The COVID19 virus and obesity – a dangerous combination

Since the beginning of 2020, and probably even before, the COVID-19 virus, which is considered dangerous, has been rampant throughout the world. The pandemic development summarised under the collective term Corona crisis has far-reaching consequences for all life in the world – also in Switzerland. Even if the infection figures and the number of deaths caused by COVID-19 are currently declining, the virus has not gone away. It is still there. And in many countries there is and growing fear that a second high wave of infection can be expected in autumn at the latest.

Evaluate risk groups correctly

In principle, it can be assumed that almost anyone can be infected by the Corona virus. Across age groups, social boundaries and income groups, the virus can affect anyone. Protective measures such as social distancing, wearing mouth and nose masks and maintaining good hand hygiene can significantly reduce the risk of infection, but not eliminate it.

With the statistical collection and evaluation of data on the course of the Corona pandemic and its spread, certain risk groups have been defined whose risk of infection is clearly and measurably above average. Currently known risk groups include

  • in principle, all persons aged 65 and over
  • People with high blood pressure
  • Adults with chronic respiratory diseases
  • Diabetics of both levels
  • Men and women with diseases and therapies associated with a weakened immune system
  • all people with cardiovascular diseases and
  • Cancer patients.

Many of these diagnoses also apply to severely overweight people who have a BMI of over 40 and are thus classified as severely obese.

Obesity and corona form a dangerous combination

Interesting and at the same time worrying is the combination of obesity and an infection with the COVID-19 virus. After all, chronic obesity is often associated with risk factors such as high blood pressure, fatigue, diabetes, a weakened immune system, cardiovascular problems and a lifestyle that is accompanied by little exercise in the fresh air.

In this constellation, very overweight people are particularly often found in the risk groups for corona infection. This means that significantly obese adults in particular are at substantially greater risk of infection.

What we recommend to patients with obesity

In the dangerous connection between obesity and the risk of corona infection described above, we recommend that people who are significantly overweight receive accompanying advice and care from a specialist, for example from the obesity surgery doctors in the Swiss1Chirurgie and Centre for Bariatric Surgery (ZfbC) clinics. Here, people are aware of the entire problem of obesity, especially in connection with the COVID19 virus, and can give the decisive tips.

In addition, affected patients are advised to seek treatment at the Swiss1Chirurgie obesity centres before the expected arrival of the second wave of infection. In addition to thorough diagnosis and advice on individual treatment options for morbid obesity, the specialists at Swiss1Chirurgie and ZfbC offer comprehensive advice on preventive options for sufferers with regard to possible COVID-19 disease.

Focus on dietary and lifestyle changes

Given the particular vulnerability of overweight people with a BMI of 40 or more, it is strongly advised that they immediately change their entire diet and lifestyle to a healthier option. What is so easy to put into words here poses great challenges for most of those affected.

Therefore, specialist counselling and care is an option that should definitely be used, not only with regard to the risk from the COVID19 virus. This is because overweight people in particular often have an accumulation of risk factors that favour both infection with the corona virus and a comparatively more problematic course of the disease.

Irrespective of the current corona pandemic, we strongly advise overweight people to seek specialist advice, treatment and care, for example in the Swiss1Chirurgie obesity surgery clinics. Not only does this effectively counteract the risk of a severe course of COVID-19 infection, but it is also a promising first step towards a healthier future overall.

Grade III obesity as a risk factor for a more severe course of COVID-19

is officially on the list as of today: Annex 6 of COVID Regulation 2, adaptation of 14 May 2020, item 7.

To the list

Communication from: Eidgenössisches Departement des Innern EDI Bundesamt für Gesundheit BAG Direktionsbereich Öffentliche Gesundheit Sektion Prävention in der Gesundheitsversorgung

Prof. Dr. Jörg Zehetner supervises the European Mountain Village Championship 2020

Dear patients and interested parties, dear newsletter subscribers,

for the Soccer Bergdorf European Championship 2020 in the Ottmar-Hitzfeld-GsponArena, Prof. Dr. Jörg Zehetner from Swiss1Surgery will provide medical care for the entire tournament. At his side are experienced medical professionals who are constantly dealing with infection events in Switzerland with appropriate preventive care and support, even during the corona pandemic. In addition to the observation and assessment of the situation regarding the corona pandemic, the accident-surgical and surgical departments are also the focus of care during the days from 28 to 30 August 2020.

