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Obesity in Germany

• While people with other chronic diseases, such as diabetes mellitus, have access to a wide range of treatment methods, experts and contact points, this is not – or only marginally – the case for people with obesity. Even among physicians and other professional groups, there are completely outdated ideas about the nature of the disease and available treatment options. The causes of this disease are not taught at universities and are not known to the majority of the medical profession.4
• The overwhelming majority of those affected do not receive a guideline-based therapy – although one does exist. This is unimaginable in the case of recognised diseases.
• Useful treatment methods exist but are only reimbursed to a limited extent and on a case-by-case basis. Drugs are completely excluded from reimbursement.
• Obesity is not recognized as a chronic disease in Germany, rather it is still classified as a lifestyle disease. At the same time, treatment in the concomitant and secondary diseases (e.g. diabetes mellitus, coronary heart disease, high blood pressure) is running at full speed and absorbs resources amounting to billions.5 It is obvious that obesity treatment – and also its recognition as a chronic disease – would make the system as a whole, much more efficient. Overweight accounts for 10.7 % of Germany’s health expenditure.6
• Obesity is predominantly classified as a “lifestyle phenomenon” in terms of health policy as well as treatment. In today’s social paradigm, patients are expected to solve their “lifestyle problem” independently and “alone”, using personal resources.
• People with obesity are exposed to huge stigma with terms such as “weakness of will”, “self-inflicted” and “lack of discipline” used regularly.
• Due to the prevailing paradigm and prejudices experienced by people with obesity, self-stigmatisation becomes deeply entrenched. Their value as a person in society is no longer recognised; guilt and shame weigh heavily on most of those affected. This results in the isolation of people with obesity who rarely seek help, are trapped by their shame and often simply give up.

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About the German Obesity Alliance (DAA)

The DAA is committed to:

  • Fundamentally changing the awareness of, and attitude towards, obesity in German society.
  • Advocating for better research, prevention and care of obesity.
  • Creating successful cooperation between member organisations and affected persons in Germany. This will be achieved through:
    • Intensive communication and coordination amongst members
    • Professional project management
    • The integration and alignment of members’ goals.
  • The development of a strategy called “further up the river” which aims to position obesity as a chronic disease which can lead to other serious diseases (e.g. diabetes, cardiovascular disease etc). In this way, both the economic and medical significance/effectiveness of an effective obesity treatment and strategy can be clearly demonstrated politically.

Key Achievements

• Held inaugural meeting to agree on mission, vision and plans
• Signed Letter of Intent (LOI) with most important stakeholders
• Developed national briefing book on obesity, calling for action
• Held an expert talk at Parliament with various Members of the German Parliament (MdB)
• Onboarded additional organisations
• Held goals workshop at German Parliament and established working groups to drive action
• Cooperation with International Obesity Networks (e. g. OPEN)

Priorities in 2020 and beyond

  • The DAA is developing a joint project and action plan to significantly change the current situation for people with obesity in Germany.
  • The DAA members contribute to the work of the DAA as experts and affected persons, in particular members:
    • Commit themselves in public to the goals of the DAA.
    • Make an active contribution to the development of projects, topics and messages.
    • In accordance with available resources, work on the overall development of the DAA, its financing and the implementation of an action plan as a virtual joint project as well as promoting the work of the DAA. Current examples are:
      • Mention of the DAA at the congress of the German Obesity Society (Sept 2019; key note and press release)
      • Presentation of the DAA at a conference (University of Witten/Herdecke, April 2020)
  • In the medium and long term, the DAA is to be transformed into a sustainable organisational structure. This structure should be partly oriented towards models such as the National Cancer Plan and other national and international success models.
  • A key focus of the DAA is to establish an expert group to develop the strategy “further up the river” as well as feed into the policy debate on obesity and its impact upon “neighbouring” indications. A number of experts as well as the conclusions from the German White Book on Obesity show that good obesity treatment should have strong, positive effects on secondary diseases (“further down the river”).

Members of the German Obesity Alliance

Status: April 2020

Alexander Krauß: Member of the German Parliament (MdB)
Melanie Bahlke: 1st Chairwoman of the Obesity Surgery Self-Help Germany e. V. (AcSD e.V.)
Andreas Herdt: 2nd Chairperson AcSD e.V.
Dr. Christine Stier: Member of the Board of the Working Group Metabolic Endoscopy of the German Society for Endoscopy and Imaging Techniques e. V. (DGE-BV) and Committee Member of the Bariatric Endoscopy der International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO)
Prof. Martina de Zwaan: Chairwoman of the German Obesity Association (DAG)
Dr. Stefanie Gerlach: Board of the German Obesity Association (DAG), Media-Spokesperson
Dr. Susanne Weinbrenner: Deutsche Rentenversicherung (DRV, German Pension Insurance)
Dr. Christina Holzapfel: Working Group Obesity, Professionals Association Oecotropholgie e. V. (VDOE)
Dr. Andrea Lambeck: Managing Director, Professionals Association Oecotropholgie e. V. (VDOE)
Thomas Hegemann: Organizational and strategic developer and coach, expert for the German healthcare system, Managing Partner CGC GbR
Dr. Robert Haustein: Head of Berlin Office, Market Access & Public Affairs, Novo Nordisk Pharma GmbH
Daniela Rimpf: Patient Relations Manager, Novo Nordisk Pharma GmbH
Oliver Martini: Director Government Affairs & Policy, Johnson & Johnson GmbH

To find out more, please contact the DAA Secretariat

References

1 Schienkiewitz A et al. (2017). DOI 10.17886/RKI-GBE-2017-025.
2 Effertz T et al. (2015). DOI 10.1007/s10198-015-0751-4.
3 Whitlock G et al. (2009). DOI 10.1016/S0140-6736(09)60318-4.
4 Caterson ID et al. (2019). Diabetes, Obesity and Metabolism; 21(8): 1914-1924.
5 Klein S et al. (2016). Weißbuch Adipositas, S156.
6 OECD (2019). The Heavy Burden of Obesity. Oe.cd/obesity2019.