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Preparing for Bariatric Surgery in Switzerland: Checklist
Preparing for bariatric surgery in Switzerland: tests, diet, psychological assessment and organisation

Preparing for bariatric surgery in Switzerland: tests, diet, psychological assessment and organisation

In short: preparing for bariatric surgery takes months, not days, and the preparation is part of the treatment. In Switzerland, the guidelines of the Swiss Society for the Study of Morbid Obesity and Metabolic Disorders (SMOB), to which basic insurance refers, require a structured preparation of at least three months between your first contact with the centre and the operation. During that time you will have blood tests, an abdominal ultrasound, a gastroscopy with a test for Helicobacter pylori, nutritional counselling and a psychiatric or psychosomatic assessment, plus heart, lung or sleep tests if your risk profile requires them. In the last weeks, most teams prescribe a low-calorie or very low-calorie diet to shrink the liver, ask smokers to stop at least four weeks before surgery, and adjust medicines such as insulin or GLP-1 injections. This guide explains each step, why it matters and how to organise your life around it, whether you are operated on in Switzerland or abroad.

This article is general information. It does not replace a consultation or medical advice from a qualified doctor.

To choose between operations, read our guide on sleeve, bypass, band or balloon. For the period after surgery, see our guide to life after bariatric surgery, and for diabetes, our article on metabolic surgery and type 2 diabetes. This article covers only the preparation phase.

Contents

The preparation timeline at a glance

Every centre has its own schedule, but the broad sequence is similar. The table below summarises a typical path for a person living in Switzerland.

When What happens Why it matters
First months Referral, first consultation, information session, gathering of documents on previous weight-loss attempts Confirms the indication and starts the structured preparation
During preparation Blood tests, ultrasound, gastroscopy, nutritional counselling, psychological assessment, specialist tests if needed Identifies risks and chooses the right operation
Obesity board The multidisciplinary team reviews the file and decides Surgery is planned only after a positive team decision
At least 4 weeks before Smoking stopped completely Reduces complications and ulcer risk
Usually 2 to 4 weeks before Low-calorie or very low-calorie diet, as prescribed Shrinks the liver and makes surgery safer
Last days Medicine adjustments, fasting instructions, preparing home and food Safe anaesthesia and a smooth return home

Why does it take so long?

Because the operation permanently changes the way you eat and absorb food. The team needs time to make sure the operation is right for you, to correct problems such as anaemia, uncontrolled diabetes or an infection of the stomach, and to give you the knowledge and habits you will need afterwards. The SMOB guidelines say the preparation period is longer if nutritional knowledge is lacking or if the patient’s reliability in following recommendations and attending follow-up is doubtful.

Can I speed things up?

To some extent: by bringing complete documents, attending appointments promptly, starting the recommended changes early and stopping smoking well in advance. What you cannot skip are the tests and assessments the team needs, nor the minimum preparation period required for insurance cover in Switzerland.

What Swiss rules require

Understanding the rules avoids unpleasant surprises with your insurer and explains why the centre asks for certain documents.

When does basic insurance pay for bariatric surgery?

Annex 1 of the Swiss health care benefits ordinance (KLV/OPAS), in its edition of 1 July 2026, lists bariatric surgery as covered when the patient has a body mass index (BMI) above 35, when an adequate two-year weight-loss therapy has failed, and when indication, procedure, quality assurance and follow-up comply with the SMOB guidelines of 1 July 2023. The operation must take place in a centre able to respect these guidelines; for SMOB-recognised centres this is assumed, while for a non-recognised centre the insurer’s prior approval is required.

What counts as a failed two-year therapy?

According to the SMOB guidelines, a weight-reduction programme carried out over a cumulative period of at least two years is considered to have failed if it does not achieve and maintain a BMI below 35. Keep records of previous attempts: consultations with your doctor or a dietitian, structured programmes, medicines, and their results. These documents are part of your file.

What else do the SMOB guidelines ask of patients?

Adults must understand the lifestyle and eating changes required after surgery and give written consent to lifelong follow-up within the bariatric network of an accredited centre. The guidelines also require written information about the operation, possible complications, eating changes and follow-up, written informed consent and a positive decision by the multidisciplinary team before surgery is scheduled.

