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Preparing for bariatric surgery: diet, tests, Tunisia
Preparing for bariatric surgery in Tunisia: pre-operative diet, tests, psychological assessment and stopping smoking

Preparing for bariatric surgery in Tunisia: pre-operative diet, tests, psychological assessment and stopping smoking

In short: Preparing for bariatric surgery takes months, not days, and the quality of that preparation strongly influences safety and long-term results. It includes a complete medical assessment with blood tests, vitamin levels and an upper endoscopy, screening for sleep apnoea, a psychological assessment that looks at eating behaviour and expectations, nutrition counselling, stopping smoking, adjusting medicines, including weight-loss injections, and usually a low-calorie diet for a few weeks before the operation to shrink the liver. If you plan surgery in Tunisia, you also need to organise your follow-up in Switzerland before you leave. Surgery in Tunisia is significantly cheaper than in Switzerland; the exact price is given in a free personal quote within 48 hours.

This guide is written for people living in Switzerland, including expatriates in Geneva, Zurich, Basel and Lausanne, who have decided, or are close to deciding, on a sleeve or a gastric bypass. If you are still choosing between procedures, start with our guide on how to choose weight-loss surgery. Here, we focus on the months and weeks before the operation: what is checked, why, and what you can do yourself.

Contents

Why does preparation matter so much?

Is bariatric surgery just an operation?

No. Medespoir’s guide to obesity surgery describes it as a tool in the service of a change in lifestyle, not a passive solution, and stresses that lifelong follow-up, especially nutritional follow-up, is essential. The Swiss Society for the Study of Morbid Obesity and Metabolic Disorders (SMOB) makes the same point in its guidelines: surgery alone does not achieve lasting results without dietary, physiotherapeutic, psychological and social support. Preparation is where that support begins.

What does good preparation achieve?

Four things. It makes the operation safer, by detecting and treating problems such as sleep apnoea, uncontrolled diabetes, anaemia or a stomach infection beforehand. It makes the operation technically easier, by reducing the size of the liver. It helps choose the right procedure, for example by revealing reflux that makes a sleeve less suitable. And it prepares you for life afterwards: eating differently, taking supplements for life and coping with the psychological changes of rapid weight loss.

How long does preparation take?

In Switzerland, the SMOB guidelines require a structured preparation of at least three months between the first contact with the centre and the operation, longer when nutritional knowledge, adherence or follow-up are uncertain. Teams abroad do not follow the Swiss insurance rules, but a serious team will still insist on a complete assessment. Even if you are self-funding surgery in Tunisia, plan at least a few months between your first contact and the operation.

Can a team refuse to operate after the assessment?

Yes, and that is a sign of seriousness. Medespoir’s obesity guide states that it never proposes a technique before the endoscopy and refuses a request when the desired technique does not match the assessment. A postponement is more common than a refusal: a team may ask you to treat sleep apnoea, stop smoking, correct a deficiency or address an eating disorder first.

What is new in 2024, 2025 and 2026?

What is the latest guidance on GLP-1 injections before surgery?

In October 2024, five American societies, representing gastroenterology, bariatric surgery, anaesthesiology, perioperative care of patients with obesity and gastrointestinal surgery, published joint guidance on the safe use of GLP-1 receptor agonists such as semaglutide and tirzepatide around surgery. It favours shared decision-making over a blanket rule. The medicines may be continued in patients without an elevated risk of delayed stomach emptying and aspiration. Risk factors include the dose-escalation phase, higher doses, weekly formulations and symptoms such as nausea, vomiting, abdominal pain or constipation. A liquid diet for at least 24 hours before surgery is an option when delayed stomach emptying is a concern. If the medicine is paused, the guidance refers to holding daily formulations on the day of surgery and weekly formulations for a week. Your anaesthetist decides in your case.

What does recent research say about the pre-operative diet?

