Obesity is also known as obesity . This refers to an increase in body fat that exceeds normal levels.
Obesity is medically assessed and categorized using the body mass index (BMI ). It is calculated as the quotient of body weight (kg) and height squared (m²).
- Overweight (preadiposity): BMI 25-29.9
- Obesity grade 1: BMI 30-34.9
- Obesity grade 2: BMI 35-39.9
- Obesity grade 3 (morbid obesity, morbid obesity): BMI ≥ 40
As a result of severe obesity, people with morbid obesity often suffer from comorbidities such as
They also have an increased risk of strokes, joint diseases and certain cancers.
The treatment of obesity aims to achieve a permanent reduction in body weight. This initially involves a range of conservative measures such as
- nutritional counseling,
- exercise therapy and
- psychological support by means of behavioral therapy
are available.
Surgical intervention is usually only considered when all conservative therapies have been exhausted without success. The range of surgical therapies used in certified obesity centers includes in particular

Obesity requires interdisciplinary treatment © Kurhan | AdobeStock
Certification as an obesity center is only awarded to surgical clinics and specialist departments that
- fulfill the certification criteria and quality requirements defined by the DGAV and CAADIP and
- have successfully completed the certification process.
The list of requirements for certified obesity centers includes, among other things
- Minimum intervention figures in the field of bariatric surgery,
- quality characteristics of the treating physicians,
- the existence of interdisciplinary cooperation with other medical specialties,
- the implementation of quality assurance measures,
- regular participation in further training and
- specifications for equipment and departmental organization.
These criteria for certified obesity centers can be met to a lesser or greater extent. Surgical clinics or specialist departments can therefore be certified as
- competence center,
- reference center or
- center of excellence
for bariatric surgery and metabolic surgery.
An important criterion for certification is interdisciplinary cooperation. The specialist areas involved in the competent diagnosis and treatment of obesity include
The management of a certified obesity center is usually the responsibility of the obesity surgery department in the visceral surgery department. Within the framework of an obesity center, this specialist department cooperates in particular with the specialist departments mentioned above. Close cooperation and direct communication between these specialist departments is of the utmost importance.
The social and psychological care of obesity patients beyond pure treatment is also part of an obesity center. For this reason, certified obesity centers must also have cooperation agreements with
must exist.
The interdisciplinary cooperation in certified obesity centers is intended to provide comprehensive care for obesity patients. An obesity center must be able to guarantee therapies that are optimized for the individual patient.
The aim of certification as an obesity center is to improve the quality of treatment and at the same time make it transparent.
The DGAV and the CAADIP define the certification criteria according to scientific guidelines and clinical experience. If a specialist department meets these criteria, it can be assumed that it meets the highest quality standards in the treatment of morbidly obese patients.
The certification procedure for obesity centers is organized on behalf of the DGAV and CAADIP. It is carried out by the Servicegesellschaft für Allgemein- und Viszeralchirurgie SAVC GmbH.
In the first step, the SAVC formally examines the application for certification submitted by a surgical clinic or department. The application can be for certification as a competence center, reference center or center of excellence for bariatric surgery and metabolic surgery.
If the surgical clinic or department to be certified formally meets the criteria, the next step is an on-site audit. This involves checking whether the information on the quality of the obesity center to be certified is correct and whether the facility actually meets all certification criteria.
After the on-site audit has been evaluated, a decision is finally made. If the obesity center to be certified meets all quality requirements and criteria, it is awarded the certificate as a competence center, reference center or center of excellence for obesity surgery and metabolic surgery.
Quality requirements and criteria for certification as a center for obesity surgery and metabolic surgery are
Qualification of physicians
The responsible surgeons must be visceral surgeons with special experience in obesity surgery.
Specifically, they must have been working in bariatric surgery for at least 5 years. They must also have personally performed at least 100 bariatric surgery procedures.
Departmental organization
Obesity centers must regularly offer special obesity consultation hours at least once a week. During these consultations, the indication for surgical treatment and the aftercare of patients who have undergone surgery are determined.
The workflows for
- Establishing the indication,
- preoperative diagnostics and preparation,
- patient information,
- anesthesia,
- surgical procedures,
- complication management and
- aftercare
must be set out in writing.
Equipment
The following equipment and facilities must be available in obesity centers:
- at least one operating table with a load-bearing capacity of at least 225 kg
- a complete laparoscopic unit
- instruments and materials adapted to the needs of bariatric surgery
- Equipment adapted to the requirements of morbidly obese patients, e.g.
- Special beds,
- special chairs,
- wheelchairs and
- examination tables with a load capacity of up to 200 kg,
- special scales,
- barrier-free showers and
- nightgowns and underwear in special sizes
Interdisciplinary cooperation
Obesity centers must demonstrably cooperate with the departments of
- Internal Medicine,
- laboratory medicine,
- radiology,
- interventional endoscopy,
- intensive care medicine,
- physiotherapy,
- nutritional counseling,
- psychology and psychosomatics and
- self-help groups
cooperate. In addition, access to conservative treatment programs should be possible.
Minimum number of interventions
Obesity centers must have at least
- 50 (competence center),
- 100 (reference center) or
- 200 (center of excellence)
obesity surgery procedures per year. These must include, among other things
are included.
Quality assurance
Obesity centers must, among other things, fully document all obesity surgery procedures for quality assurance purposes. The data of the interventions and follow-up examinations must be entered into the CAADIP database.
Follow-up care must be documented for at least 75 percent of patients who have undergone surgery.
Further training
Departmental staff in obesity centers must have access to the latest literature on obesity surgery. The responsible surgeons must regularly take part in further training events, such as
- CAADIP meetings,
- congresses or symposia recommended by the CAADIP,
- DGAV workshops on the subject of bariatric surgery.
The Center for Bariatric Surgery and Metabolic Surgery certificate is valid for three years after initial certification. Re-certification is possible after three years. In this case, the certified obesity center must undergo a new certification procedure by the DGAV and CAADIP.