MMW Fortschritte der Medizin
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Personal contact with a hospital and patients who have received treatment there offer the best opportunity to assess its quality. A certification merely shows that a quality management system has been implemented, but says nothing about the quality of the actual outcomes achieved. ⋯ There appears to be a correlation between large numbers of operations and the quality of the surgery. In this area, the physician is dependent on voluntary publication of performance reports.
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Obesity, defined as a body mass index of 30 kg/m2, or more is considered to be the decisive factor for the development of the metabolic syndrome and numerous other diseases prevalent in affluent societies. The high level of comorbidity and the shortening of life expectation underscore the need for an evidence-based, risk-stratified treatment strategy. Major elements of the latter are a hypocaloric diet that is also satiating, an increase in physical activity, specific behavioral changes and, where indicated, weight-reducing medication. For the treatment of extreme obesity, such surgical procedures as gastric banding or a gastric bypass are also available.