Are there situations in which surgery is not possible?

Yes. The SMOB guidelines list contraindications, including pregnancy, unstable coronary disease, severe kidney failure without dialysis, advanced liver cirrhosis, a pulmonary embolism or deep vein thrombosis in the previous six months, uncontrolled cancer or cancer in remission for less than two years (unless oncologists agree), serious mental illness with repeated decompensations in the previous two years, persistent substance abuse unless at least six months of documented abstinence and specialised follow-up, and insufficient compliance or understanding of the treatment. Some of these are temporary: once the problem is treated, surgery may become possible.

Medical tests before surgery

The SMOB guidelines define a minimum set of examinations and a list of optional ones depending on your risk profile.

Which tests are always done?

  • Routine examinations as before any major abdominal operation: medical history, physical examination, blood tests and an abdominal ultrasound.
  • Micronutrient status: vitamins and minerals, because deficiencies are common even before surgery and must be corrected.
  • Assessment of your general health and nutritional state, including obesity-related diseases.
  • Nutritional counselling.
  • A psychiatric or psychosomatic consultation.
  • Gastroscopy (upper digestive endoscopy) with a search for Helicobacter pylori and eradication if it is present.
  • Optimisation of treatment of associated diseases to reduce surgical risk.

Why is a gastroscopy needed?

Because it influences the choice of operation and the safety of the procedure. It can show reflux disease, inflammation of the oesophagus, a hiatus hernia, ulcers or other lesions. Severe reflux usually argues against a sleeve gastrectomy and in favour of a bypass. Medespoir’s obesity surgery guide also describes upper endoscopy as decisive for the choice of technique.

Why test for Helicobacter pylori?

Helicobacter pylori is a common stomach bacterium that can cause gastritis and ulcers. After a gastric bypass, ulcers can form at the junction between the small stomach pouch and the intestine (marginal ulcers). A 2023 meta-analysis in the Journal of Gastrointestinal Surgery, covering 14 studies and 344,829 bypass patients, found that Helicobacter pylori infection (odds ratio 4.97), smoking (2.50) and diabetes (1.80) were significant predictors of marginal ulcers. Testing and treating the infection before surgery is therefore part of standard preparation.

Which additional tests may be requested?

Depending on your age, history and symptoms, the SMOB guidelines list optional examinations: ECG, exercise test, chest X-ray, lung function tests, overnight oximetry, imaging or pressure measurement of the oesophagus, sleep studies for sleep apnoea and obesity hypoventilation syndrome, echocardiography or coronary angiography, body composition measurements and bone density.

Why is sleep apnoea checked?

Obstructive sleep apnoea is common in people with severe obesity and is often undiagnosed. It increases the risks of anaesthesia and of breathing problems after surgery. If you snore loudly, wake up unrefreshed, feel sleepy during the day or your partner has noticed pauses in your breathing, mention it. If sleep apnoea is found, you may be asked to use a CPAP device before and after surgery.

What happens if a test shows a problem?

Often the problem is treated and the preparation continues. Anaemia is corrected with iron, vitamin D deficiency with supplements, diabetes with better control, Helicobacter with antibiotics, sleep apnoea with CPAP. More serious findings may delay surgery or change the choice of operation. These adjustments are a sign of a careful team, not of a failed preparation.

The psychological assessment

Many patients worry that the psychological assessment is an exam they could « fail ». In reality, its main purpose is to prepare you and to identify needs for support.

What is the purpose of the assessment?

According to the SMOB guidelines, the medical aims are to identify significant psychological disorders and psychosocial risk factors, to understand your coping strategies and their role in your weight history, and to reduce the risk of dropping out of follow-up. From the patient’s perspective, the assessment aims to raise awareness of the links between stress, eating and physical activity, to explain the physical and psychological effects of surgery, to create space for a free decision, to prepare informed consent and to offer psychotherapeutic support before and after the operation when needed.

What happens during the assessment?

It combines an interview with standardised questionnaires. The interview explores current symptoms of depression, anxiety, psychosis, substance use and eating disorders, past psychiatric treatment, stressful life events, sources of conflict and your expectations of surgery. The SMOB guidelines specifically mention looking for binge eating, night eating syndrome, compensatory behaviours such as laxative use or excessive exercise, grazing throughout the day, emotional eating and body image disorders. Questionnaires such as the Hospital Anxiety and Depression Scale (HADS) or the SF-36 quality-of-life survey may be used.

