Treatment of obesity in Germany means an individual approach to each patient and the application of effective methods.
Overweight and obesity are health and appearance problems for many people today. A large amount of money and effort is invested in their solution. This issue should be approached comprehensively, as only the right choice of clinic and specialist guarantees the success of treatment, as well as a positive result for many years.
In Munich, Germany, there are a large number of medical centers that provide obesity treatment and correction of overweight.
One of the widely known centers is the Center for Surgical Treatment of Obesity at the Bogenhausen Clinic. The directors of the clinic, Prof. Dr. Thomas P. Hüttl, M.D., and Dr. Peter Stauch, M.D., have extensive experience in working with obese patients.
These surgeons treat obesity using endoscopic techniques. In 2008, Dr. Hüttl was awarded the title of professor in the field of obesity treatment. This event took place at the Charité Clinic in Berlin.
With rapid weight loss, the subcutaneous fatty tissue and skin do not have time to tighten and therefore require skin tightening surgery or removal of excess skin. The Bogenhausen Clinic performs skin tightening surgeries in all areas: skin tightening of the abdomen, thighs, arms and breasts. In addition, bodylift — torso lifting and plastic surgery — is also performed.
If there are problems in other areas of the body, a preliminary consultation is carried out, based on the results of which the doctor will identify the problem areas and tell about all the methods that can be applied in a particular case. The Obesity Surgical Treatment Center cooperates with plastic surgery clinics, so if necessary, there is an opportunity to get additional consultation with several plastic surgeons. At the Center for Surgical Treatment of Obesity, plastic surgery is performed by doctors Jörg H. Widmann and Privat-Docent Max Geisäuser, M.D., are in charge of plastic surgery at the Center for Surgical Treatment of Obesity.
The obesity treatment center has an outpatient dietetics department, headed by Hildegard Wood, a long-time dietitian. She has implemented nutritional standards into the work of the center. Dr. Hildegard Wood advises all patients at the center on proper dietary habits — pre-surgery and post-surgery. She conducts ongoing seminars and conferences to educate the center’s staff on post-operative nutrition.
Many psychological disorders often lead to obesity. These include depression, eating disorders, and «burnout at work» syndrome. The center has a psychotherapy department, whose staff helps in dealing with such disorders. Often counseling and psychological support is required for people six months or a year after surgery, as excess weight gain may begin. If the causes are addressed before or in parallel with direct treatment of obesity, the success rate increases dramatically.
Obese patients usually have a large number of comorbidities such as arterial hypertension, coronary heart disease, thyroid and pancreas disorders. Before starting surgical treatment it is desirable to correct these pathologies, and in this case the specialists of the therapeutic department of the obesity treatment center help. Endocrinologists, therapists, nutritionists, gastroenterologists and other specialists work in the department.
Obesity can lead to the development of oncological diseases of the gastrointestinal tract, genitourinary system (in both men and women), and there is also a risk of gynecological tumors. To exclude pathology, the obesity treatment center employs gynecologists and urologists who, having high-class equipment at their disposal, will help to exclude these diseases.
In addition, obese people have problems with the pelvic organs: bladder, rectum, vagina. Patients complain of incontinence and pain. The Obesity Treatment Center collaborates with the Pelvic Floor Disease Center, which diagnoses and treats these disorders.
Surgery is usually performed on people with a body mass index of more than 40 kg/m2, unless there are contraindications. Surgery is also considered when conservative methods have been exhausted.
The Obesity Treatment Center provides a variety of surgical techniques that range from minor to more extensive surgeries.
Gastric banding. The band is placed on the upper part of the stomach, which makes its volume significantly smaller, facilitating faster satiety with a small amount of food. The inside of the band is filled with liquid and a reservoir of liquid is implanted under the skin. If weight loss is severely slow, the doctor fills the reservoir with fluid by puncturing it and the band on the stomach is narrowed, which reduces the volume of the stomach. If the rate of weight loss is adequate or too fast, the fluid is pumped out of the band and the band is loosened. The bandage is placed endoscopically for life.
Roux-Y shunt. The essence of this method is that part of the stomach and duodenum is excluded from the digestive process, which leads to a reduction in the amount of food consumed, as satiety occurs much faster. In addition, it leads to the digestion of not all components of food. This operation is characterized by a moderate disruption of the digestive process.