Two systematic reviews give a useful picture. A 2021 review in Obesity Surgery found that low-calorie diets of 800 to 1,200 kcal per day, followed for two to eight weeks, reduced liver volume by 12% to 27% and weight by 4% to 17%, mostly in the first weeks, with acceptable adherence; the authors suggest that such a diet for two to four weeks may be preferred to a very-low-calorie diet. A 2023 meta-analysis of four randomised trials in Frontiers in Nutrition found that very-low-energy liquid diets led to more weight loss before surgery and possibly fewer complications, although this last result was not statistically significant. The diet before surgery is useful; its exact form is decided by your team.

Why do bariatric teams insist so much on stopping smoking?

Because of marginal ulcers, among other reasons. A marginal ulcer is an ulcer at the junction between the stomach pouch and the intestine after a gastric bypass. A 2023 meta-analysis in the Journal of Gastrointestinal Surgery, which included 14 studies with 344,829 bypass patients, found that smoking multiplied the odds of a marginal ulcer by about 2.5. Infection with Helicobacter pylori multiplied it by about 5, and diabetes by about 1.8. The authors conclude that stopping smoking, controlling blood sugar and eradicating H. pylori reduce the risk. These are exactly the points that a good preparation addresses.

Have the Swiss rules changed?

The SMOB guidelines in force since 1 July 2023 remain the reference for surgery covered by Swiss basic insurance. They set out the minimum preoperative investigations: routine examinations as for other major abdominal surgery, a review of micronutrients, an assessment of general health and nutrition, nutrition counselling, a psychiatric or psychosomatic consultation, an upper endoscopy with testing for Helicobacter pylori and its eradication if present, and optimisation of related diseases. Our guide on choosing weight-loss surgery explains the Swiss insurance criteria.

A timeline from six months to the day of surgery

What happens when?

Every team has its own schedule, but the broad sequence is similar. The table below gives a typical order of steps; your team will adapt it to your health and to the date of surgery.

When What to do Why
Three to six months before First contact, send medical history; see your GP; start nutrition counselling; stop smoking; review alcohol Time to detect problems, change habits and plan follow-up
Two to three months before Blood tests including vitamins and minerals; upper endoscopy with H. pylori test; sleep apnoea screening if indicated; psychological assessment Results guide the choice of procedure and allow deficiencies or infection to be treated
One to two months before Treat deficiencies, H. pylori or sleep apnoea; adjust diabetes and blood pressure treatment; arrange follow-up in Switzerland; book time off work Arrive at surgery in the best possible condition
Two to four weeks before Pre-operative low-calorie diet as prescribed; walking and breathing exercises; prepare home and supplements Shrink the liver, improve fitness, prepare for the first weeks
The last week Follow instructions on medicines, including GLP-1 injections and blood thinners; pack documents and CPAP if used Safety of anaesthesia and surgery
The day before Consultation with surgeon and anaesthetist on site; final tests if needed; fasting as instructed Confirm the plan and the safety of anaesthesia

Why start so early?

Because some steps take time. Treating Helicobacter pylori takes several weeks, followed by a test to confirm eradication. Correcting iron or vitamin D deficiency takes weeks to months. Adapting to a CPAP machine for sleep apnoea takes time. Stopping smoking is easier with a plan and support. And psychological preparation, if needed, cannot be rushed.

Medical tests before surgery

Which blood tests are needed?

Medespoir’s obesity guide lists a complete blood check including blood sugar, blood lipids, and liver, thyroid and kidney function, together with vitamin and mineral status, which is often already deficient before surgery. In practice, teams commonly check a full blood count, iron stores, vitamin B12, folic acid, vitamin D, calcium and other parameters as needed, as well as HbA1c in people with diabetes or prediabetes. The SMOB guidelines mention a review of micronutrients among the minimum investigations.

Why check vitamins before surgery?

Because many people living with obesity already have deficiencies, particularly in vitamin D and iron, and surgery, especially a bypass, reduces the absorption of several nutrients. Starting with low reserves increases the risk of fatigue, anaemia, bone loss and neurological problems later. Medespoir’s guide notes that correcting deficiencies conditions healing. Correcting them beforehand is easier than catching up afterwards.

Which other examinations may be needed?