Can a psychological problem prevent surgery?

Some conditions are relative contraindications according to the SMOB guidelines: active substance abuse, 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. In these situations, the guidelines suggest offering psychotherapy before surgery and postponing the operation, not necessarily refusing it forever. Depression or anxiety that is well treated does not usually exclude surgery.

Should I hide my difficulties to get approved?

No. Hiding binge eating, depression or alcohol use does not make them disappear, and these problems can return or worsen after surgery, when food can no longer be used to cope. Being honest allows the team to offer support that improves your long-term result.

How should I prepare for the assessment?

  • Think about your weight history: when it started, life events, previous attempts.
  • Reflect on your eating patterns honestly, including emotional eating or night eating.
  • Think about what you expect from surgery, in your health, relationships and work.
  • Consider how your family and colleagues will react and who will support you.
  • Bring information about any current or previous psychiatric treatment.

Nutritional counselling and the pre-operative diet

Nutritional counselling before surgery is not just about losing a few kilos. It teaches you how you will eat for the rest of your life.

What does the dietitian cover before surgery?

The SMOB guidelines describe pre-operative nutritional counselling as reviewing and improving your nutritional knowledge, eating habits and type of diet, explaining the changes in eating behaviour after surgery and, if necessary, starting nutritional therapy to optimise associated diseases or your nutritional status. In practice this often includes eating slowly, chewing well, separating drinking from eating, prioritising protein, recognising hunger and satiety, and planning regular meals.

Which habits should I start before surgery?

  • Eat three structured meals and, if advised, small planned snacks, rather than grazing.
  • Take 20 to 30 minutes for each meal, put the cutlery down between bites and chew thoroughly.
  • Stop drinking during meals and wait a while afterwards, as you will need to after surgery.
  • Reduce sugary drinks, fizzy drinks and alcohol.
  • Start each meal with protein: meat, fish, eggs, dairy, legumes or tofu.
  • Keep a food diary to identify patterns.

Do I have to lose weight before the operation?

Many centres expect some weight loss in the final weeks, mainly through the liver-shrinking diet. The ERAS Society’s 2021 bariatric guidelines (published in the World Journal of Surgery in 2022) recommend pre-operative weight loss using a very low or low-calorie diet before bariatric surgery. Gaining weight during the preparation period can be a warning sign that the team will want to discuss with you, because it may indicate that the habits needed after surgery are not yet in place.

The liver-shrinking diet in detail

The pre-operative diet is the part of the preparation patients ask about most. Its main purpose is technical: making the operation safer.

Why does the liver need to shrink?

In people with obesity the liver is often enlarged and fatty, and its left lobe lies over the stomach. During keyhole surgery, the surgeon must lift the liver to reach the stomach. A large, heavy liver makes this harder, increases the risk of bleeding or injury and can in rare cases force the surgeon to switch to open surgery. A short period of strict calorie restriction depletes the liver’s fat and sugar stores and makes it smaller and softer.

What does the evidence show?

A systematic review in Surgery for Obesity and Related Diseases (Holderbaum and colleagues, 2018) analysed nine studies with 849 patients who followed very low-calorie diets for between 10 days and 12 weeks before surgery. The diets led to weight loss of 2.8 to 14.8 kg and reduced liver volume by 5% to 20%. The effect on complications was less clear. A 2023 meta-analysis of four randomised trials (McKechnie and colleagues, Frontiers in Nutrition) found greater pre-operative weight loss with liquid very low-energy diets, on average 3.38 kg more than control diets, and a trend, not statistically significant, towards fewer complications within 30 days. The ERAS guidelines nonetheless rate the recommendation as strong.

What does the diet look like?

It varies between centres. Common versions use meal-replacement shakes, soups and bars several times a day, sometimes with a small amount of vegetables, or a structured low-calorie diet rich in protein and low in carbohydrates and fat. The duration is often two to four weeks but may be longer for a very large liver. Follow exactly the plan given by your centre; the Holderbaum review noted that greater restriction did not necessarily give better results, so there is no benefit in going further than prescribed.

