More and more XXL operations

More and more obese see the last resort in an operation

09/11/2013

Highly obese people undergo surgery more and more often to get their weight problems under control. As the DAK health reports, increased with their insured „Surgery in so-called obesity surgery has increased by 64 percent in the past five years, reaching a new high in 2012.“ Lots „XXL patients“ Seeing in a gastric band, gastric balloon, or a gastric reduction seems to be the only chance of significantly reducing weight.

Since the number of morbidly obese in Germany has been increasing significantly for decades, the increase in appropriate interventions for the treatment of obesity seems an understandable consequence here. Because in the past, significantly fewer people simply fulfilled the requirements that apply to obesity surgery. One of these medical requirements, for example, according to DAK health, „Patients are severely overweight for more than five years and have a body mass index (BMI) over 40“, What would mean for a 1.70 -meter-tall woman that weighs 117 kilograms. For patients who suffer from chronic comorbidities such as diabetes mellitus or severe spinal complaints, a BMI of more than 35 is the limit. Furthermore, it must be proven, „Conservative treatment methods such as diet, exercise and behavioral therapies did not achieve the hoped-for success“, reports the DAK health.

Gastric band, gastric balloon or stomach reduction
The increased operations „XXL patients“ According to the DAK health also have a massive increase in costs for the health insurance to follow. That would have happened „Spending on gastric surgery in overweight patients has more than doubled since 2008.“ The DAK health are according to their own information in 2008 „through 406 operations with gastric banding, gastric balloon or gastric reduction cost a total of 2 million“ emerged. In 2012 were „already 669 interventions for 4.6 million euros settled“ and „In the first half of 2013 there were 331 hospital treatments with expenditure of 2.5 million euros“, so the message of the DAK. This means that the trend towards cost increases will continue in 2013 as well. According to the health insurance, this is not least due to this, „that the average cost of an operation has increased rapidly.“

Rising Case Costs in Obesity Surgery
While the so-called case costs of stomach surgery in 2008 were still just under € 5,000 per procedure, they reached almost € 7,500 in the first half of 2013.„The clinics are increasingly calculating major operations with complex interventions“, which leads to a corresponding increase in the case costs, explains the hospital expert Peter Rowohlt in the press release of DAK-health. In the period from 2010 to 2013 alone, the proportion of heavy operations rose from 62 percent to 76 percent. Rowohlt emphasized that he was worried about this development because „Not only does it drive costs, it also poses a health risk to many patients.“ Doctors, nutritionists and psychologists are called upon to avert further increases in intervention through early consultation.

Berlin and Hamburg strongholds of the stomach operations
From the hospital statistics goes out according to the DAK-health, that especially „in Berlin and Hamburg, the rates of treated heavily obese far above the national average“ lie. Thus, in 2012, 41 out of 100,000 insured persons in Berlin had undergone a corresponding intervention. In Hamburg, 33 stomach operations were performed per 100,000 insured persons. The nationwide average, however, is only twelve interventions per 100,000 insured persons. A possible explanation for the significantly increased case numbers in Berlin and Hamburg was, „that special centers are also used by patients from the surrounding area“, so the message of the DAK.

Overweight women are increasingly under the knife
The health insurance company further stated that a significant majority of surgeries in obesity surgery were performed on women. Whole 81 percent of the interventions concerned XXL patients. A distribution that by no means corresponds to the proportion of the population of severely overweight women and men. Obviously, women decide on a massive overweight significantly more often for an operation than men.

Avoid surgery by prevention
The development shown by the DAK health also reflects a certain extent the attitude to life or the body consciousness in the population. All too often, many years of misconduct are accepted and then attempts to remedy the problem with surgery. This is not only true for overweight, but for many ailments, such as cardiovascular diseases and back problems. If the affected persons took countermeasures at the earliest signs of back pain or heart problems at an early stage and changed their lifestyle accordingly, further measures would often not be necessary. But not infrequently is the end still the intervertebral disk operation, heart surgery or - in the heavily overweight - the obesity surgery. With a single intervention the mistakes of the past are to be solved. The importance of prevention can therefore not be emphasized enough. (Fp)