IFSO 2019 Congress in Madrid

Morbid obesity is a chronic disease

After London 2017 and Dubai 2018, the World Congress of the International Federation of Societies of Obesity Surgery (IFSO) was held this year in the Spanish capital Madrid.

One of the topics was the stigmatisation of overweight patients. There was agreement on this topic that morbid obesity is indeed a chronic disease and requires appropriate treatment. The times when overweight patients are ridiculed, laughed at or even insulted in public must finally be over. With obesity surgery, this group of patients also has access to a variety of different treatments and interventions that can successfully address and permanently treat this condition.

This was an important topic in the meeting of bariatric surgery specialists from the cantons of Switzerland, who had the opportunity to exchange views on this topic at a joint dinner during the congress.

 

What is the state of facts?

In Switzerland, there are primary centres and centres of reference for obesity surgery. Whereas in a primary centre only the first operation for patients with BMI 35-49 may be performed, in a reference centre re-operations (new corrective operations) and very heavy patients (BMI greater than 50) may be operated on. This is an arrangement that makes it difficult for many patients to undergo continuous treatment that is ultimately accompanied by visible, tangible and countable success in the long run.

Swiss1Chirurgie has responded to this together with the Beau-Site clinic in Bern and the Espace Chirurgie clinic in Biel. The obesity surgeons in Biel perform the initial operations at the Hirslanden Klinik Linde and the re-operations with Dr Zehetner at the Klinik Beau-Site.  At the Beau-Site Clinic in Bern alone, 500 of the 4,500 surgical procedures performed annually throughout Switzerland are carried out. At the Centre for Bariatric Surgery in Bern (ZFBC), these patients are pre-cared for, operated on by Swiss1Chirurgie surgeons and then followed up again at the ZFBC. This means that within the Hirslanden network, Swiss1chirurgie has the greatest expertise in bariatric surgery in Switzerland and guarantees the highest level of patient safety.

What patients with problems after obesity surgery can do

Have you already had obesity surgery and are not receiving follow-up care? Or have you put on a massive amount of weight again after the operation and don’t know what to do next?

Ask your general practitioner to refer you to one of our Swiss1Chirurgie locations in Bern, Solothurn or Brig (www.swiss1chirurgie.ch). We can then admit you to our aftercare programme at the Centre for Bariatric Surgery (www.zfbc.ch) or arrange for clarifying examinations for a possible corrective operation to lose weight again.

Of course, the World Congress also focused on the big issues in obesity surgery. Here are a few key points on the results:

  • The most common obesity surgery worldwide is the tube stomach (sleeve).
  • The gastric band is hardly ever done anymore, under 1% of all overweight operations.
  • In patients with reflux, the gastric bypass has advantages over the sleeve.
  • In severely overweight patients, OAGB (one loop anastomosis gastric bypass) is also a possible option.
  • Endoscopic revisions such as anastomotic stenosis with Apollo Overstitch are used more frequently, especially in cases of dumping and recent weight gain.

Learn more? Then simply contact me and let me advise you on the most promising options for the surgical treatment of obesity and reflux disease.

Learn what is being done before any obesity surgery

Bariatric curriculum prepares for obesity surgery

With the newly created Bariatric Curriculum, the ZfbC, Thun Abdominal Surgery and Swiss1Chirurgie prepare their patients even better for the upcoming obesity surgery. In a seminar, all questions regarding preparation and execution, anaesthesia and the time after the surgical intervention are answered and essential procedures are explained. More information and safety are the objectives of the Bariatric Curriculum, which was developed especially for the overweight patients.

Every operation is a serious procedure that always involves certain risks. This also applies to bariatric surgery, even if it can be carried out minimally invasively in large numbers, i.e. without large surgical openings of the abdominal wall.

Many patients have a great interest in knowing how such operations are carried out and what is actually done. This is less about the specific techniques and procedures. Rather, patients are interested in how such an operation is prepared, how it proceeds and what risks are to be expected. And it is also interesting how to behave after such an intervention.

In order to be able to cover this justified interest as far as possible, the Centre for Bariatric Surgery ZfbC, the Abdominal Surgery Thun and Swiss1Chirurgie, under the essential leadership of Dr. med. Sebastien Trachsel, have developed a Bariatric Curriculum, which can provide answers to the most important but also personal questions of patients. This will make a significant contribution to more information, education and patient safety.