From June 12th to June 14th 2020 the games of the Small Mountain Village European Championships took place in the Ottmar-Hitzfeld-GsponArena. The games of the upcoming official Bergdorf European Championship 2020 have already been played here on the professional kicker table. And with great national and international interest. Belgium ultimately won the tournament, followed by Germany and Switzerland. Whether this will also be the final result of the true Bergdorf European Football Championship 2020 in Staldenried / Gspon is still up in the stars high above the Valais mountains.

Jörg Zehetner on the Bergdorf EM and the health situation

In total, Prof. Dr. Jörg Zehetner commented on the tournament in the mountains and the health situation at the Small Mountain European Championship. Due to the extremely low and well-controlled infection rate in Switzerland, he has so far seen no obstacles that would call the Bergdorf European Championship 2020 into question at the end of August. Special observation is given by Dr. Jörg Zehetner the Swedes, who have to report significantly higher infection numbers than Switzerland and other European countries because of a different way of dealing with the crisis.

Jörg Zehetner always focuses on the health of active players, referees, helpers and the people from the audience. The doctor is always in discussion with the official offices and authorities as well as with the organizers of the Bergdorf EM 2020 regarding the current situation assessment.

There is no denying the great interest that the doctor is bringing to the extraordinary football tournament. Even the Small Mountain European Championship as a preliminary tournament for the big mountain football meeting demands respect and appreciation, since he also likes to see his own children at the table at home. And of course, the sporting aspect and the charitable commitment are also the focus here.

Before we now read the full text of the interviews with Prof. Dr. Jörg Zehetner summarize, we would like to refer you to the recordings of the interviews on the occasion of the Small Mountain Village European Championship. You can find the links here.

For more information, use the website of the Bergdorf EM 2020 www.bergdorf-em.com or the information directly on the website of Swiss1Chirurgie or in the app m.swiss1chirurgie.ch .

We wish you a pleasant summer time and maybe see you again at the Bergdorf European Championship 2020 from 28th to 30th August 2020 in Staldenried / Gspon in the Valais mountains.

Until then, greet you warmly

Jörg Zehetner and the
Swiss1Surgery team

Aftercare in the focus of obesity surgery

Interview with Dr Steffen, ZfbC

In an in-depth interview, Dr Steffen from the Centre for Bariatric Surgery ZfbC discusses the importance of follow-up care for overweight patients. In addition to the actual bariatric surgery, structured aftercare is of enormous importance. Only if those affected are actively involved in the process throughout their lives is sustainable success possible. A detailed article on the interview and the interview with Dr Steffen himself can be found here.

New information page for patients: www.nachsorge.ch

Aftercare in the focus of obesity surgery

Anyone who talks about bariatric surgery, such as stomach reduction or the formation of a tube stomach, must also talk about professional aftercare and further treatment for patients.

This is exactly what Dr Steffen from the ZfbC, Centre for Bariatric Surgery, does in the featured video interview. With over 30 years of experience and 3,600 stomach operations performed himself in the field of obesity surgery, Dr Steffen is one of the leading luminaries in this medical speciality in Switzerland.

Evaluation of the risks

Whether gastric banding, gastric bypass, stomach reduction or other techniques, there is always a certain risk of relapse for the treated patients. It is precisely the reduction of the recidivism rate, ZfbC, when it comes to professional aftercare following obesity surgery. Dr Steffen makes this unmistakably clear.

Obesity treatment is a lifelong process

It should also be clear that after an initial operation for the majority of those affected, there will be further interventions to ensure the success of obesity surgery. At the same time, this means that in the majority of cases, surgery alone will not be enough for the rest of one’s life. Accordingly, it is important to accompany and care for the patients continuously and individually in the aftercare.

Children in obesity surgery

According to Dr Steffen, children are not excluded from the problem of morbid obesity. Fat children usually also become fat adults, so that early intervention can make sense if there is an appropriate indication. It is important to note that the rules and regulations for bariatric surgery must also be observed for minors.

Follow-up care is the decisive success factor

Dr Steffen believes that ongoing follow-up care is more important than the timing of the surgical intervention. From experience, he knows that many patients do not take proper care of themselves after an initial overweight operation has been performed. However, it is also the professional colleagues who must be held accountable, as they do not always focus on special aftercare in their further care. Here, the ZfbC can definitely fill treatment gaps. One should understand morbid obesity similarly to an incurable disease, so that a good strategy for lifelong aftercare must be presented here as well. What Dr. Steffen cannot understand is the fact that he repeatedly encounters patients who are left alone in their problem situation after obesity surgery and are not sufficiently perceived.

