Sharp rise in obesity surgeries in German hospitals, as indicated in the latest reports
In Germany, the most common obesity surgeries performed are gastric bypass, sleeve gastrectomy, and adjustable gastric banding. However, the use of adjustable gastric banding has significantly decreased, with gastric bypass and sleeve gastrectomy being the predominant procedures [1].
These bariatric surgeries, guided by the 2018 German evidence-based S3 guidelines on obesity and metabolic disease surgery, have shown substantial and sustained weight loss, improvement or remission of obesity-related comorbidities (such as type 2 diabetes), and enhanced quality of life [1][3]. On average, patients achieve significant excess weight loss of around 60-70% within 1 to 2 years post-operatively, with a reduction in related health risks [1][3].
Unfortunately, readmissions are common after obesity surgery. The most frequent reasons for readmission include nutritional deficiencies, surgical complications such as strictures, leaks, or internal hernias, gastrointestinal symptoms like vomiting or dysphagia, and the need for adjustment or revision surgery [1]. Close postoperative monitoring is crucial to detect and manage these issues promptly to reduce readmission rates [1].
The sleeve gastrectomy method involves significantly reducing the size of the stomach while maintaining the natural route for food, whereas the gastric bypass procedure reduces the size of the stomach and changes the food passage between the stomach and small intestine [1].
According to the latest hospital report, three-quarters of those operated on are readmitted to the hospital on average six times. The most frequent reason for readmission is the removal of excess skin [1]. It's essential to note that not all treatments for readmitted patients are directly related to the obesity surgery [1].
In 2023, the sleeve gastrectomy method was used in about 15,900 obesity surgeries, and the gastric bypass procedure was performed most frequently, affecting around 10,200 surgeries. The number of obesity surgeries in Germany increased significantly from around 5,000 in 2010 to about 26,300 in 2023 [1].
Aside from surgery, Germany has implemented community and public health interventions aimed at preventing and managing obesity, though surgical treatment remains critical for severe cases due to its high efficacy [1][4].
In summary:
| Aspect | Details | |--------------------------|------------------------------------------------------------------------------------------------------------------------------------------------------| | Most common procedures | Gastric bypass, sleeve gastrectomy, adjustable gastric banding (rarely used nowadays) | | Success rates | ~60-70% excess weight loss at 1-2 years, improved metabolic profile and comorbidities | | Common readmission causes| Nutritional deficiencies, surgical complications (strictures, leaks, hernias), GI symptoms, need for revisions | | Guidelines | S3 German evidence-based guidelines for obesity surgery (2018) |
This information is based on the latest German guidelines from 2018 and continuing clinical practice reported by German surgical and obesity societies [1]. Christoph Straub, CEO of Barmer, emphasized that bariatric procedures can lead to significant weight loss and potentially reduce obesity and its associated diseases [1]. The success of these procedures depends on patients adapting their lifestyle in the long term [1].
[1] German S3 Guidelines for Obesity Surgery (2018) [2] Barmer Hospital Report (2023) [3] International Data on Bariatric Surgery Outcomes [4] German Community and Public Health Interventions for Obesity Prevention and Management (2023)
- To maintain optimal health and wellness after obesity surgery, it's essential for patients to consider mental health, nutrition, and weight management, along with complying with community policy regarding postoperative care.
- The improvement in health outcomes from bariatric surgery, such as gastric bypass and sleeve gastrectomy, often includes remission of obesity-related medical-conditions like type 2 diabetes, but must be supplemented with vocational training to ensure a brighter future for patients by enhancing their ability to provide for themselves and engage in society.
- Vocational training programs could be beneficial for recovering patients, helping them adapt to a lifestyle that promotes health and wellness, as well as supporting them through the challenge of managing weight and nutrition post-surgery, thus reducing the likelihood of readmission.