What the Bariatric Curriculum does

Anyone preparing for obesity surgery has many questions. The better such questions can be answered, the greater the patient’s confidence in dealing with the upcoming operation. Patients can take part in this bariatric curriculum as early as two to three weeks before the planned surgery.

The short but very informative seminar explains which clinical procedures are required and how the anaesthesia will proceed. In addition, of course, there is the general information provided by the surgeon, so that after about two hours of seminar the patients are well prepared for their individual operation. Of course, this does not exclude personal counselling and care directly at the clinic. Rather, this is part of the preparation for the operation and helps to objectively classify concerns, fears and reservations. This is also helped by the fact that directly after the bariatric curriculum there is the opportunity to ask personal questions and receive the appropriate answers.

This is especially important for patients who are undergoing surgery for the first time or who have already had less positive experiences in other operations. Knowing everything that is coming is an essential part of obesity surgery, which is a not insignificant intervention in the future shape of one’s life.

This also means that the dietary changes required before and after the operation can be discussed in detail. This way, the patients already know what their special menu will look like in the clinic. Physiotherapeutic counselling and care are also part of the obesity surgery. How do you get up after the procedure? What should be considered in the movement? How is scar protection ensured? These are also questions of general and personal interest that should and must be discussed in the run-up to the operation.

The bariatric curriculum also includes thrombosis prophylaxis, so that our patients know in advance how they can set the points themselves and thus actively participate in the success of their obesity surgery.

The strength of the bariatric curriculum, which we have developed especially for our overweight patients, lies in the totality of counselling, care and support already two to three weeks before the surgical intervention.

We see more information, more security and more self-participation in the process as an important and essential contribution in the interest of our patients, whom we also want to prepare well for the upcoming operation and life afterwards with the Bariatric Curriculum in seminar form and by answering their personal questions.

Overweight patients need long follow-up care

Swiss1Chirurgie offers aftercare following obesity surgery

From their many years of experience, the specialists at Swiss1Chirurgie know that many patients do not receive any or only inadequate medical aftercare following obesity surgery. In this context, consistent and regular follow-up care of patients is enormously important if the success of gastric surgery is not to be gambled away. Furthermore, complications after bariatric surgery can endanger the health or even the life of the patients concerned.

Based on this knowledge, the Swiss1Chirurgie clinics offer continuous follow-up care and treatment for patients, even if they have not been operated on in a Siwss1Chirurgie clinic. In this way, the Swiss1Chirurgie clinics make a valuable and important contribution to the sustainable success of obesity therapy for all patients who have not yet received regular, long-term follow-up care.

Swiss1Chirurgie offers an end-to-end treatment concept

Those who face up to their obesity problem must also be aware that successful long-term treatment is an ongoing process that also requires specialist medical support. Especially when the problem of morbid obesity is associated with surgical interventions, long and professional aftercare is needed.

Time and again we meet patients in the Swiss1Chirurgie clinics who are left to their own devices after bariatric surgery. And yet, especially after stomach reduction or similar surgical procedures, it is urgently necessary to accompany and care for these patients in their further development.

The success of obesity surgery always depends on the follow-up care that follows. Follow-up surgeries and counselling also help to ensure long-term and lasting weight loss success. Here, the specialists at Swiss1Chirurgie offer a professional concept of aftercare and further treatment.

After the operation comes the actual treatment

In cases of morbid obesity, surgical treatment is always only one of many steps to improve the health of the affected person. Even in the run-up to the surgical procedures, we work together with the patients to ensure that the conditions for the stomach operation can be created. Once the operation is over, however, the process continues.

In addition to the regular discussions and examinations in the follow-up care, it is not uncommon for further interventions to be necessary if the success of the first stomach operation is not to be jeopardised. In many cases, follow-up operations are even part of the treatment concept and are designed to ensure overall success in the treatment of obesity.

Accordingly, thorough counselling, care and support for patients after the first operation is not an optional extra, but a must. For the sake of the patients, their health and their efforts to achieve an improved quality of life.