Accordingly, the ZfbC would also like to open up to patients who have not been treated in a Swiss1Chirurgie clinic or an affiliated clinic. Here, anyone who complains about a wide range of problems after bariatric surgery should get a sympathetic ear and professional support. What definitely does not work is that patients are simply left to their own devices after obesity surgery with reference to their diet programme. This contradicts every ethical and medical claim.

It should also be clear in this context that anyone who cannot successfully deal with their excess weight before an operation will not be able to do so without help even after the operation has taken place.

Understanding aftercare as a standard

For Swiss1Chirurgie, structured aftercare is part of the standard in obesity surgery. Even though this is unfortunately not the case everywhere, the experts at Swiss1Chirurgie, together with the ZfbC, attach great importance to professional and structured aftercare in the best interests of the patient. This is the only way to ensure initial success, to identify problems in time and to build on the long-term success of the therapy. Anything else doesn’t make much sense.

It is also worth noting that deficiency symptoms can always occur due to the way the different treatment methods work. Such processes must of course be monitored and controlled to show patients how to compensate for certain deficiencies such as calcium deficiency or vitamin deficiency.

Follow-up care for overweight patients is a team effort at ZfbC. In addition to Dr Steffen himself, other specialist colleagues also devote themselves to the patients’ problems in special aftercare consultations. Around 8,000 patients are now being cared for. In the regulations, the Federal Office of Public Health requires follow-up over five years. However, the experts at Swiss1Chirurgie know that, in fact, lifelong follow-up of patients is sensible and necessary. Here, the legislative requirements obviously fall short.

Complications can occur at any time

The problems of the individual patients are very different. The aftercare must be correspondingly individualised. Some of the problems are real complications such as chronic abdominal pain, persistent diarrhoea, deficiency symptoms, vomiting or other functional problems. In principle, every affected person must expect that some kind of problems will occur over a short or longer period of time. Even if this ultimately does not affect everyone, it is still a clear proportion of patients who have to deal with certain problems after obesity surgery.

Alcohol and obesity

As Dr Steffen clearly explains, alcohol has a special effect on obesity and even more so on patients treated accordingly. In his opinion, alcohol has just as high a caloric value as pure fat, in addition to the typical symptoms of intoxication. Accordingly, it makes little sense or is even counterproductive for overweight patients to consume alcohol beyond a low level. The best thing would be to abstain completely from alcohol. This is also the aim of good aftercare.

With every intervention, the risk increases

Regarding the general risks in obesity surgery, Dr Steffen emphasises that laproscopic surgery as such is first of all extremely safe and associated with only a few risks. The first operation is always less risky than every subsequent one, although it also depends on how experienced the surgeons are in the respective clinics. Much more common are the complications that can occur after the procedures. First and foremost are deficiency symptoms, digestive problems and problems in the area of the oesophagus. This must always be expected after obesity surgery, which is why lifelong aftercare is also sensible and recommended. This must also be clear to the general practitioners and is already addressed in the first educational discussion.

Obesity and Corona

Currently, the corona virus plays a significant role in society as a whole. Those who are overweight must expect a more severe course after an infection due to their physical constitution. If overweight people already have breathing problems, these will certainly be even greater with COVID disease, even more so with assisted or artificial ventilation. It is difficult to decide not to operate on overweight people now, as they will then be much more affected in the event of an infection later on.

The role of general practitioners

The first way for overweight people who want to improve their situation is always to see their family doctor. The latter will then make a referral to the specialists in the given case. Here, the Swiss1Chirurgie clinics are recommended as competence centres for bariatric surgery. The family doctor could also be the first point of contact for appropriate information to the patient. In addition, we as Swiss1Chirurgie offer a comprehensive information service for all those affected. This ranges from our special consultation hours to the detailed and extensive information on the internet and via our app. However, information about any site or place on the internet is always associated with the risk of getting the wrong information. Here, Dr Steffen likes to refer to the pages of Swiss1Chirurgie, which, in contrast to any forums or chat rooms, provide extremely professionally correct, comprehensive and structured information.