The number of stomach reductions is likely to continue to rise in the coming years. Every second man in Germany is overweight, i.e. has a BMI of more than 25, around one in five is obese or obese. The values are slightly lower for women. More and more children and adolescents are also affected by overweight and obesity. According to studies, the life expectancy of those affected can be reduced by up to ten years.
With pathological obesity and a body mass index over 40, it is often difficult for those affected to lose weight.
A bariatric (weight-reducing) operation is an option for extreme obesity grade III or for obesity grade II if there are serious co morbidities such as diabetes, chronic joint pain and cardiovascular diseases.
Stomach Reduction: Surgical Techniques
Various procedures are used in obesity surgery. The most common are restrictive techniques such as gastric sleeve or gastric bath and gastric bypass. However, the doctor only operates on a patient if the so-called conservative therapy options such as calorie reduction as well as exercise and behavior therapy measures were demonstrably inadequate over a longer period of time.
Gastric banding or gastric banding
Restrictive techniques such as the sleeve stomach and gastric band reduce the stomach volume. With the gastric band, the surgeon places an adjustable silicone band around the upper part of the stomach in order to significantly reduce its absorption capacity. The patient feels full more quickly and eats less food. The gastric band can be adjusted according to needs and the desired weight reduction.
Here, too, the capacity of the stomach is reduced. To do this, the surgeon removes large parts of the stomach, leaving a tubular organ. As with the gastric band, the patient is full faster, but with this technique the stomach can expand again over time. The suture on the stomach wall may also loosen or burst.
Bypass techniques bypass part of the digestive tract, thereby limiting food intake. In this procedure, performed under general anesthesia, the surgeon first makes the stomach smaller. He then cuts through the small intestine and sutures a deeper loop of the small intestine to the exit of the remaining stomach so that the food no longer passes through the duodenum. The result: saturation sets in faster, and fats are no longer digested completely.
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However, this procedure has lifelong consequences: bridging the duodenum not only limits the intake of food, but also the intake of nutrients. Because of the risk of nutrient deficiency, patients have to be tested regularly in the laboratory for deficiencies and usually consume certain vitamins, trace elements and protein for a lifetime.
Effects: less appetite, altered metabolism
Obesity surgery can significantly improve the state of health in extremely overweight people and extend life expectancy. Most patients lose weight significantly within a few months. The procedure also changes appetite, satiety and metabolism. Studies show that blood sugar levels often improve just a few days after an operation.
Change your life after gastric surgery
Gastric surgery for weight loss should be carefully considered for several reasons. On the one hand, as with all surgical procedures, there is a risk of surgery and anesthesia. In addition, most interventions cannot be reversed. You can also have other interventions such as skin tightening. Deficiency symptoms can mean that those affected have to take vitamin and mineral supplements for a lifetime.
In addition, patients learn new behaviors and have to exercise a lot of discipline. If certain meal plans are not followed, there is a risk of complications that can lead to repeated operations. For the health insurance companies, assuming the costs of an operation is therefore only an option if, according to the medical opinion, the stomach reduction can actually help to reduce the secondary diseases.
The health insurance company will assume the costs
The health insurance companies can basically cover the costs of a stomach reduction. To do this, the patient must submit an application together with the doctor, which is also accompanied by a medical certificate. The Medical Service of the Central Association of Health Insurance Funds (MDS) offers guidelines for assessing applications for stomach reduction. The following requirements must therefore be met, among others:
- BMI greater than 40 kg / m2 or BMI greater than 35 kg / m2 with obesity-related co morbidities
- In individual cases, the BMI can also be below 35 – for example in difficult-to-treat type 2 diabetes
- Overweight for more than three years
- Treatable diseases that cause severe obesity were excluded – such as the underactive thyroid
- Age between 18 and 65 years
- At least two unsuccessful diet attempts, cures or rehabilitation, if possible under medical guidance
- No psychiatric illnesses or serious drug or alcohol addiction
- No existing pregnancy
- Exclusion of severe metabolic diseases
- Information through formula: BMI calculator – is your weight in the healthy range?
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