Obesity has been recognised by the World Health Organisation (WHO) as a chronic disease and is now included as a diagnosis in the International Classification of Diseases (ICD).
Overweight and obesity lead to secondary diseases, depending on the severity, duration of the disease and individual predisposition. In addition to cancer, lung and joint diseases, the development of cardiovascular risk factors such as diabetes mellitus type 2, high blood pressure and lipid metabolism disorders should be mentioned in particular.
Conservative therapies of severe obesity for weight reduction usually fail, which is why bariatric surgery is often the only treatment option for many patients, which not only leads to sustained weight loss, but also to a better quality of life, an improvement in the following diseases of obesity and an extension of life expectancy.
In many countries, obesity and metabolic surgery are therefore among the established medical procedures for weight reduction due to their proven effectiveness. Not, however, in Germany. There are two main reasons for this. Currently, only about 12,000 bariatric operations per year are performed in Germany, although around 4 million patients are eligible for bariatric surgery. If they were all to undergo surgery, the german health system would collapse economically. On the other hand, obesity and its treatment by surgery are stigmatised due to a lack of knowledge - also among doctors and other therapists. The patient's decision to undergo bariatric surgery is often ridiculed as his own failure, lack of willpower and a convenient alternative to exhausting, conservative weight loss.
However, the fact that conservative measures for weight reduction - a change in diet, exercise and behavioural therapy - fail in many cases is usually not due to unwilling patients, but rather to the sophisticated defence strategies of the human body when it comes to protecting existing fat reserves in the event of a negative energy balance (e.g. diet) and thus preventing a sustained reduction in weight.
Bariatric operations are often regarded as serious, high-risk procedures in which healthy organs are mutilated and the patient is crippled. In Germany, however, bariatric interventions are carried out under the eyes of medical associations. According to the quality procedures of the German Society for General and Visceral Surgery, the procedures should only be performed at certified clinics or centres. The procedures are performed at these facilities in a standardised manner with low complication rates using the so-called minimally invasive technique.
And the effect of bariatric interventions is now well documented, as the New York Times commented in February 2017 as follows:
"Bariatric surgery is probably the most effective intervention we have in health care."
For patients with severe obesity, it is worth taking a closer look at bariatric surgery. On the following pages, patients will find everything they need to know about obesity, its development, conservative and especially surgical treatment.
Bibliographical sources:
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Arterburn DE, Olsen MK, Smith VA et al (2015) Association between bariatric surgery and long-term survival. JAMA 313:62–70
Dietrich A (2018) AWMF S3-Leitlinie Chirurgie der Adipositas und metabolischer Erkrankungen
Driscoll S, Gregory DM, Fardy JM et al (2016) Long-term health-related quality of life in bariatric surgery patients: a systematic review and meta-analysis. Obesity (Silver Spring) 24:60–70
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