Surgery away fat: Obesity surgery could save many lives

Opportunities for life-saving obesity surgery are often left unused

In surgery, the chance of life-saving interventions for obesity is used 30 times less often in Germany than in other countries. A total of 60 to 80 percent of the excess weight can be removed by gastric bypass surgery or gastric reduction. The German Society for Cardiology (DGK) reports that in Germany this operation could be considered for around 1.4 million people who have a Body Mass Index (BMI) over 40. An obstacle is often the health insurance company, which in many cases does not want to finance such an operation.

The main reasons for the rare use of this effective method were recently discussed at the DGK congress in Mannheim. Accordingly, many overweight people are not aware of their poor health. To make matters worse, health insurance companies are often reluctant to finance such an operation. "After almost 15 years of obesity surgery, we now know that this help is sustainable and that these effects are retained even ten years after the operation," reports Prof. Dr. Dieter Birk in a press release on the congress.

Unused effective help

"We can effectively help extremely overweight people today with surgical procedures," said Birk. This counts especially for people with a body mass index over 40, for whom all other weight loss options have been exhausted. Together with being overweight, the side effects would also disappear or at least decrease in many patients, according to the expert.

Health benefit for concomitant diseases

As a result of the operation, the cardiovascular system reacts very positively to the relief. There are also significant improvements in diabetes. According to Birk, 70 to 80 percent of patients experience such a large decline in disease within the first five years after the operation that those affected can do without insulin.

Obesity is a serious illness

"To speak of a serious illness in a BMI over 40 is by no means an exaggeration," explains Birk. At this stage, an operation is also clearly foreseen in the guidelines. To clarify the severity, Birk compares it to colon cancer. "A BMI of 40 in combination with cardiovascular disease and diabetes reduces life expectancy like a colon carcinoma," said the expert.

Health insurance companies oppose the operation

In Germany, just 10,000 such interventions are carried out every year. Compared to other EU countries, Germany lags behind. "In Austria, Switzerland, France or Belgium, there are ten to thirty times more, based on the population," reports the professor. According to Birk, the small number of cases is mainly due to the extremely restrictive handling of health insurance companies on the subject. Surgery against obesity is currently not included in the billing catalogs of the health insurance companies.

More educational work needed

"This shows us that we have to significantly increase the awareness-raising efforts both on the medical side and in health policy in general," summarizes Birk. From a medical point of view, it is incomprehensible why these operations are usually rejected for flimsy reasons.

Those affected can defend themselves

At the end of his lecture, Birk made an appeal to those affected: "It is worthwhile to take action against negative decisions." In practice, it has been shown that a single letter from a lawyer is often enough to make the committees rethink. In cases where such matters were resolved before a social court, Birk said that nine out of ten cases were granted the right to such treatment. (vb)

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