[Bariatric surgery -- stereotypes and paradigms]. / Adipositaschirurgie im interdisziplinären und rechtlichen Spannungsfeld.

Many physicians regard obesity as a sin and treat fat patients with disdain befitting a moral leper. Non-bariatric physicians, being a product of our culture, seem more likely to have an obesity paradigm close to that of the public. Many members of the public regard obesity surgery as dangerous. Many insurers reject morbid obese patients from bariatric surgical treatment with the paradigmal statement that obesity is totally the fault of a fat person. These medical experts do not accept obesity as a disease (which WHO does) and therefore social courts also reject applications of patients who want to undergo bariatric surgery. Morbid obesity is a multifactorial problem with genetic, biochemical, hormonal, environmental, behavioral and cultural elements. It is recognized as an extreme health hazard which is rarely the result of an aberrant moral problem or true addictive behavior. We need to change effectively the negative paradigms towards obesity and its surgery from some of our colleagues, hospital administration, medical insurers and the public. The existing prejudices are not acceptable.