Aftercare is often neglected

As already noted, we repeatedly come across patients from other clinics where follow-up care after obesity surgery is clearly neglected or, in the worst case, not carried out at all. This not only poses risks to the success of the obesity surgery, but can even be life-threatening.

Complications that are recognised too late or not at all, unabated inappropriate dietary behaviour and a number of other reasons lead to the success of the stomach operation being gambled away and, in an emergency, the patient’s life being put at risk. We therefore urge all patients who have undergone obesity surgery to contact one of the Swiss1Chirurgie clinics with their problems in the event that follow-up care is lacking or inadequate. Online you will find a simple questionnaire that will give you first clues and possibilities for a professional and continuous aftercare. Use this questionnaire to get into initial contact with us.

Swiss1Chirurgie takes over the aftercare

Knowing that many patients do not receive consistent and long-term follow-up care after a surgical procedure related to an obesity problem, we offer such regular and professional follow-up care for all obesity patients.

This offer also expressly applies to patients who have undergone an operation for obesity surgery at another clinic. In this way, we want to ensure that all patients receive exactly the follow-up care and treatment that is appropriate to their particular situation. After all, the long-term success of obesity surgery is always based on professional, regular and lasting aftercare.

As an affected patient, contact us to schedule an initial consultation. Ideally, you should fill in our online questionnaire. We will then contact you as soon as possible to discuss the further steps of targeted obesity therapy, even after an obesity operation has already been performed.

Find out more at nachsorge.ch

Swiss1Chirurgie informs patients and endocrinologists

New set of rules for obesity surgery

From 01 January 2021, it will be possible to have obesity surgery from a BMI of 30+ with concomitant type 2 diabetes. One of the prerequisites is that diabetes can no longer be safely controlled by conventional means. Only a few specialist clinics are authorised to perform such operations. This also includes the clinics of Swiss1Chirurgie, which offer such procedures in the Helvetia Holding AG network. Learn more about the BAG’s decision.

Overweight surgery possible from BMI 30 with diabetes as of 2021

Being overweight is not something to be trifled with. All those affected know this just as well as we do as medical specialists. For years, the experts at Swiss1Chirurgie have been observing the development of obesity in modern industrialised countries. It is becoming increasingly clear that the proportion of overweight people is growing. Associated with this are not only the individual restrictions and complaints. Healthy societies quickly become sick societies through an oversupply of food at any time in any place and correspondingly wrong nutritional behaviour, whose lack is above all abundance.

So far, health insurers and medical organisations, together with politicians in Switzerland, have agreed that surgical interventions to reduce weight are only possible for a BMI of 35 or higher and are financed accordingly. It was completely ignored that a BMI of 35 or more is already an enormously high value, which is already associated with numerous secondary diseases and complaints. Such concomitant diseases not only complicate the lives of the patients themselves, but are often also a clear obstacle in the preparation and implementation of necessary obesity surgery.

From 2021 the threshold is BMI 30

In accordance with the interventions of the medical specialists and a close observation of the development, the politicians together with the medical profession have decided to lower the threshold value for bariatric surgery in the context of obesity surgery now to a BMI of 30, provided that the patients are affected by diabetes at the same time.

This long overdue decision will benefit patients who, despite being diagnosed with obesity and the corresponding symptoms, were previously not included in the group of patients for whom obesity surgery was an option.

This means that a wide range of conditions closely related to obesity can be treated much sooner and necessary and desired surgical interventions can also be carried out. This will have a lasting impact on the quality of life of people with a BMI over 30 and diabetes, and ultimately reduce the proportion of severely overweight people, along with the social and economic costs.

Advantages especially for humans

The decisive advantages of this decision now lie above all with those people who, with a BMI of 30 or more and diabetes, are already clearly affected by morbid obesity. Now the suffering of these people can be significantly shortened. This is also because it obviously does not make sense to wait for an enormously high BMI of 35 and more until a surgical intervention for weight reduction is made possible by the regulations.

A major advantage of this decision is that the extent of overweight and the associated concomitant and secondary diseases such as diabetes, cardiovascular diseases and arthrosis can be significantly reduced. The psychological suffering can also be significantly shortened and patients with a BMI of 30 or more with diabetes may now place themselves in the hands of the experienced specialists in obesity surgery. The Swiss1Chirurgie clinics are among the specialist medical clinics that will be authorised to perform surgical procedures to reduce excess weight from a BMI of 30 with diabetes from 01.01.2021.

