Often last remedy for obesity gastric surgery

Obesity surgery is often the last resort for sufferers

04/12/2013

Surgeries such as gastric band, gastric or gastric bypass surgery in severe obesity are considered controversial. Nevertheless, the number of surgeries against obesity and thus the costs for the health insurance companies is increasing. According to DAK health, since 2008 expenditure on gastric surgery has more than doubled. Many doctors advocate therapy as an effective measure against obesity and its dangerous concomitant and sequelae.

Costs for surgery due to obesity carry health insurance from a BMI of 40
According to the Robert Koch Institute (RKI), two thirds of men (67 percent) and more than half of women (53 percent) are overweight in Germany. Around a quarter suffers from severe overweight (obesity). Especially women from educationally disadvantaged backgrounds are affected by obesity according to the evaluation of the health monitoring. The World Health Organization (WHO) defines three levels of obesity: grade one is at a body mass index (BMI) of 30.0 to 34.9, grade two at a BMI of 35.0 to 39.9, and grade three a BMI of 40.0 or higher. The BMI for normal weight is 18.5 and 24.9.

Gastric band, gastric or gastric bypass surgery is performed only in case of severe obesity and is by no means an alternative to dieting. Rather, sufferers usually already have numerous diets behind them before deciding on such an intervention. The health insurance company covers the costs from a BMI of 40 onwards. If the patient suffers from severe overweight as well as comorbidities such as diabetes or hypertension, the OP can also be taken on at a BMI of 35 or above. In principle, the health insurance companies pay only if a weight loss attempt has failed under medical supervision, which must include a diet, behavioral training and exercise program.

Stephan Herpertz of the Clinic for Psychosomatic Medicine and Psychotherapy of the Ruhr University Bochum advises patients urgently from private financing of the operation from. In addition to the costs of the intervention, expensive follow-up treatment may be necessary, he explains to the news agency „dpa“. „An emergency treatment for complications can then quickly ruin financially. "

Obesity carries the risk of dangerous comorbidities
„Obesity is a deadly disease that causes serious comorbidities such as diabetes, hypertension, stroke and heart attack, "reports Jürgen Ordemann, head of the Center for Obesity and Metabolic Surgery at the Charité in Berlin, to the news agency. „There is hardly a way to get rid of this disease with conventional therapies.“ While critics speak of a cost explosion and premature decisions for life-changing operations, Ordemann points out that the increasing number of interventions is due to these operations succeeding and most other therapies failing in very obese ones.

Three different procedures for obesity surgery
Anyone who chooses a weight-loss surgery has the choice of gastric band, gastric and gastric bypass surgery in Germany. Together with the attending physician, the appropriate surgical procedure is selected, which depends on various factors. „There is no blanket recommendation for a particular procedure, "explains Ordemann, explaining the lifestyle, the degree of obesity, comorbidities and the patient's desire.

The gastric band is less effective than the other two methods and is used less and less frequently. The advantage may be the ability to subsequently remove the gastric band again. In the other two procedures, the stomach is surgically reduced in size. In the case of gastric bypass surgery, a part of the intestine is also bypassed, so that less food can be absorbed. „Certain hormones that control hunger and satiety are formed in the stomach itself and are reduced by partial removal, "explains Ordemann. „Thus, hunger and satiety mechanisms change, causing obese people to eat less. "

Patients with gastric tube and especially gastric bypass surgery usually show the strongest weight loss after the procedure. However, both procedures also result in lifelong check-ups and aftercare as well as dietary supplements with minerals and vitamins.

Patients usually have numerous diets before surgery for obesity
Before an obesity operation is approved by the health insurance, several physicians have submitted statements. Family doctor, surgeon, psychotherapist and possibly other specialists need to check whether the procedure is promising. Herpertz advises sufferers to turn to an obesity center. „This is the best way to ensure that patients receive the comprehensive pre- and post-treatment required for such an operation.“

Many of these centers wish patients less hurdles for obesity surgery. „Most patients who come have already had countless diets, "explains Christine Stier from the Center of Excellence for Obesity and Metabolic Surgery at the Sachsenhausen Hospital in Frankfurt am Main to the news agency. „Obesity surgery is not a lifestyle operation, it's a crystal-clear therapy that is well documented in studies, "Stier says, adding that weight loss surgery can significantly reduce the risk of serious complications such as diabetes, cancer, heart attack and stroke. „Surely this is not a one hundred percent solution, and it is not a push of a button to make patients slim, "explains the expert. „It's a life changing intervention that requires a lot of discipline from the patients. "(Ag)