  • An abdominal ultrasound, listed among routine examinations in the SMOB guidelines, which can show gallstones or a fatty liver.
  • An electrocardiogram, and sometimes a heart ultrasound or stress test, depending on your age and risk factors.
  • A chest X-ray and lung function tests if you have breathing problems.
  • Sleep studies to look for sleep apnoea and obesity hypoventilation.
  • Tests of oesophageal function if you have significant reflux or swallowing problems.
  • A bone density scan in some situations.

These optional tests are chosen according to your risk profile, as described in the SMOB guidelines.

Can I do the tests in Switzerland before travelling to Tunisia?

Often, yes, and it is a good idea. Your GP knows your history and can organise blood tests and some examinations; a gastroenterologist can perform the endoscopy. Whether your insurance pays for these tests depends on whether they are medically indicated and on your insurer; ask beforehand. Sending the results to the team in Tunisia allows them to plan the operation and treat any problem in time. The anaesthetist on site will still check your health and may repeat some tests.

The upper endoscopy

Why is an endoscopy so important before bariatric surgery?

Because it looks directly at the oesophagus, the stomach and the beginning of the intestine, and can change the choice of operation. Medespoir’s guide calls the endoscopy decisive and notes that a sleeve can worsen pre-existing reflux, which makes the endoscopy indispensable. It can reveal oesophagitis, a hiatus hernia, Barrett’s oesophagus, ulcers, polyps or Helicobacter pylori infection. After a bypass, part of the stomach can no longer be easily examined with a normal endoscope, which is another reason to examine it first.

What happens if Helicobacter pylori is found?

It is treated with a combination of antibiotics and stomach-protecting medicines, and the eradication is then checked. The SMOB guidelines require testing for H. pylori during the endoscopy and eradication in case of infection. As noted above, H. pylori is associated with a much higher risk of marginal ulcer after a bypass.

Is an endoscopy unpleasant?

It is usually performed with a throat spray and often light sedation, and lasts a short time. Most people find it much easier than they feared. If you have sedation, you will need someone to accompany you home and should not drive for the rest of the day.

Can reflux rule out a sleeve?

It can make it less suitable. Medespoir’s guide lists confirmed absence of reflux on endoscopy among the conditions for a sleeve. In people with significant reflux, a gastric bypass is often preferred, because it usually improves reflux. The final decision is made by the surgeon after the endoscopy and a discussion with you.

Ready to start your assessment? Send your medical history, current weight and height, medicines and any recent test results with a free quote request. You receive a personal answer in your name within 48 hours. Surgery in Tunisia is significantly cheaper than in Switzerland; the exact price is on your quote.

The psychological assessment

Is the psychological assessment a test I have to pass?

No. It is a conversation to understand your situation, identify factors that could make the period after surgery harder and offer support where needed. Nobody expects you to be free of stress, low moods or difficulties with food: if you had a simple relationship with food, you would probably not need surgery. The aim is to prepare, not to exclude.

What does the psychologist or psychiatrist look at?

According to the SMOB guidelines, the assessment combines an interview with standardised questionnaires. It looks for current mental health problems such as depression, anxiety, psychotic symptoms, substance misuse and eating disorders, and covers previous psychiatric treatment, psychosocial stress, sources of conflict and your expectations of the operation. It also examines eating behaviour specifically: binge eating, night eating, compensatory behaviours such as laxative misuse or excessive exercise, constant grazing, emotional eating and body image disorders. It may explore past traumatic experiences, the consequences of weight loss for your family and professional circle, and your cognitive and mental resources.

Which conditions may lead to a postponement?

The SMOB guidelines list significant psychiatric conditions that can be relative contraindications: active substance misuse, an active psychotic disorder, major depression not controlled by treatment, severe personality disorders, uncompensated major eating disorders such as bulimia or binge eating disorder, and severe intellectual disability. They note that it can be useful to offer psychotherapy before surgery and therefore postpone the operation. In other words, these situations often mean « not yet », rather than « never ».

Why does binge eating matter?

Because after surgery, the stomach can hold only small amounts. Episodes of uncontrolled eating can cause pain, vomiting and, over time, weight regain. Grazing, eating small amounts constantly throughout the day, is another behaviour that can undermine results because it bypasses the feeling of fullness. Recognising and working on these patterns before surgery gives you a better chance afterwards.

