Dr. Sylvia Weiner is an experienced specialist in general and visceral surgery and one of the leading experts in the field of obesity and metabolic surgery. Since October 1, 2022, she has headed the Clinic for Obesity Surgery and Metabolic Surgery at Sana Klinikum Offenbach. With in-depth training in minimally invasive surgery and a clear focus on obesity surgery, Dr Weiner has specialized not only in the surgical treatment of obesity, but also in conservative therapeutic approaches and endoscopic procedures.
After studying at the University of Würzburg and gaining her license to practice medicine at the University of Giessen, Dr. Weiner began her medical career at one of the first German centers of expertise for obesity therapy at Sachsenhausen Hospital in Frankfurt. There she acquired in-depth knowledge in the holistic treatment of obesity. Her professional career then took her to the Main-Taunus-Kliniken Bad Soden and finally to Krankenhaus Nordwest in 2014, where she focused on obesity, visceral and reflux surgery in her position as Chief Physician. Another highlight of her career was the founding of the Obesity Academy together with Dr. med. The facility in Kelkheim offers comprehensive programs to combat and treat obesity and has quickly established itself as a leading institution in the Frankfurt-Rhine-Main metropolitan region.
Dr. Weiner is not only a recognized doctor and leader, but is also actively involved in raising awareness of the risks of morbid obesity. By taking on the patronage of the “Gesunde Neugier e.V.” association, Dr. Weiner is also committed to educating and supporting those affected and their families. Her motto “Obesity is not a fate, it's a disease!” reflects her passion for helping people to improve their health and quality of life in the long term.
In an interview with Dr. Weiner, the editorial team of the Leading Medicine Guide learned more about her work as the future patron of the association Gesunde Neugier e.V. and about the increasingly centralized disease of obesity.
Obesity, often referred to as morbid obesity, is one of the biggest health challenges facing modern society. It is not just an aesthetic problem, but is associated with numerous serious health risks, including cardiovascular disease, type 2 diabetes and joint problems. Despite the growing awareness of this issue, obesity is still often underestimated and inadequately treated. Early diagnosis and comprehensive treatment are crucial to improving the quality of life of those affected and avoiding long-term health problems. It is therefore of great importance to raise even more awareness and offer those affected targeted help - be it through medical treatment, psychological support or preventative measures.
Several measures are needed to reduce the stigma surrounding obesity and create greater acceptance of it as a chronic disease that should be taken seriously.
"Obesity is a serious metabolic disease - the public needs to become much more aware of this. It is indeed difficult to explain why this understanding is so difficult to gain acceptance. It seems as if society is downright opposed to recognizing obesity as a disease. Deeply rooted beliefs and social conditioning play a major role here, as do economic interests. Many companies benefit from the fact that the focus continues to be on self-discipline, diets and fitness programs - and not on the medical causes. In order to change society's image in the long term, comprehensive educational work is needed, especially on the part of doctors. The aim is to increase understanding of the pathophysiological relationships. Unfortunately, even in direct contact with those affected, it is often a challenge to make them understand that their illness has nothing to do with personal failure, but with a chronic metabolic change. Many still believe that they themselves are to blame for their situation - and this is a key problem. For this reason, I am intensively involved in public relations work, give lectures, train colleagues and try to make the topic more present in the context of medical training. At universities, this topic should be dealt with in a much more in-depth and differentiated way - but this change will take time," Dr. Weiner explains at the beginning of our conversation and adds:
"As far as social acceptance is concerned, we experience a form of stigmatization with obesity that is largely tolerated - it is socially acceptable, so to speak. And that is highly problematic. There is a lack of political interest, public discussion and, above all, a lobby for those affected. Obesity is a taboo subject - just as queer identities were for a long time. Here, too, it took decades for society to become more open and accept diversity. The big difference: in the case of gender identity, it is now widely accepted that no one is to blame for their identity. With obesity, on the other hand, it is not only outsiders who believe this - those affected themselves often wrongly take the blame for their condition. This shows how deep the social stigmatization goes. As long as there is no public debate and people with obesity are not given a voice in politics and the media, this image will only change slowly. This is precisely why a platform like Gesunde Neugier e.V. is so important - to promote discussion, impart knowledge and, above all, to create empathy".
The non-profit organization Gesunde Neugier e.V. is committed to helping people with obesity by raising awareness, networking those affected and offering concrete support.
