Surging on fat Obesity surgery could save many lives

Opportunities for life-saving obesity operations often go unused

In surgery, the chance of life-saving interventions in obesity is used less often in Germany than in other countries. Whole 60 to 80 percent of excess weight can be eliminated by gastric bypass surgery or gastric reduction. The German Society of Cardiology (DGK) reports that in Germany this operation would be suitable for approximately 1.4 million people with a body mass index (BMI) over 40. A hindrance is often the health insurance, which in many cases does not want to finance such an operation.

Main reasons for the rare use of this effective method were recently discussed at the congress of the DGK in Mannheim. Thus, many obese are not aware of their poor health. To make matters worse, that health insurance companies often object to the financing of such surgery. "After nearly 15 years of applied obesity surgery, we now know that this help is sustainable and that these effects are maintained ten years after the operation," reports Prof. Dr. med. Dieter Birk in a press release to the congress.

In Germany, gastric reduction or gastric bypass is performed 10 to 30 times shorter than in many neighboring countries. (Image: reineg / fotolia.com)

Unused effective help

"We can effectively help extremely overweight people today with surgical procedures," says Birk. This is especially important for those with a body mass index over 40 who have exhausted all other weight loss opportunities. Together with the overweight, the symptoms would disappear or at least decrease in many patients, the expert said.

Health Benefit for comorbidities

As a result of the operation, for example, the cardiovascular system reacts very positively to the discharge. Diabetes also shows significant improvements. According to Birk, between 70 and 80 percent of patients within the first five years after the operation experience such a large decline in their illness that they can do without insulin.

Obesity is a serious illness

"Speaking of a serious disease in a BMI over 40 is by no means exaggerated," explains Birk. At this stage, surgery is also clearly provided for in the guidelines. To illustrate the severity, Birk draws a comparison to colon cancer. "A BMI of 40 in combination with cardiovascular disease and diabetes reduces life expectancy much like a colon carcinoma," says the expert.

Health insurance companies oppose the operation

In Germany, just 10,000 such interventions are performed each year. Germany is lagging behind compared to other EU countries. "In Austria, Switzerland, France or Belgium, there are ten to thirty times more, when compared to the population figures," reports the professor. According to Birk, the small numbers of cases are mainly due to the extremely restrictive treatment of the health insurance companies with the subject. An operation against obesity is currently not provided in the billing catalogs of the health insurance companies.

More education needed

"This shows us that we need to significantly strengthen the educational efforts both on the part of doctors and in health policy in general," summed up Birk. From a medical point of view, it is incomprehensible why these operations are usually rejected on flimsy grounds.

Affected persons can fight back

At the end of his presentation, Birk appeals to those affected: "It is worthwhile to take action against unfounded decisions." In practice, it has become apparent that a single letter from a lawyer is often enough to persuade the committees to rethink. In cases where such matters were settled before a social court, according to Birk, nine out of ten cases were given the right to such treatment. (Vb)