What about depression and medicines for mental health?

Stable, treated depression is not a contraindication. Tell the team about all your treatments. The SMOB guidelines note that after procedures with a malabsorptive component, such as a bypass, antidepressants, antipsychotics and anticonvulsants may need dose adjustments. Your psychiatrist or GP should be involved before and after surgery.

How can I prepare for this assessment?

Think honestly about your eating patterns, previous attempts to lose weight, what you expect from the operation and who will support you afterwards. Write down your questions. If you are already seeing a psychologist or psychiatrist, bring a short report. Being open allows the team to help you; hiding difficulties only postpones them until after surgery, when they are harder to manage.

Nutrition counselling and the pre-operative diet

What is nutrition counselling before surgery for?

The SMOB guidelines describe it as reviewing and improving your nutritional knowledge, eating habits and type of diet, explaining the changes in eating behaviour after surgery and, if necessary, providing nutritional therapy before surgery to optimise related diseases or your nutritional state. In practice, you learn to eat slowly, chew thoroughly, stop at the first sign of fullness, prioritise protein, separate drinking from eating, and plan regular small meals. Practising these habits before surgery makes the first weeks after it much easier.

Why is a diet needed before surgery?

Medespoir’s guide mentions a pre-operative diet of a few weeks to reduce the volume of the liver and make the operation easier. In people with obesity, the liver is often enlarged by fat, and its left part lies over the upper stomach where the surgeon works. A smaller, softer liver gives the surgeon better access and can make the operation safer. The reviews mentioned above show that a low-calorie diet over two to four weeks can shrink the liver noticeably.

What does the pre-operative diet look like?

It is prescribed by your team. It may be a low-calorie diet of ordinary foods with an emphasis on protein and vegetables and very little sugar, fat and alcohol, or a very-low-calorie diet based on meal replacement shakes. The 2021 review described low-calorie diets of 800 to 1,200 kcal per day; very-low-calorie diets are generally defined as 450 to 800 kcal per day. Follow the exact instructions you are given, including on fluids and protein intake.

I have diabetes. Can I follow a low-calorie diet safely?

Only with medical supervision. A sudden reduction in calories can cause dangerously low blood sugar if your medicines, especially insulin or certain tablets, are not adjusted. Discuss the diet with your GP or diabetologist before you start, monitor your blood sugar more often and know how to treat a low. Our guide on type 2 diabetes and metabolic surgery covers this in detail.

What if I cannot stick to the diet?

Tell your team. Difficulties with the diet are common and can be addressed with practical tips, a different meal plan or more support. Hiding it may lead to a more difficult operation or a postponement on the day if the liver is still large. Honesty helps everyone plan.

Should I lose a lot of weight before surgery?

Some weight loss before surgery is useful, mainly for the liver. Your team will tell you whether a specific target applies. What matters most is showing that you can adopt the new habits you will need afterwards.

Smoking, alcohol and other substances

Do I really have to stop smoking?

Yes. Medespoir’s guide lists stopping smoking among the essential steps, because smoking impairs the healing of the digestive sutures. Smoking also increases the risk of marginal ulcers after a bypass, as shown in the 2023 meta-analysis cited above, as well as wound infections, lung complications and blood clots. The ideal is to stop for good, not just for the operation.

How long before surgery should I stop?

As early as possible. Your team will give you a minimum period; the earlier you stop, the more your body benefits. Ask your GP or pharmacist about nicotine replacement and other support. Tell the team honestly if you have not managed to stop: it may affect the choice of procedure, since a bypass is particularly sensitive to smoking.

What about e-cigarettes, snus and cannabis?

Nicotine itself narrows blood vessels, so e-cigarettes and snus are not harmless for healing. Cannabis smoke irritates the lungs and can interact with anaesthesia. Declare all substances you use, so that the anaesthetist and surgeon can advise you.

Why is alcohol discussed before surgery?

For two reasons. Before surgery, alcohol adds calories, disturbs sleep and interacts with medicines. After surgery, especially after a bypass, alcohol is absorbed faster and can reach higher blood levels with smaller amounts, and some people develop a problematic relationship with alcohol after weight-loss surgery. The SMOB guidelines list active substance misuse as a relative contraindication. Reducing alcohol before surgery is part of preparation.

