After interventions to reduce the number of knee operations in people over 50, the National Institute for Health and Disability Insurance (RIZIV) has come up with an action plan against hasty gastric reductions.
Because some overweight people go under the knife too quickly, the INAMI imposes a ‘minimum pre-operative period’ of three months.
In our country, 20 percent of the adult population suffers from obesity. It is estimated that about 14,000 people are operated on for this annually.
Under the knife too soon
“Currently, in Belgium, we note that the time span between the first consultation with a bariatric surgeon (bariatric surgery – also known as obesity surgery – is the branch of surgery that deals with the surgical treatment of obesity ed.) and the intervention varies greatly : although most interventions take place after those 3 months, of which 25% after 6 months, 31.7% of the interventions take place within a period of less than 3 months, and 4.3% without prior consultation”, says the INAMI.
In a report on the efficacy, safety and cost-effectiveness of bariatric surgery, the Federal Knowledge Center for Health Care (KCE) already showed in 2009 that “surgery is more effective than conservative treatment in morbid obesity and severe obesity, in combination with other conditions.” on the other hand, the procedure does not solve all the problems and there is a risk of complications and side effects, because for a successful, long-term effect, the patient must adapt his eating habits and behavior (e.g. more physical activity) throughout his life, and he must undergo long-term medical, nutritionally and psychologically. He must therefore be well informed about this, and he must receive good guidance, both before and after the procedure”.
One speaks of being overweight when the BMI (= body mass index) > 25, of obesity or obesity with a BMI > 30. This obesity is called “morbid or morbid” from a BMI > 40. (BMI = weight in kg/ (height in m)² ).
The KCE study also recommended an interval of at least 3 months between the initial consultation and the actual procedure, except for urgent medical reasons. That waiting time should lead to better guidance. Ideally, obese patients also see a dietician, psychologist and endocrinologist in the meantime.
The new action plan, which requires a ‘minimum pre-operative period’ of three months, should lead to ‘a better thought-out operation policy’, says Michel Creemers, the chairman of the National Council for Quality Promotion (NRKP) of the RIZIV in De Tijd. ‘Now sometimes operations are performed too quickly.’
Bart Van der Schueren, the head of the UZ Leuven obesity clinic, regrets in the same newspaper that the postoperative process was not included. “Guidance is also crucial after the procedure. An operation is anything but the end point. Ultimately, it comes down to more exercise and healthy eating.”
2023-08-26 07:15:00
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