DGVS calls for research in the fight against obesity

17.05.2015 17:51

Germans are gaining weight: According to a current WHO forecast, almost half of all women and two thirds of all men in Germany will be overweight by 2030. Based on surveys from 2010, the proportion of obese women and men is estimated to be growing by six and seven percent respectively - unless successful countermeasures can be taken. In view of this prediction, the German Society for Gastroenterology, Digestive and Metabolic Diseases (DGVS) warns of the long-term consequences and calls for more research into the prevention and treatment of obesity in connection with metabolic diseases.

Overweight starts with a body mass index (BMI) of 25, obesity from 30. This corresponds to a weight of 98 kilos and a height of 180 centimeters. According to the WHO forecast, in 15 years almost one in four men and one in five women would be obese. “We need clear and evidence-based concepts with which we can successfully counteract this fatal development,” explains DGVS spokesman Professor Christian Trautwein, Director of the Clinic for Gastroenterology, Metabolic Diseases and Internal Intensive Care Medicine (Medical Clinic III) at the RWTH Aachen University Hospital.

The consequences for the metabolism are significant and sometimes even fatal for patients. In up to 90 percent of severely overweight people, the liver becomes fatty. The organ often becomes inflamed and fatty liver disease develops. If not treated early, hepatitis can progress to liver cirrhosis and liver cancer. An increase of five units in body mass index (BMI) increases the risk of hepatocellular carcinoma by an average of 39 percent. “A new DGVS guideline has just been published that doctors can use as a guide when treating non-alcoholic fatty liver disease,” says Trautwein. In addition to developing scientifically based treatment recommendations, it is necessary to invest even more in prevention research, the expert adds. For example, in recent years it has become apparent that the composition of the intestinal flora influences weight. “Studies suggest that disruptions to the microbiome promote a tendency to be overweight,” explains Trautwein. Children who receive antibiotics during the first five months of life are more likely to be overweight. Conversely, a change in the intestinal flora also seems to improve obesity and diseases such as type 2 diabetes. “Such connections need to be investigated in more detail and the functions of individual strains of intestinal bacteria need to be clarified,” says Trautwein.

It is part of every doctor's mandatory program to help his patients lose weight and to familiarize them with the principles of prevention: sufficient exercise and a moderate, appropriate diet. Interdisciplinary, individually tailored treatment approaches help those who are overweight most effectively. The DGVS believes that surgical treatment of obese patients should remain the last resort. A surgically inserted gastric band or gastric bypass reduces the size of the digestive organ and makes the patient feel full more quickly. Surgical treatment is recommended for a BMI of 40 or more, and for a BMI of 35 or more only if there are comorbidities. “It must become a matter of course for patients and doctors to regularly look at the scales,” says Trautwein. “If we manage to draw the right conclusions from the statistics, the trend may be reversed in the foreseeable future.”