The young field of obesity surgery (bariatric surgery) in Germany expands as a consequence of the rapid increase of overweight and obesity.

• New surgical methods, minimal access techniques and the enormous increase of scientific studies and evidence, all contribute to the success of bariatric surgery, which is the only realistic chance of permanent weight loss and regression of secondary diseases in many cases.
• Obesity surgery is an integral component of the multimodal treatment of obesity, which consists of multidisciplinary evaluation and preparation, conservative and surgical treatment elements and a life-long follow-up.
• Precondition for surgery is the failure of a structured conservative program of 6-12 months or the expected futility of it.
• Type II diabetes mellitus becomes an independent indication criterion for BMI < 35 kg/m (metabolic surgery).
• The standard techniques are gastric balloon, gastric banding, gastric bypass, gastric sleeve, and biliopancreatic diversion.
• The choice of procedure is based on profound knowledge of results, long-term effects, complications, and patient-specific circumstances. The after-care should be structured and organized long term.
• Patient care should improve after implementation of these guidelines in clinical practice.

For further reading logon to

http://www.docguide.com/evidence-based-german-guidelines-surgery-obesity?tsid=5

http://en.wikipedia.org/wiki/File:Obesity6.JPG

http://en.wikipedia.org/wiki/File:Adjustable_gastric_banding.png