What side effects should I expect?

Hunger and irritability during the first days, tiredness, headaches, constipation, bad breath and feeling cold are common and usually improve after a few days. Drink plenty of water, take the supplements you are given and plan the diet for a quieter period at work if possible.

What if I have diabetes?

Then the diet must be supervised. The ERAS guidelines point out that a very low-calorie diet improves insulin sensitivity, so patients taking glucose-lowering medicines must monitor their blood sugar closely and be aware of the risk of hypoglycaemia. Your doctor will usually reduce insulin or some tablets at the start of the diet. Never start the diet without a plan for your diabetes medicines.

What if I cannot stick to the diet?

Tell the team early. They can adapt the plan, offer support or extend the duration. Arriving on the day of surgery having ignored the diet can lead to the operation being more difficult or even postponed.

Starting to plan? Request a free, personalised quote for bariatric surgery. Treatment in Tunisia is significantly cheaper than in Switzerland; the exact price is given in the quote, sent within 48 hours and without commitment.

Stopping smoking, alcohol and other substances

Few preparation steps have as clear a benefit as stopping smoking.

How long before surgery must I stop smoking?

The ERAS Society’s bariatric guidelines state that all patients should be screened for tobacco and alcohol use and that smoking should be stopped at least four weeks before surgery (moderate evidence, strong recommendation). They note that an intervention starting at least four weeks before surgery, with weekly counselling and nicotine replacement therapy, is the most likely approach to reduce complications and achieve long-term cessation. Many bariatric teams ask patients to stop earlier and permanently.

Why is smoking especially dangerous after a bypass?

Because it more than doubles the risk of marginal ulcers, according to the 2023 meta-analysis cited above (odds ratio 2.50). These ulcers can cause pain, bleeding and, rarely, perforation. Smoking also slows wound healing, increases the risk of blood clots and lung complications after anaesthesia. Our article on stopping smoking before an operation, published on this blog in French, gives practical advice.

Do e-cigarettes and snus count?

Ask your team. Nicotine itself narrows blood vessels and affects healing, so many surgeons ask patients to stop all nicotine products, except nicotine replacement therapy prescribed as part of a cessation plan, which is sometimes accepted. Do not assume that vaping is allowed.

And alcohol?

The ERAS guidelines recommend strict abstinence for one to two years for patients with alcohol abuse and acknowledge the risk of relapse after bariatric surgery. After surgery, alcohol is absorbed faster and reaches higher blood levels, especially after a bypass, and some patients develop a new problem with alcohol. Use the preparation period to reduce or stop drinking and to discuss any concern openly.

What about cannabis and other drugs?

The SMOB guidelines list persistent chronic substance abuse, specifically naming alcohol, cannabis and opiates, as a contraindication unless at least six months of documented abstinence and specialised follow-up. Honest disclosure allows the team to plan support.

Medicines: diabetes, GLP-1, blood thinners and the pill

Your medicines will be reviewed in detail. Bring an up-to-date list, including supplements and herbal products.

Should I stop my GLP-1 injection before surgery?

Not necessarily, but you must tell your surgeon and anaesthetist. In October 2024, the American Society of Anesthesiologists, together with gastroenterology, bariatric surgery and endoscopic surgery societies, published guidance stating that most patients can continue GLP-1 medicines such as semaglutide before elective surgery. Patients at highest risk of digestive side effects, such as those on a higher dose, should follow a liquid diet for 24 hours beforehand, and patients with nausea, vomiting or abdominal pain should wait until symptoms have resolved. The reason is that these medicines slow stomach emptying, so food may remain in the stomach during anaesthesia. Your team will give you specific instructions.

Can GLP-1 medicines be used to prepare for surgery?

Some teams use them to lose weight before surgery, especially in people with very high BMI. A 2026 meta-analysis in Surgery for Obesity and Related Diseases, including 10 studies with 5,461 patients, found that pre-operative GLP-1 medicines were associated with modest additional weight loss before surgery, did not significantly increase complications and did not improve weight loss after surgery. In Switzerland, Wegovy (semaglutide) has been on the list of reimbursed medicines under strict conditions since 1 March 2024 and Mounjaro (tirzepatide) since 1 January 2026; reimbursement depends on the specific limitations, and medicines bought outside pharmacies may be counterfeit.