Medicines and GLP-1 injections

Should I stop Wegovy, Ozempic or Mounjaro before surgery?

Do not decide alone. As explained above, the 2024 multisociety guidance favours an individual decision based on your risk of delayed stomach emptying. The anaesthetist may ask you to continue the medicine with a liquid diet for at least 24 hours before surgery, or to pause it, for example a week before for a weekly injection. Tell the team which medicine you take, at what dose, since when, and whether you have digestive symptoms.

What about blood thinners?

Blood thinners, such as anticoagulants and antiplatelet drugs, must be managed carefully. Stopping them increases the risk of clots; continuing them increases the risk of bleeding. The decision depends on why you take them and is made with your prescribing doctor and the surgical team. Never stop them on your own.

And diabetes and blood pressure medicines?

They often need adjustment during the pre-operative diet and after surgery, because blood sugar and blood pressure frequently improve quickly. Your GP or diabetologist should plan these adjustments with you, and you should know how to monitor yourself. Bring a written list of all doses to Tunisia.

Do I need to stop the contraceptive pill?

Discuss it with your gynaecologist and the surgical team. Oestrogen-containing contraceptives increase the risk of blood clots, which matters around surgery. After a bypass, the absorption of oral contraceptives may also be less reliable. Teams usually recommend reliable contraception and advise against pregnancy during the period of rapid weight loss; Medespoir has a dedicated page on pregnancy after a sleeve.

What about supplements and herbal remedies?

Declare them all. Some supplements affect bleeding or interact with anaesthesia. Your team will tell you which to stop and which to continue, and which vitamins and minerals you will need to take after surgery.

Physical preparation and sleep apnoea

Should I exercise before surgery?

Yes, as far as your health allows. Regular walking, swimming or cycling improve your fitness, your breathing and your mood, and prepare you to be active from the day after surgery. Early mobilisation and physiotherapy are part of hospital care according to the SMOB guidelines. Breathing exercises, sometimes taught by a physiotherapist, help prevent lung complications after abdominal surgery.

Why is sleep apnoea checked?

Because it is common in people living with obesity and often unrecognised, as Medespoir’s guide notes. Untreated sleep apnoea increases the risks of anaesthesia and of breathing problems after surgery, especially with painkillers that depress breathing. Signs include loud snoring, pauses in breathing noticed by a partner, waking up unrefreshed and daytime sleepiness. A sleep study confirms the diagnosis.

I use a CPAP machine. Should I bring it?

Yes. Bring your CPAP machine, mask and power adapter to Tunisia, and tell the team in advance. You will usually be asked to use it after surgery. Check with your airline how to carry it on board.

Is there anything else I should do physically?

Take care of your skin, especially in skin folds, to avoid infections; have any dental infection treated; and make sure your vaccinations are up to date. If you have joint problems, a physiotherapist can suggest exercises that are gentle on your joints.

Practical organisation: work, home and follow-up

How much time off work should I plan?

It depends on the procedure, your recovery and your job. Plan for the stay in Tunisia plus a period of recovery at home, during which you follow a liquid and then soft diet, rest and walk. People with physically demanding jobs need more time. Discuss it with the team and with your employer in advance.

How should I prepare my home?

  • Buy the supplements you will need, as advised by the team, before you leave.
  • Prepare a supply of protein drinks, broths and suitable soft foods for the first weeks.
  • Have a blender, small plates and measuring cups.
  • Plan help with shopping and household tasks for the first days.
  • Keep a notebook or app to track fluids, protein and symptoms.

Why must follow-up in Switzerland be organised before surgery?

Because bariatric surgery requires follow-up for life. Medespoir’s obesity guide describes full check-ups at three, six and twelve months, then every year for life, with vitamin status checks and adjustment of supplements. The SMOB guidelines require at least four nutrition consultations in the first year and one per year from the second to the fifth year in Swiss programmes. If you have surgery in Tunisia, identify before you leave who will do your blood tests, who will see you if you have pain and which dietitian will follow you. Inform your GP. Medespoir provides remote follow-up after your return, but local care is essential for examinations and emergencies. Our guide to life after bariatric surgery and follow-up in Switzerland explains the details.

