgery have therefore become firmly established
in the treatment concept of obese patients.
More than
300,000 bariatric procedures are performed worldwide every year, most of them
in terms of population in Sweden (90 procedures/100,000 inhabitants), Belgium
(77/100,000) and the USA (69/100,000). With around 11 interventions per 100,000
inhabitants, bariatric interventions are comparatively rare in Germany. This
means that not even 1% of patients with severe obesity in Germany receive
bariatric surgery, although they are eligible for it according to the
recommendations of medical associations.
The main
reason for the low number of bariatric operations in Germany is the complicated
approval practice of the health insurance companies, which drive affected
persons forward with a lengthy and bureaucratic application procedure. Often
the application procedures lead to a delay of the operation with considerable
health consequences for the affected persons. Recommendations and reasons for
rejection by the Medical Service of Health Insurance Funds (MDK) are often
incomprehensible.
However,
taking into account the sharp increase in the number of severely obese people
and the very good effectiveness of bariatric surgery, an increase in bariatric
interventions can also be expected in Germany. Experts estimate that 20,000 to
30,000 operations will be performed per year in the future.
Bilbiography
sources:
Carlsson
LM, Peltonen M, Ahlin S, et al. (2012) Bariatric surgery and prevention of type
2 diabetes in Swedish obese subjects. N Engl J Med 367: 695–704
Deutsche Adipositas-Gesellschaft, Deutsche Diabetes
Gesellschaft, Deutsche Gesellschaft für Ernährung, deutsche Gesellschaft für
Ernährungsmedizin (2014) Interdisziplinäre Leitlinie der Qualität S3 zur
„Prävention und Therapie der Adipositas“. AWMF-Register Nr. 050/001. Klasse:
S3. Version 2.0.
Deutsche Gesellschaft für Allgemein- und Viszeralchirurgie,
Chirurgische Arbeitsgemeinschaft für Adipositastherapie (CAADIP), Deutsche
Adipositas-Gesellschaft (DAG), Deutsche Gesellschaft für Psychosomatische
Medizin und Psychotherapie, Deutsche Gesellschaft für Ernährungsmedizin (2010)
S3-Leitlinie: Chirurgie der Adipositas.
Fried M,
Yumuk V, Oppert JM, et al. (2013) Interdisciplinary European Guidelines on
Metabolic and Bariatric Surgery. Obes Facts 6: 449–468
Hüttl TP, Stauch P, Wood H, Fruhmann J (2015) Bariatrische
Chirurgie. Aktuelle Ernährungsmed 40: 256–274
Lo Menzo E,
Szomstein S, Rosenthal RJ (2015) Changing Trends in Bariatric Surgery. Scand
J Surg 104: 18–23
