Can I have obesity surgery ?

Adresse

Switzerland

Christian Toso
Professor
Christian Toso
Head of Division

What are the criteria to be eligible for obesity surgery?

To be eligible for obesity surgery, you must meet the following criteria established by the Swiss Society for the Study of Morbid Obesity (SMOB):   

  • Your BMI is ≥35 (grade II obesity or above),Your BMI is between 30 -34.9 (grade I obesity) and you are suffering from diabetes at the same time
  • You have followed a weight reduction program monitored and accompanied by a health professional (physician, nutritionist, dietitian, psychotherapist) or, in some cases, on your own, for a minimum of two years, without lasting success,
  • You agree to attend regular follow-up visits after surgery. These follow-up visits are essential for the success of the procedure. 

If you meet all criteria, the Federal Social Insurance Office (OFAS) recognizes the benefits of the operation for you. From then on, your health insurance company will cover the costs of the intervention and postoperative follow-up. 

What are the contraindications ?

Obesity surgery cannot be performed if you have one of the following conditions, because the risk to your health and well-being would be too high :

  • Severe liver disease, such as cirrhosis,
  • Severe kidney failure without dialysis,
  • Severe mental disorders,
  • Chronic substance abuse (for example: alcohol, cannabis, opiates),
  • Mental incapacity to understand the conditions and constraints of postoperative follow-up (requires a formal assessment by a specialized healthcare professional)

This list includes the most common contraindications to obesity surgery. Depending on your health status, we may perform additional investigations to ensure that obesity surgery is safe for you.

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If you are 65 years old or above, you can still be eligible for obesity surgery but the risks and benefits of the procedure need to be carefully weighed.

What can I expect from obesity surgery ?

This intervention will help you :

  • Significantly and sustainably lose weight,
  • Improve your health  and improve and/or cure obesity-related diseases such as diabetes, hypertension and sleep apnoea
  • Improve and/or cure gastroesophageal reflux disease 
  • Improve your quality of life, especially by increasing your physical capacities

What can I do to get the best results from this surgery ?

Surgery does not do all the work. In order to obtain the greatest benefits from it, you should be aware that the operation is only effective if :

  • You adopt healthy eating habits for life,
  • You come to the appointments set with your surgeon and the team (see What follow-up after your discharge? ),
  • You take regular blood tests to monitor your nutritional status,
  • You take lifelong, daily vitamins and sometimes other nutritional supplements, as prescribed by your physicians,
  • You engage in regular physical activity.

How is the operation scheduled ?

After your initial visit with your surgeon, your case is presented at a multidisciplinary meeting including several healthcare professionals (internal medicine physicians / endocrinologists, nutritionists, specialized dieticians, psychiatrists and psychologists). If the multidisciplinary team sees no contra-indication, the preoperative work-up can begin. The time interval between your first consultation and the procedure is usually three months, but it can sometimes be longer, for instance if additional investigations need to be performed or if your preparation to the intervention supervised by a dietitian or a nutritionist is not sufficient yet. Our team will keep you updated at every step of the process. 

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Gastric bypass is the intervention of choice for patients with obesity suffering from diabetes, gastroesophageal reflux and hiatal hernia.

What examinations, consultations and measures are necessary before obesity surgery ?

The following steps are mandatory for all patients

  • Participation to a 3-day preparation course with the team of the Patient Therapeutic Education Unit (UETP)
  • Blood tests
  • Upper endoscopy (also called gastroscopy), to rule out esophagus and/or stomach disease (and to treat a bacteria called  Helicobacter pylori, if it is present in your stomach)
  • Abdominal ultrasound to detect stones in the gallbladder
  • Assessment of your respiratory function
  • Electrocardiogram, possibly a cardiac ultrasound
  • Consultation with a psychiatrist
  • Consultation with an anaesthesiologist
  • Consultation with a dietitian
  • Protein-rich diet three weeks before the operation. 

Depending on your health status, the following additional measures might be required

  • Sleep study, if there is a suspicion of sleep apnoea. If the diagnosis of sleep apnoea is confirmed, you must wear a breathing therapy device at night for at least three months before surgery
  • Cessation of smoking in order to reduce the surgical risks (leakage from the anastomosis and ulcer) at least three months before surgery
  • Consultation with an endocrinologist if you have diabetes
  • Consultation with a pulmonologist
  • Consultation with a cardiologist.
     

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The most appropriate obesity surgery intervention for your will be chosen according to your needs and your health status.

More information

Last update : 04/01/2022