Prof. Dr. med. Kaja Ludwig, chief physician and deputy medical director of the Klinikum Südstadt Rostock about experiences at the obesity center.
Well over half of Germany's population is overweight, and one in four is even morbidly obese, which is what medical science refers to as obesity. Where do you see the causes for the increasingly high proportion of people who are overweight?
Prof. Dr. Kaja Ludwig: The population of Mecklenburg-Vorpommern leads the statistics for overweight people in Germany. But the problem is not region-specific, it exists worldwide. Living conditions have changed fundamentally globally. 100 years ago, people walked an average of 12,000 steps a day; today, they walk 2,800 to 3,500 steps. The car dominates mobility. Industrialization has also led to an extreme decrease in physical labor, and the proportion of computer jobs is still growing. Leisure time behavior is also too often dominated by sedentary activities such as TV, video and computer games. This is compounded by unhealthy eating habits. We eat too much sugar and too much fat.
Does people's education play a role in obesity and malnutrition?
Prof. Dr. Kaja Ludwig: In our experience, all social classes are affected by overweight and obesity. However, a healthy and varied diet also has its price and is not affordable for everyone. Fast food is often cheaper and also hits the taste buds of many people due to the sugary additives.
Should a sugar tax be introduced?
Prof. Dr. Kaja Ludwig: In France and Mexico, there have been good experiences with the tax. It has encouraged manufacturers to bring products with less sugar onto the market. In Germany, this tax is rejected because consumers are expected to take responsibility for themselves. Klinikum Süd in Rostock has earned a good reputation for treating obese patients.
What is the treatment strategy?
Prof. Dr. Kaja Ludwig: When a patient comes to the special outpatient clinic, we start by evaluating therapy offers. An interdisciplinary team of psychologists, physiotherapists, nutritionists, internists and surgeons work closely together to help patients individually achieve long-term, stable weight loss and minimize the risks of secondary diseases. These are primarily high blood pressure, diabetes, heart disease and cancer. Scientists believe that from a body mass index of 40, human life expectancy is shortened by about 7-8 years. With our structured conservative treatment program over six to twelve months, good results can be achieved, provided the patient actively participates and is willing to change his or her previous lifestyle habits.
When are surgical interventions necessary?
Prof. Dr. Kaja Ludwig: Surgery is always an intervention in the integrity of the individual and should only be considered when the medical indicators for it are present. People with a BMI above 45 and 50 can hardly achieve any significant long-term weight reduction by conservative means. For the most part, they have been through countless diet programs and their expectations are dampened. In weighing the risks and benefits, surgical stomach reduction may be a good way to get a better handle on lifestyle changes. The surgical procedure results in the patient having to undergo regular check-ups and rely on taking minerals and medications.
What do you advise patients to do to prevent obesity?
Prof. Dr. Kaja Ludwig: First of all, it is important to look in the mirror and become aware of one's own lifestyle habits. After that, everyone should have the courage to put their self-knowledge into practice. Just get up and go. It's best to get a dog and walk 10,000 steps every day. I also recommend regular contact with your family doctor, who can keep an eye on your fat metabolism through medical checkups and identify problems in good time.
