The treatment of obesity still needs improvement. In the current issue of Deutsches Ärzteblatt International, Norbert Runkel and colleagues present a new, interdisciplinary S3 guideline entitled "Bariatric Surgery" (Dtsch Arztebl Int 2011; 108: 341).
One in two persons in Germany is overweight, and every fifth one is obese. Conservative treatment is considered to have been exhausted when it fails to bring about a 10% to 20% loss of weight in one year in a patient whose initial body-mass index was between 35 and 40 kg/m2.
In this situation, bariatric surgery is much more effective than conservative treatment for lowering weight and reducing the frequency of other medical problems due to obesity. The goal of surgery is to make the stomach smaller or shorten the passage of food through the gastrointestinal tract, so that the body takes up a smaller amount of nutrients. The currently established types of bariatric surgery in Germany are gastric banding, gastric bypass, sleeve gastrectomy, and biliopancreatic diversion. In the new guideline, the authors discuss the choice of the operative procedure, surgical complications, and postoperative care.
The guideline was produced according to the method specified by the Association of Scientific Medical Societies in Germany (Arbeitsgemeinschaft der Wissenschaftlich-medizinischen Fachgesellschaften, AWMF). Its evidence-based recommendations are intended to aid in the further development of bariatric surgery in Germany along with the necessary quality assurance.