Through events, lectures and its own platforms, the association provides information about the causes, consequences and treatment options of the disease and promotes understanding of obesity as a chronic metabolic disorder. At the same time, it supports self-help groups, arranges contacts with specialist clinics and consultants and promotes health-related projects in order to sustainably improve medical care and social acceptance of obesity patients.
"The initiative goes back to a former patient who - inspired by his own experiences - set himself the goal of taking the topic of obesity out of the taboo zone and creating supra-regional structures that network self-help groups and those affected. What began as a personal initiative was soon supported by medical experts such as Professor Dr. Meier, a pioneer of obesity surgery in Germany. With the generational change and Professor Dr. Meier's retirement, the patronage passed to new shoulders - with the aim of carrying the topic forward and providing new impetus. The vision: to create a neutral platform for exchange, education and networking - independent of hospital operators or industry interests. After all, in an area where pharmaceutical and medical technology companies are increasingly establishing their own formats, it is particularly important to offer an objective and trustworthy point of contact. In order to further increase the reach of the content, the association relies on a combination of press work, information events and close cooperation with regional obesity networks. Events are planned for those affected as well as formats for doctors in private practice - with the aim of not only talking about prevention, but also about specific approaches to therapies, advice and care. A particular focus is on dialog with self-help groups, whose wealth of experience and commitment are often indispensable for those affected. In this way, the association wants to help ensure that people with obesity finally get the social lobby they deserve," explains Dr. Weiner, who took over the patronage on May 1, 2025.
Several improvements in the healthcare system are needed to give obesity patients easier access to specialized doctors and clinics.
First of all, it would be important to facilitate access to specialized obesity centers. These centers offer comprehensive treatment, which often requires a multidisciplinary approach, and should therefore be promoted more strongly. "Many sufferers are faced with the problem of - metaphorically speaking - not seeing the wood for the trees. The multitude of information and contact points makes it difficult for them to find the right path to suitable treatment. It is particularly challenging to identify the right doctor or clinic that specializes in obesity and can provide individualized help. This is precisely where modern platforms come in to structure and facilitate access. Services such as the Obesity Academy and the website www.adiposa.clinic.com have created a way to make an uncomplicated online inquiry. In this way, targeted and regional referrals can be made - patients receive an initial orientation and are then directed either to suitable contact points locally or online. This structured referral follows the current medical guidelines, which clearly define the indications for treatment and thus enable targeted, needs-oriented management. Self-help groups play a key role in informing as many patients as possible about these digital options. They act as important multipliers in direct exchange with patients. In recent years, this network has been less active - after the death of the original founder of the association, there was a temporary lack of coordination and personnel commitment. However, this commitment is now being resumed in order to establish a strong connection to those affected, particularly via the self-help groups, and to provide them with low-threshold services. In Hesse in particular, there is already a broad network of committed self-help groups that not only do valuable work at a local level, but are also politically committed to bringing the issue of obesity more into the focus of public debate. This combination of digital platforms, personal advice and dedicated self-help forms the basis for making access to effective treatment much easier for those affected in the future," Dr. Weiner explains.
The medical recognition of obesity as a chronic disease is an important step in the fight against this widespread disease.
