Overweight (Obesity): Surgical Therapy

According to the guidelines of the German Obesity Society, surgical therapy is considered when conservative therapy has failed to achieve the therapeutic goal and

  • BMI ≥ 40 kg/m2 (extreme obesity) exists or
  • BMI ≥ 35 kg/m2 and significant comorbidities (concomitant diseases such as, for example, diabetes mellitus type 2, coronary heart disease (CHD), heart failure, hyperlipidemia, arterial hypertension) are present.

The primary indication may be when any of the following conditions are present:

  • In patients with a BMI ≥ 50 kg/m2.
  • In patients in whom an attempt at conservative therapy has been judged by the multidisciplinary team to be unpromising or futile.
  • In patients with particular severity of concomitant and secondary diseases that do not allow postponement of surgical intervention.

Over one million people in Germany suffer from morbid obesity (BMI > 40). These patients can help surgical procedures with gastric bypass or gastric banding. Young patients with high BMI benefit most from surgery.

Considering the indications for surgical therapy, it can be said that bariatric surgery is the most effective weight loss intervention.

The procedures presented below should only be used in motivated and fully informed individuals because, as with any surgical procedure, complications can occur. Furthermore, it should be noted that surgery alone cannot bring success. A lifelong dietary change must also be made. Surgical treatment of obesity can only be considered if qualified conventional dietary, exercise and behavioral therapy has not brought sufficient success for at least six to twelve months beforehand.

The following surgical measures are used as part of bariatric surgery (synonym: bariatric surgery):

After all surgical measures, participation in nutritional, exercise and behavioral therapy is also required. For more information on the above surgical measures, see “Bariatric surgery“.