Treating obesity: the options

The German S3 guideline recommends combining adjusted eating, more everyday movement and elements of behavioural therapy. Not a crash diet, but changes you can sustain long term.

Behavioural therapy helps you spot patterns, such as eating when stressed or bored, and build new routines.

Medicines are approved for adults with a BMI of 30 or more, or 27 or more with a weight-related condition. They're used alongside the foundation therapy, not instead of it. GLP-1 medicines, which influence fullness, are the best studied.

GLP-1 treatment at Solean is self-pay.

A fluid-filled balloon is placed in the stomach via endoscopy or a capsule. It takes up space and encourages earlier fullness. It stays only for a limited time, usually a few months, and is then removed.

Nausea and cramps are typical in the first days. Whether the weight change lasts depends heavily on the habits formed during that time. Costs are usually not covered by statutory insurance.

Operations such as gastric bypass or sleeve gastrectomy permanently change the digestive tract. Under the guideline they're mainly considered at very high BMI, or high BMI with serious related conditions, usually after other measures haven't been enough.

Surgery is a major procedure with lifelong follow-up, such as regular check-ups and vitamin and mineral supplements.

This Journal article offers general information. It is not a diagnosis, a prescription or a promise of any result. Whether treatment is suitable for you is decided by a doctor after reviewing your questionnaire. For acute or severe symptoms, contact your GP, the out-of-hours medical service (116117) or, in an emergency, 112.