The State of Obesity and Bariatric Surgery in Austria
Obesity and Bariatric Surgery Trends Around the World
The state of obesity and bariatric surgery varies from country to country. In this series, authors from around the world discuss obesity and bariatrics in their country, answering questions on the most recent trends, most frequently performed procedures, access to care, health coverage, requirements, accreditation, and cultural considerations. This series is dedicated to providing updates on the global state of obesity.
This month:
An Interview with Dr. Karl Miller, Associate Prof. of Surgery at the University Clinic Innsbruck, Austria; Head of the Surgical Department, Hallein Clinic, Austria
FUNDING: No funding was provided.
DISCLOSURES: The author reports no relevant conflicts of interest.
Bariatric Times. 2014;11(8):26.
How did you become a bariatric surgeon? How many bariatric surgeons are there in Austria today?
Dr. Miller: I became a bariatric surgeon in 1994. After I completed my training with Professor Belachev, we formed a multidisciplinary team with Professor Hell. Together, we founded the Austrian Society for Obesity and Metabolic Surgery. My interest in becoming a bariatric surgeon started with performing laparoscopic anti-reflux surgery and implanted adjustable gastric bands. In Austria, there are 34 bariatric surgeons.
Do you need a special certification to conduct bariatric procedures in Austria?
Dr. Miller: Since 2002, the Austrian Society for Obesity and Metabolic Surgery has had the same criteria as the International Federation for the Surgery for Obesity and Metabolic Disorders (IFSO). We work on a quality control system, which will be established at the end of 2014. A legal requirement of specific certification, however, does not exist in Austria. Nevertheless, the hospital financing systems do cover procedures only in hospitals that perform more than 25 gastric bypasses procedures per year.
Are centers that perform bariatric surgery accredited by any society in Austria?
Dr. Miller: No, there is no accreditation, but we do have Centers of Reference, which fulfills the criteria of IFSO.
What is the obesity rate in Austria? Is it increasing or decreasing? How about children?
Dr. Miller: The obesity rate in Austria varies from East to West—six and 30 percent, respectively.
Is there anything unique about the country culture/lifestyle that may contribute to the obesity rate (e.g., extreme cold or heat, dominant occupations, access to food and drink)?
Dr. Miller: Interestingly, the lifestyle in West Austria seems to be significantly different from East. This may play a role in the West’s higher obesity rate.
What percentage of the obese population actually undergo bariatric surgery? Are those number increasing or decreasing?
Dr. Miller: The number of bariatric surgeries performed in Austria has remained stable for five years at approximately 2,400 procedures yearly. The estimated number of people with morbid obesity in Austria is over 100,000.
What are the current trends in bariatric surgery in your country? Meaning what are the most popular procedures?
Dr. Miller: The last survey from the Austrian Society for Obesity and Metabolic Surgery shows the following for 2013: gastric bypass (GBP), 74 percent (Y-Roux GBP, 63%, Loop GBP, 11%), gastric sleeve 17 percent, gastric banding, seven percent. Duodenal switch and minimally invasive procedures, such as primary obesity surgery, endolumenal (POSE), make up the remaining percentages.
What procedures do you perform at your center—order from most frequent to least frequent with statistics, if available.
Dr. Miller: I perform Y-GBP, loop GBP, Sleeve, gastric banding, and POSE.
What is thehealthcare/insurance system like in your country? How do patients pay for weight loss surgeries?
Dr. Miller: If the patient meets the criteria (Body mass index [BMI] > 35kg/m2 with comorbidities or BMI >40kg/m2 with and/or without comorbidities), the insurance system will cover the cost of the hospital. Bariatric surgeons are employed by the hospital. Private patients are the minority.
What is your prediction for the future of bariatric surgery in your country?
Dr. Miller: The future must be prevention programs because the huge number of procedures will be not be possible with our resources. In my opinion, the future of surgery is minimally invasive procedures (e.g., endolumenal) as well as bypass procedures as a prevention for type 2 diabetes.
If you would have to choose a bariatric procedure for yourself or a relative of yours, which one would you choose?
Dr. Miller: Honestly, I would prefer a satiety procedure, such as POSE. I would not wait until I was morbidly obese. I would decide on an intervention much earlier. I know that those minimally invasive procedures will not work in patients with eating disorders, and fortunately, I do not have an eating disorder.
Category: International Perspective, Past Articles
Subscribe
If you enjoyed this article, subscribe to receive more just like it.