This type of treatment is only indicated for a certain group of patients and is performed after a multidisciplinary diagnosis.
Gastroplasty. This is a type of surgery in which part of the stomach is removed and only a small sleeve-shaped portion remains. Therefore, this type of therapy is also called sleeve gastroplasty. This treatment leads to a rapid improvement in the health of the obese patient, and pathologies such as hypertension, diabetes, respiratory disorders due to weight improve quite quickly. Blood sugar and blood pressure normalize. In addition, weight is reduced by 60-70% during the first few years.
Scopinaro’s surgery. This intervention is aimed at excluding the duodenum from the digestive process, which leads to a decrease in the absorption of starches and fats. This contributes to a fairly rapid weight loss, however, this operation requires a lifelong intake of vitamins and micronutrients.
Stomach stimulant. The method is innovative and was first used in an obesity treatment center. The stimulator is inserted through a mini-invasive access in the stomach area and works together with a mini-computer, which sends stimuli for accelerated satiety, in addition to recording all the foods eaten, the quality and quantity of physical activity.
Intragastric balloon. A balloon filled with saline solution is inserted into the stomach through an endoscope. After the necessary weight loss, the balloon is removed from the body. Spontaneous rupture of the balloon is possible, however, it is safely eliminated from the body with feces, but in any case it is necessary to be monitored by the attending physician.
Endobarrier. Another modern method of treating obesity is the installation of an endobarrier. An endobarrier is a small tube that is placed in the intestinal area and prevents food from being absorbed into the intestinal wall, which contributes to a fairly rapid weight loss.
Treatment of obesity in Germany is carried out not only by surgical methods, the center provides consultations on the formation of an individual training plan (kinesiotherapy, exercises with the help of tape expander Tera-Band).
Another well-known center is the «Center for the Treatment of Overweight and Metabolic Disorders», which is located at the Brothers of Mercy Clinic. This clinic is part of the Munich University Clinics.
The clinic pays special attention to a comprehensive approach to the treatment of obesity. A team of nutritionists, psychologists, nutritionists and physiotherapists works in the overweight treatment center. All of them help in compiling a set of diagnostics, treatment and prevention of obesity-related diseases.
This clinic has an approved special weight loss program. It lasts about three weeks and includes:
Providing personal training with a therapist who also specializes in sports medicine.
Conducting behavioral therapy with a top-notch psychologist.
Conducting workshops with a dietitian, discussing successes and reasons for failure.
If necessary, a course on the principles of preparing healthy and wholesome food is included in the program.
One of the essential points is to carry out medical diagnosis and treatment.
Diagnosis includes evaluation of the respiratory system, blood circulation, examination for the presence of endocrine pathology. In addition, the study of internal organs is carried out using ultrasound, CT, MRI. ECG, ECHO-CG, Holter monitoring is performed.
After the treatment, an outpatient follow-up is carried out once every 6 months. For this purpose, test results are sent by e-mail. In addition, the nutritional protocol is evaluated. An additional Meal-Replacement-Therapie is possible. The patient receives the Optifast dietary formula, which is used to replace the main meals.
In addition to conservative treatment methods, surgical procedures are performed at the center:
Intragastric balloon placement. The models used at this center have an anchoring system that prevents the balloon from «slipping» into the small intestine. After the balloon is inserted, counseling is provided to develop adequate eating behavior.
Sleeve gastroplasty. This is a surgery that is one of the standard bariatric surgeries to reduce the volume of the stomach. During the surgery, the part of the stomach that produces the hormone ghrelin, which is responsible for satiety and hunger, is removed. Unlike other surgeries, there is little or no disturbance in the digestive process. The absorption of all substances entering the body takes place.
Gastric banding. It is performed in the clinic through several small incisions in the anterior abdominal wall. The bandage is fitted for life. After the bandage is fitted, you should eat only liquid or pureed food for the first month.
Gastric bypass. Laparoscopic surgery, which is the gold standard in the treatment of obesity. The clinic has extensive experience in performing this type of surgery.
In addition to the two obesity treatment centers, Munich has medical institutions such as the Munich University Hospital, the Rechts der Isar Clinic and others, where, in addition to treating various diseases, overweight correction and obesity treatment are performed.
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