What about insulin and diabetes tablets?

Doses are often reduced during the pre-operative diet and adjusted on the day of surgery and afterwards. Some diabetes medicines are stopped a few days before surgery. Your diabetologist and the bariatric team will give you a written plan. After surgery, many patients need much less medication, sometimes immediately.

Do I have to stop blood thinners?

It depends on the medicine and the reason you take it. Decisions about stopping, bridging or continuing are made by your doctors together; never stop on your own. You will receive preventive blood-thinning injections around the time of surgery in any case, as recommended by the SMOB guidelines.

What about the contraceptive pill?

Oestrogen-containing pills increase the risk of blood clots, and some teams ask women to switch to another method before surgery. After surgery, especially a bypass, absorption of oral contraceptives may be less reliable, and fertility often increases with weight loss. Discuss contraception with your gynaecologist during the preparation period, since pregnancy is usually advised against during the first period of rapid weight loss. Medespoir has a page on pregnancy after a sleeve.

Which other medicines need attention?

Anti-inflammatory painkillers increase the risk of ulcers and are generally avoided after bypass surgery. Antidepressants, antipsychotics and anticonvulsants may need dose adjustments after operations with a malabsorptive component, which the SMOB guidelines recommend guiding with blood levels. Large tablets may need to be replaced by liquid or crushable forms for the first weeks.

Exercise and fitness before surgery

Being more active before surgery helps recovery and builds habits for afterwards, even though the evidence for formal « prehabilitation » programmes is limited.

Is a structured exercise programme required?

Not usually. The ERAS guidelines conclude that although prehabilitation may improve general fitness and breathing capacity, there is insufficient data to recommend it formally before bariatric surgery. That does not mean exercise is useless: walking more, climbing stairs and breathing exercises make it easier to get up and move after the operation, which reduces the risk of blood clots and lung complications.

What kind of activity is best?

Whatever you can do regularly and safely: daily walks, swimming or aqua-gym, cycling on an exercise bike, light strength exercises. If you have joint pain, water-based activities are often easier. Increase gradually and talk to your doctor if you have heart disease or chest symptoms.

Should I practise breathing exercises?

Many teams recommend them, sometimes with a small device (incentive spirometer) that you will also use after surgery. Learning the technique beforehand makes it easier when you are sore after the operation.

Organising work, family and home

Practical preparation reduces stress and helps you focus on recovery.

How much time off work will I need?

It depends on the operation, your job and your recovery. Office workers often return after two to four weeks, while physically demanding jobs require longer. Plan time off for the last days of the pre-operative diet too, if your work is demanding. Our French-language article on sick leave after an operation gives general guidance; your surgeon will give you a certificate adapted to your case.

What should I prepare at home?

  • Liquid and puréed foods for the first phases, as described by your dietitian: clear broths, protein drinks, yoghurts, soups.
  • Small plates and cups to help with portion control.
  • A blender if you do not have one.
  • Vitamin and mineral supplements prescribed for after surgery, in a suitable form (chewable or liquid at first).
  • A water bottle with measurement marks to track your fluid intake.
  • Loose, comfortable clothing.

Who should I tell?

That is your choice. Many people tell their close family and a few friends, so that they can help practically and understand the changes in your eating. Telling your employer the reason for your absence is not required; a medical certificate is enough. Support from people around you, including at meals, makes a real difference, and the SMOB guidelines mention assessing the consequences of weight loss on your private and professional environment as part of the psychological evaluation.

What about children and care responsibilities?

You should avoid lifting heavy weights for some weeks after surgery. Arrange help with young children, shopping and household tasks for the first period. If you care for a relative, organise a replacement.

Preparing your mind and your expectations

The physical preparation is well codified. The mental preparation is less visible, but it often decides how you experience the first year.

What should I realistically expect from the operation?

Surgery is a tool that makes eating less and feeling full sooner much easier, and it improves many obesity-related diseases. It does not remove the need to choose what you eat, to move regularly and to take supplements for life. Weight loss is usually fastest in the first months and slows down afterwards; some regain over the years is common. Patients who prepare for this trajectory tend to cope better than those who expect a fixed target weight.

