Dr. Volkan Arayıcı Reports a Shift From Aesthetics to Obesity-Related Comorbidities Among German Bariatric Patients

German patients choosing bariatric surgery in Izmir are increasingly motivated by health concerns rather than appearance alone, according to Dr. Volkan Arayıcı who treats many international patients.

Izmir — The profile of German patients seeking gastric sleeve surgery in Turkey appears to be changing. While weight-loss surgery has long been associated in public discussion with body image and lifestyle goals, Dr. Volkan Arayıcı, bariatric and general surgeon based in İzmir says the patients he now sees from Germany are more likely to describe obesity as a chronic medical condition linked to Type 2 diabetes, high blood pressure, sleep apnea, joint pain and reduced mobility. He is a member of International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO).

“A few years ago, concerns about appearance often played a major role in the decision to undergo surgery,” said Dr. Volkan Arayıcı. “Today, we see a different picture. Many patients now come to us after researching obesity-related conditions. They are more aware of the medical risks of obesity and of the potential role of bariatric surgery within long-term treatment.”

From appearance-led enquiries to medical decision-making

For surgeons, this changes the nature of the first consultation. Patients who previously asked mainly about expected weight loss or physical change are now more likely to ask about metabolic improvement, medication use, long-term monitoring, nutrition, fertility, mobility, cardiovascular risk and the realistic limits of surgery.

Dr. Arayıcı said this does not mean appearance has disappeared from the discussion. Rather, it is no longer the dominant reason for many German patients.

In Germany, 17.9% of adults aged 18 and over with plausible height and weight data had a body mass index (BMI) of 30 or more, while 35.5% were in the BMI 25 to under 30 category. Taken together, 53.4% were above the normal-weight BMI range.

Revision surgery outshines

Another area where Dr. Arayıcı reports a change is revision bariatric surgery. He said more German patients are now contacting his practice after a previous bariatric procedure did not produce sufficient long-term results or after they experienced complications or weight regain.

Revision surgery may include procedures such as conversion from a gastric band to sleeve gastrectomy, or from gastric sleeve to gastric bypass in selected cases. These operations are clinically more complex than first-time bariatric procedures and require careful assessment of the patient’s previous surgery, anatomy, nutritional status, reflux symptoms, weight trajectory and metabolic conditions.

“Revision cases require a different conversation,” Dr. Arayıcı said. “The patient often arrives with a history of disappointment or concern. The first step is not to promise a second procedure, but to understand why the first treatment did not achieve the expected outcome and whether surgery is medically appropriate.”

GLP-1 medicines are changing who reaches surgery

The wider use of GLP-1 receptor agonists has also influenced the patient profile, although Dr. Arayıcı cautions against presenting medication and surgery as simple alternatives.

“Patients with a comparatively lower BMI are now more likely to try medical treatment first,” he said. “As a result, some of the patients who eventually turn to surgery have higher BMI values, more obesity-related conditions and more complex medical histories. We are also seeing more patients who have used GLP-1 analogues before considering surgery.”

İzmir is part of the German patient route

Türkiye remains a major destination for German travelers. Izmir is the third most visited city in the country by German visitors, after Antalya and Istanbul. It has international flight connections, a long-established tourism infrastructure and healthcare providers accustomed to communicating with international patients. Cost considerations may also play a role in why some patients look outside Germany, although clinicians stress that price alone should not determine a surgical decision.

Dr. Arayıcı said German patients tend to ask more detailed questions than in previous years about hospital standards, anaesthesia, complication management, post-operative nutrition and communication after returning home. “The best-prepared patients are not simply comparing destinations,” he said. “They are comparing medical processes.”

About Dr. Volkan Arayıcı

Dr. Volkan Arayıcı, a member of International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO), is a bariatric and general surgeon based in İzmir, Türkiye. He has more than 10 years of experience in gastric sleeve, gastric bypass and revision bariatric surgery. His practice works with international patients, including patients from Germany, and provides bariatric surgery assessment and follow-up within a clinical care pathway.

Contact: 
Op. Dr. Volkan Arayıcı
info@volkanarayici.com
volkanarayici.com
+905324666767