Who pays for follow-up care in Switzerland?

Care received in Switzerland after your return is paid by you or by your insurer according to the usual rules. Medically necessary consultations and tests are generally treated like other medical care, subject to your deductible and co-payment, but the cover for consultations linked to surgery performed abroad can depend on your insurer; ask in advance.

What about the journey?

Direct flights from Geneva and Basel-Mulhouse to Tunisia take about two hours; from Zurich, flights may be direct or with a connection depending on the season. To reduce the risk of blood clots during travel, walk in the aisle, move your legs, drink water and follow any advice on compression stockings or injections. The package includes all transfers on site.

Common mistakes and questions to ask

What are the most common mistakes during preparation?

  • Treating the pre-operative period as a « last chance » to eat freely, which makes the liver larger and the operation harder.
  • Booking the flight before the endoscopy and blood tests are done, which leaves no time to treat what they reveal.
  • Stopping or changing medicines without medical advice, especially insulin, blood thinners or GLP-1 injections.
  • Underestimating the first weeks at home: no protein drinks ready, no help arranged, no time off planned.
  • Leaving the question of follow-up in Switzerland until after the operation.
  • Expecting surgery to solve emotional eating on its own, without any support.

Which questions should I ask the surgical team?

  • Which tests do you need from me before I travel, and which will be done on site?
  • Which procedure do you recommend for me, and how will the endoscopy result influence the choice?
  • What exactly should I eat in the weeks before surgery, and for how long?
  • What should I do with each of my medicines, including my GLP-1 injection?
  • How many days will I stay in hospital and at the hotel, and when may I fly?
  • Which supplements will I need after surgery, and should I buy them before leaving?
  • What information will you send to my doctors in Switzerland, and how does remote follow-up work?
  • Who do I contact if I have a problem after my return?

Which questions should I ask myself?

Why do I want surgery now? What do I expect it to change, and what will it not change? Am I ready to take supplements every day for life and attend regular check-ups? Who will support me in the first months? How will I handle social meals, celebrations and stress without my usual coping habits? There are no wrong answers, but thinking about them before surgery helps you and the team prepare realistically.

What if I change my mind during preparation?

That is your right, at any stage. Preparation is also a time to reflect. Some people decide to try a GLP-1 medicine or a structured programme first; others postpone surgery for personal reasons. A serious team respects that decision.

What changes when surgery takes place in Tunisia

How does the process work with Medespoir?

Medespoir’s guide states that it organises your assessment from Switzerland, the operation in Tunisia and your follow-up. You send your history and test results; a surgeon reviews them; missing tests are identified. On arrival, you meet the surgeon and the anaesthetist, who confirm the plan and the safety of anaesthesia. The guide describes the day before surgery as the time for any additional tests, the anaesthetic consultation and fasting, and the following days as a gradual return to fluids, early mobilisation and monitoring of tolerance and vital signs. In Tunisia, consultations and medical documents are in French.

How long is the stay?

The length of the stay depends on the procedure and on your recovery, and is stated in your quote. Medespoir’s stay page describes the same organisation for obesity surgery as for other operations: transfers, hotel with a companion, care and remote follow-up. People with diabetes should allow time for blood sugar checks and medicine adjustments before flying home.

What does the package include?

The Tunisian package includes the preoperative consultation, tests, the operation, the whole team (surgeon, anaesthetist, surgical assistant), the operating theatre, the hospital stay, daily care at the hotel, the check-up and authorisation to leave, the operative report, full-board hotel accommodation for you and one companion, all transfers and remote follow-up after your return to Switzerland. Your flight, personal expenses, an extension of the stay for convenience, care received in Switzerland after your return, travel insurance (recommended) and bank charges are not included.

Which documents should I bring?

All test results and reports, the endoscopy report, your list of medicines and doses, your CPAP if you use one, your blood sugar diary if you have diabetes, and your passport. Keep digital copies. After surgery, keep the operative report and discharge instructions: your doctors in Switzerland will need them.

