Der Diabetologe

, Volume 2, Issue 3, pp 243–249 | Cite as

Chirurgische Therapie der Adipositas

Möglichkeiten und Grenzen
Leitthema

Zusammenfassung

In den letzten Jahrzehnten hat der Anteil an übergewichtigen (BMI=25–29,9 kg/m2) und adipösen (BMI≥30 kg/m2) Personen in der westlichen Welt dramatisch zugenommen. Übergewicht betrifft mittlerweile rund 1,7 Mrd. Menschen weltweit: So sind rund 1/3 der US-Amerikaner und die Hälfte der Europäer übergewichtig. Besonders dramatisch war der Anstieg bei den extrem übergewichtigen Personen: Diätprogramme, medikamentöse und verhaltenstherapeutische Interventionen brachten in der Behandlung der morbiden Adipositas (BMI≥40 kg/m2) nicht den gewünschten Langzeiterfolg. Nur mit chirurgischen Methoden können eine dauerhafte Reduktion von 25–80% des Übergewichts und damit verbunden eine Heilung bzw. Verbesserung diverser Begleiterkrankungen (Diabetes mellitus Typ 2, Hyperlipidämie, Hypertonie, Schlafapnoe usw.) erreicht werden. Im vorliegenden Artikel werden die derzeit gebräuchlichen bariatrischen (bari: althebräisch: Fett) Operationsmethoden unter Berücksichtigung von Resultaten und Komplikationen beschrieben.

Schlüsselwörter

Bariatrische Chirurgie Adipositaschirurgie Morbide Adipositas Magenbypass Gewichtsverlust 

Surgical treatment of obesity

Options and limitations

Abstract

In recent decades there has been a dramatic increase in the proportion of overweight (BMI 25–29.9 kg/m2) and obese (BMI ≥30 kg/m2) persons in the western population; 1.7 billion people are affected across the world. Approximately two thirds of adult Americans and half of adult Europeans are considered overweight.The most rapid growth has been observed in the subgroup of the severely obese (BMI ≥35 kg/m2). In the long term, conservative treatment (diet, drugs, behavioural therapy) has not had the hoped-for success in morbidly obese (BMI ≥40 kg/m2) patients. Only with specific surgical procedures can a permanent weight reduction (by 25–80% of the excess weight) be achieved with correction or improvement in various associated morbities (diabetes type 2, hyperlipidaemia, hypertension, sleep apnoea) postoperatively. This paper describes current surgical procedures applied in the treatment of obesity with reference to their results and complications.

Keywords

Weight loss surgery Morbid obesity Gastric bypass Weight loss Duodenal switch 

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Copyright information

© Springer Medizin Verlag 2006

Authors and Affiliations

  1. 1.Universitätsklinik für Chirurgie, Leitstelle 21AAKH Wien, Medizinische UniversitätWienÖsterreich

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