Diet Doctor - Nutritional Medicine Germany

How Much Does a Diet Doctor Cost in Germany?

For patients from abroad, the cost for a diet doctor is strictly regulated by the German government (GOÄ Department). German specialists in nutritional medicine are not entitled to determine their own self-calculated fees for medical services. They are legally obliged to adhere to the official fixed tariff rates for doctors.

In order to calculate the costs for a therapy in weight loss and/or optimum nutrition, healthy diet centers first require detailed information about the patient. This data can be transferred to the diet doctor in form of medical reports, findings or images taken prior to treatment. The diet center then prepares a cost estimate. In most cases, the amount due must be paid in advance.

What is Nutritional Medicine?

The purpose of nutritional medicine is to properly diagnose diseases and to heal or improve the patient’s condition by adjusting and improving his diet as well as by giving weight loss tips in order to avoid illness in first place. Nutritional medicine is a branch of medicine used in many medic fields.

How Does a Healthy Diet Look Like?

According to current knowledge, a healthy diet consists of a balanced mixed menu of macronutrients (protein, carbohydrates, fats) and micronutrients (vitamins, minerals, trace elements) which need to be consumed on a regular basis in the required amounts.

Since bad nutrition can not only be detrimental to our health but can also aggravate already existing diseases, it is important to maintain a healthy diet. The intake of optimum nutrition reduces the risk of getting specific diseases (cardiovascular, gastrointestinal, cancers, etc.). However, for certain diet-related illnesses, even the healthiest food will not help and in this case, a diet doctor for medical advice will be needed in order to change nutritional habits.

Which Doctors are Specialists in Nutritional Medicine?

Which doctor is specialized and suitable depends on the patient’s age. At a young age, pediatricians advise patients on nutritional issues. In adulthood, physicians in internal medicine (endocrinology, diabetology, gastroenterology, angiology, cardiology) as well as general practitioners with an additional certification or a degree in nutritional medicine can help patients. At old age, specialists in geriatrics (social science dealing with the health and care of old people), physicians for internal medicine, and general practitioners can help.

In Which Diseases is Nutritional Medicine Applied?

Nutritional medicine is used for the therapy of many disruptions. Its use is not limited to the digestive system. It is also used in maladies of the nervous system, joints and bones, kidneys, and many other mild afflictions of the body. Below is a short list of syndromes treated with therapeutic nutritional medicine:

• Diabetes mellitus (high blood sugar): There is type 1 diabetes mellitus which is congenital. Type 2 diabetes mellitus usually occurs in adulthood and is caused by poor diet and lack of exercise.
• Disorders of lipid metabolism: This includes, among other things, an elevated cholesterol level. With a change in diet, the increased cholesterol levels can be partially counteracted.
• Metabolic Syndrome: A disease composed of several physical symptoms including obesity, increased blood pressure, lipid metabolism disorders, and insulin resistance of the body's own cells. Again, the diet plays a major role in the onset of the metabolic syndrome.
• Food allergies: Food allergies cause individual intolerance to food. Diet doctors can sustainably adapt patients’ eating habits.
• HIV infection and AIDS: The drug therapy of HIV can lead to serious nutritional metabolism problems.
• Alcohol addiction: Alcohol addiction leads to malnutrition as well as lack of vitamins and trace elements due to the fact that alcoholics cover most of their calorie needs with alcohol and eat little other foods.
• Kidney disease: In order not to aggravate long-term kidney disease, the diet is adjusted to prevent the illness from progressing.
• Urinary stones: One of the main risk factors to get a urinary stone is wrong diet.
• Gout: A purine rich diet (meats and alcohol) is a major risk factor for getting gout.
• Osteoarthritis and arthritis: Conditions of osteoarthritis and arthritis can be improved by adjusting the diet.
• Dementia: Several studies show that deficiency of certain vitamins may be associated with dementia.

Diseases of the Digestive Tract

• Heartburn (Reflux): The unpleasant eructation of stomach acid (acid belching) is influenced by food.
• Inflammation of the gastric mucosa (gastritis): Gastritis is caused by a wrong diet, among other things.
• Lack of absorption of nutrients (malabsorption): There are many reasons for a lack of intake of nutrients, such as inflammation of the intestinal mucosa.
• Gluten intolerance (celiac disease): Gluten (cereal protein) triggers an inflammation of the intestine in those afflicted.
• Short bowel syndrome: As a result of certain diseases, parts of the intestine have to be removed and therefore, certain food components can no longer be absorbed by the body. The result are deficiency symptoms.
• Lactose intolerance: In the case of lactose intolerance, dietary behavior has to be changed since the digestive system cannot process milk sugar.
• Liver diseases: The liver plays a central role in our digestion. If this organ is defect, our digestive system will not work properly anymore.
• Gallstones: The cause of gallstones is attributed to a high-calorie and high-fat diet.
• Inflammation of the pancreas (pancreatitis): The pancreas produces substantial materials for the digestion. In an inflammation of the pancreas, the goal is to burden the pancreas as little as possible. Accordingly, the food behavior must be changed.

How Does Nutritional Therapy Work?

In the course of therapy, medical staff asks about nutritional behavior and performs physical and laboratory diagnostic tests. This creates a specific profile of the patient. An individual therapy, which contributes to the cure of the disorder, is adapted to this profile.

Nutritional therapy is rarely the only therapeutic measure, but very often part of an overall therapeutic concept.

If food intake through the mouth is not possible, nutritional therapy measures can also be achieved via artificial nutrition.

Sources (German books):

Ernährungsmedizin; Thieme 2010 (Biesalski, Hans Konrad; Bischoff, Stephan; Puchstein, Christoph)

Public Health, Gesundheit und Gesundheitswesen 2. Auflage; Urban & Fischer (F.W. Schwartz, B. Badura)