Despite this recognition, health insurance companies in Germany generally only cover bariatric surgery if a patient's BMI (Body Mass Index) exceeds a certain threshold. Dr. Weiner comments: "The question of health insurance coverage for bariatric surgery remains a sensitive and complex issue in Germany - mainly because access to surgery is linked to relatively high BMI limits. The impression is often created that patients with a BMI below 40 have little chance of receiving support. However, the medical guidelines are actually quite clear about the requirements for surgery: bariatric surgery is medically justified and can be performed if the patient has a BMI of 35 or more and relevant concomitant illnesses - such as type 2 diabetes or high blood pressure. According to the guideline, the procedure is also permitted from a BMI of 40, regardless of other illnesses. Nevertheless, patients with a BMI between 30 and 40 in particular find themselves in a therapeutic gray area. Although conservative treatment approaches such as nutritional advice, drug therapy or structured group programs (e.g. Optifast or offers from the Obesity Academy) are available for them, there is a lack of clear guidelines and comprehensive cost coverage by health insurance companies. Many of these offers are not reimbursable, which makes access more difficult for those affected. Although there are prevention programs that are offered and partially funded by central agencies, they are only available for people with a BMI between 25 and 30, and only without concomitant illnesses. Patients with a BMI over 30, but without an immediate indication for surgery, are often left to their own devices. This treatment gap is a central problem in obesity care in Germany. This is precisely why programs such as the Obesity Academy are used to make specific, quality-assured treatment options available to this target group," she continues:
"In practice, it also appears that many clinics now operate without lengthy cost applications because the legal framework allows this - provided the medical requirements are met. The often feared ‘application circus’ is therefore no longer a reality everywhere. Nevertheless, structural improvements are urgently needed, particularly in early care, in order to avoid long-term damage. Another point: the body mass index (BMI), on which many of these regulations are based, is a highly simplified measurement that was originally introduced by American insurance companies. It does not take into account muscle mass or water balance and therefore often only provides a rough picture. It is now increasingly recommended that modern measurement methods such as bioelectrical impedance analysis should also be used to assess body composition. International guidelines are already more advanced in this respect - in many countries, bariatric surgery is already planned from a BMI of 30 with secondary diseases. Germany is clearly lagging behind in this development. Experience has shown that it can take five to ten years before national guidelines are adapted accordingly. However, the need to revise the threshold values downwards is increasingly being recognized - not least in order to take preventive action before serious secondary diseases even develop."
Today, most health strategies for obesity focus on prevention and weight management through diet and exercise. However, in many cases this conservative treatment is not enough, especially for patients who are unable to significantly reduce their weight due to genetic factors or other serious health problems. For these patients, bariatric surgery could be one of the most effective and sustainable solutions. Earlier access to this type of surgery could help to reduce the risk of chronic disease and break the vicious cycle of obesity and its sequelae.
The role of the media and the food industry in the context of obesity development is complex and should not be underestimated. From a medical point of view, a major problem is that the industry shows no real interest in creating transparency about ingredients, processing levels or health effects.
"Political initiatives such as a sugar tax, which have already been successfully introduced in other countries, could also be an effective instrument in this country - but so far there has been a lack of implementation. At the same time, increasing media consumption, especially among children and young people, is having a massive impact on their perception of health. The constant confrontation with idealized body images, promises of beauty and supposedly health-promoting products in advertising, cooking shows and social media contributes to a distorted perception of health and nutrition. The media creates stigmatization and false ideals at the same time - a dangerous combination that contributes to the increase in overweight and obesity in young age groups. Another major problem is the consumption of highly processed foods," criticizes Dr. Weiner.
In a fast-paced society, many people turn to industrially produced convenience foods that are rich in additives, sugar and saturated fats. This is also a recurring theme in training programs - a central point here is the return to natural foods that are as unprocessed as possible. In order to really make a lasting change here, a much stronger commitment is needed at a political level.
"Health education and nutrition education should start at school, ideally with structured offers such as comprehensive school cooking programs, practical nutrition training and daily exercise programs. Closer cooperation with sports clubs and greater promotion of exercise programs could also make a decisive contribution to prevention. In the long term, it would therefore be necessary not only to take action at an individual level, but also to push for structural, social and political changes in order to enable children, young people and adults to lead healthier lifestyles - free from false promises and commercial interests," Dr. Weiner says critically.
One particularly noteworthy aspect of the Gesunde Neugier e.V. association is its low-threshold access to reliable information on all aspects of obesity. The aim is to make it as easy as possible for those affected to access counseling and therapy - without hurdles, without shame and with an open, supportive approach.
"The platform offers the opportunity to obtain information in an uncomplicated way and to take the first steps towards treatment - be it through online advice services, event information or networking opportunities with experts and self-help groups. It is precisely this low-threshold approach that makes the association particularly valuable. After all, those affected often don't lack the will to change, but rather the courage or the orientation as to where they can start. This is precisely where Gesunde Neugier e.V. comes in. The platform thrives on the participation of both patients and therapists. It is a non-profit association that grows and gains visibility through active participation, use and commitment. Therefore, every contribution is welcome - whether through voluntary work, by sharing content or simply by using the existing offers. After all, it is only through joint action that awareness of obesity as a serious disease can be further established in society. Instead of getting lost in often superficial discussions on social media, Gesunde Neugier e.V. offers a well-founded, supportive and neutral platform for real education and help," emphasizes Dr. Weiner at the end of our conversation.
Thank you, Dr. Weiner - raising awareness about obesity is immensely important!