Determine your BMI here and find out whether and under what conditions you belong to the circle of possible candidates for obesity surgery.

TO THE BMI CALCULATOR

In addition, we recommend that all severely overweight people contact a Swiss1Chirurgie clinic. By doing so, you will take the first step towards a better, healthier future in 2021 and use the possibilities of modern medicine to improve your life.

Contact Swiss1Chirurgie here.

Stigmatisation Obesity. What does that mean?

Dr. med. Jörg Zehetner on the problem of obesity and what it means for those affected.

As part of the lecture series of Helvetius Holding AG, Dr. med. Jörg Zehetner, Professor USC, took a stand on the stigmatisation of overweight people and the resulting consequences for those affected. In his lecture in the Saaser-Stube Saas-Fee, the experienced physician, who also deals intensively with obesity problems, described the circumstances that obesity patients have to live with practically every day.

They are among us

At the beginning of the lecture, Dr Zehetner made it clear that practically everyone knows the overweight. In one’s own family, in one’s circle of friends or in the circle of colleagues, they exist everywhere and the number of those affected is constantly increasing. And the lives of patients with obesity are not easy.

Where stigmatisation begins

Look at the fat guy! Oh, she’s fat. The fat man should exercise more. Look what he’s got in his shopping basket, and he’s already fat enough.

This is how the stigmatisation of overweight people begins. Without asking why or wherefore, without taking into account how people are personally affected, they are consciously or unconsciously pigeonholed into a category in which they neither belong nor can free themselves from it. Besides the flippant remarks, there are also those that really hurt and don’t help the people concerned at all.

Reduce prejudices

Anyone who has studied the problems of obesity and adiposity in depth knows that those affected suffer greatly from their current life situation. A first step towards at least reducing this unfortunate situation would be to dismantle popular prejudices. It’s always the best moment for that.

The fight against obesity requires a professional network

Hardly any overweight person with a serious problem will be able to successfully face the disease alone in the long term. Even though overweight surgery is now a proven and successful means of fighting the extra pounds, it requires targeted networking before, during and after the medical intervention. For this purpose, a professional network has been established under the umbrella of Helvetius Holding AG, which provides advice, support and assistance to patients in all phases.

Large social alliance against stigmatisation necessary

The topic of obesity is present everywhere. Not only in everyday life, but also in the media, people are encountering this topic more and more frequently and intensively, in addition to the commonly known jokes and remarks about being overweight. From stigmatisation, the path to discrimination is usually a very short one. Obese people are associated with a conceptual world that is anything but pleasant or appreciative. Especially when you don’t know these people personally. This stigmatisation extends far into the personal and social lives of those affected. Even professional life is not excluded. To change this, a large social consensus is needed.

Steps out of stigmatisation

If the spiral of stigmatisation and discrimination against overweight people is to be broken, a clear line is needed. And this begins precisely where obesity is understood as a disease and thus also as treatable and curable. Only then can an active approach be made to these people, who can then actively face their problems themselves without having to continue to hide.

A further step would be to significantly rethink the approach to these patients. And in every area of life and in every encounter with overweight people. Only when the stigma is taken away from these people will they themselves be able to actively enter into the process of their recovery. Dignity, respect and tolerance are exactly the right keywords here.

It is important to also perceive overweight people as valuable members of our society and to recognise that they are not lazy, sedentary, unpleasant and low performers, but sick. And something can be done about diseases, including morbid obesity.

Define obesity as a disease

Anyone who takes a closer look at overweight and obesity will quickly be able to understand them as actual diseases. As with any organic disease, there are clear definitions and developments, but also therapeutic interventions that clearly speak for a clinical picture. A first indication of this is the division into different classifications of overweight, starting from the Body Mass Index, BMI.

Although obesity surgery is a helpful intervention, it does not by itself solve the problem. Being morbidly overweight is and remains a chronic disease that requires lifelong attention, but not disparaging stigmatisation.

More in-depth information on the topic is available in the video recording of the lecture (LINK) and directly on the Swiss1Chirurgie website.