Can I compare Tunisia and Turkey for bariatric surgery?

Both destinations remain significantly cheaper than Switzerland, and the quote can compare them. Medespoir confirms only hair transplants for Turkey; for bariatric surgery, the quote states whether it is possible and where.

Price and Swiss insurance

How much does bariatric surgery in Tunisia cost?

Surgery in Tunisia is significantly cheaper than in Switzerland. The exact price depends on the procedure and on your assessment, and is given in a free, personal quote issued in your name within 48 hours. Make sure it states which tests are included on site and what is expected from you beforehand.

Will Swiss basic insurance pay if I meet the criteria?

Swiss basic insurance covers bariatric surgery under specific conditions, in recognised centres following the SMOB guidelines, as explained in our guide to bariatric surgery in Tunisia in 2026. Planned surgery abroad is generally not covered. If you meet the Swiss criteria, compare the Swiss route carefully before deciding; surgery in Tunisia is mainly a self-funded alternative.

Is travel insurance useful?

Yes, it is recommended. Check that it covers complications of planned treatment abroad and repatriation, and read the exclusions carefully.

What is the most important thing to remember?

That the operation is one day, and preparation and follow-up are months and years. People who arrive well prepared, with treated deficiencies, no smoking, realistic expectations and a follow-up plan, give themselves the best chance of a safe operation and lasting results.

This article provides general information and does not replace a medical consultation. Your GP, your specialists and the surgical team are the right people to advise you on tests, medicines and diet.

Ready to plan your preparation? Request your free quote with your medical history and test results.

Sources

  • Swiss Society for the Study of Morbid Obesity and Metabolic Disorders (SMOB), guidelines for the surgical treatment of obesity, in force since 1 July 2023: smob.ch
  • Kindel T. L. et al., multisociety clinical practice guidance for the safe use of GLP-1 receptor agonists in the perioperative period, 2024: pubmed.ncbi.nlm.nih.gov
  • Romeijn M. M. et al., low-calorie diet for liver volume reduction before bariatric surgery, systematic review, Obesity Surgery, 2021: pubmed.ncbi.nlm.nih.gov
  • McKechnie T. et al., very low energy diets before bariatric surgery, meta-analysis of randomised trials, Frontiers in Nutrition, 2023: pubmed.ncbi.nlm.nih.gov
  • Beran A. et al., predictors of marginal ulcer after gastric bypass, meta-analysis, Journal of Gastrointestinal Surgery, 2023: pubmed.ncbi.nlm.nih.gov
  • Federal Health Insurance Act (KVG/LAMal, SR 832.10): fedlex.admin.ch
  • Medespoir (in French): obesity surgery guide, sleeve, gastric bypass, obesity, pregnancy after a sleeve, stay

Frequently asked questions

How long before bariatric surgery should I start preparing?

Ideally several months. In Swiss programmes, the SMOB requires at least three months of structured preparation.

Is an endoscopy always required?

Serious teams require it. It checks for reflux, ulcers and Helicobacter pylori and can change the choice of procedure.

What is the liquid diet before surgery for?

Mainly to shrink the liver and make the operation easier and safer. Your team prescribes its type and duration.

Can I fail the psychological assessment?

It is not an exam. It may lead to support or a postponement, for example to treat an eating disorder or depression first.

Do I have to stop smoking completely?

Yes, ideally for good. Smoking impairs healing and increases the risk of ulcers after a bypass.

Should I stop my GLP-1 injection before surgery?

The anaesthetist decides. Recent guidance allows continuation in low-risk patients, sometimes with a 24-hour liquid diet, or a pause before surgery.

Can I bring someone with me to Tunisia?

Yes. The package includes hotel accommodation for you and one companion, and all transfers.

What should I organise in Switzerland before leaving?

Your GP, regular blood tests, a dietitian and a plan for emergencies. Follow-up is lifelong.

When can I get pregnant after bariatric surgery?

Teams advise against pregnancy during rapid weight loss. Discuss timing and contraception with your gynaecologist and surgical team.

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