How can I prepare for the loss of food as comfort?

If food has helped you cope with stress, boredom or sadness, that function will be much harder to use after surgery. During preparation, identify the situations in which you eat for emotional reasons and test alternatives: a walk, calling someone, a hobby that occupies your hands, relaxation techniques. If emotional eating is strong, ask for psychological support before the operation rather than after.

Should I think about loose skin already?

It is useful to know that significant weight loss often leaves loose skin on the abdomen, arms, thighs or breasts, and that body-contouring surgery, if desired, is usually considered only after weight has been stable for a period. Knowing this in advance avoids disappointment. Our guide to life after bariatric surgery covers skin surgery after weight loss.

How will relationships change?

Meals are social. Family and friends may comment on what and how much you eat, and some may find your transformation hard to accept. Discussing this with your partner and close family before surgery, and involving them in an information session if the centre offers one, prepares everyone.

Your document checklist

Collecting documents early saves weeks. Here is what most centres and insurers need.

  • A referral letter from your family doctor, if your centre requires one.
  • Records of previous weight-loss attempts over at least two years: consultations, dietitian reports, programmes, medicines and weights.
  • A list of your diagnoses and current treatments, with reports from specialists (diabetes, heart, lungs, sleep).
  • Recent blood test results, if available.
  • Reports of any previous abdominal surgery.
  • Your insurance details, including any supplementary insurance.
  • For surgery abroad: your passport, the quote and the list of what is included, and travel insurance documents.

Do I need my insurer’s approval before surgery?

In a SMOB-recognised centre in Switzerland, the centre usually handles the administrative steps and insurers rely on the guidelines. For a centre that is not recognised, KLV Annex 1 requires the insurer’s prior approval. In any case, ask the centre what has been sent to your insurer and keep a copy of the reply.

The last week and the day before

As surgery approaches, the instructions become very specific. Follow your centre’s written instructions above any general advice.

What are the fasting rules?

The ERAS guidelines recommend that, for elective bariatric surgery and in the absence of contraindications such as gastroparesis or bowel obstruction, patients may eat solids until six hours before the start of anaesthesia and drink clear liquids until two hours before. Patients taking GLP-1 medicines or with slow stomach emptying may receive different instructions. Your centre’s rules apply.

What should I bring to hospital?

  • Your identity documents, insurance card and any letters from the centre.
  • Your list of medicines and the medicines themselves, in their packaging.
  • Your CPAP machine if you use one.
  • Comfortable clothes, flat shoes and toiletries.
  • A long phone charging cable, headphones and something to read.

What happens in hospital?

According to the SMOB guidelines, care in hospital includes antibiotic prophylaxis, prevention of stress ulcers, weight-adapted prevention of blood clots, early mobilisation and physiotherapy, and dietary advice. At discharge, you usually receive a stomach-protecting medicine (proton pump inhibitor), possibly blood-thinning injections to continue at home, micronutrient supplements and your first follow-up appointment.

What follow-up is planned from the start?

Lifelong follow-up is part of the commitment you sign during preparation. For sleeve gastrectomy and gastric band, the SMOB guidelines plan check-ups at 1, 3, 6, 9 and 12 months, then annually or as needed. Nutritional consultations with a dietitian take place at least four times in the first year and once a year from the second to the fifth year. Annual blood tests include blood count, iron status, vitamins, liver and kidney values and other parameters.

Preparing for surgery abroad

Some people living in Switzerland choose bariatric surgery abroad, often because they do not meet the Swiss insurance criteria or prefer to pay privately. Preparation is just as important, and in some ways more so.

Does Swiss insurance pay for bariatric surgery abroad?

As a general rule, basic insurance does not pay for planned treatment abroad, except in specific situations such as emergencies or special agreements. If you are considering surgery abroad, assume that the operation is self-funded and check with your insurer how follow-up care in Switzerland, including complications, will be handled.

What does Medespoir require before surgery in Tunisia?

Medespoir organises the work-up from Switzerland, the operation in Tunisia and follow-up. Its obesity surgery guide lists a full blood work-up including glucose, lipids, liver, thyroid and kidney function, vitamin and mineral status, upper digestive endoscopy, a search for sleep apnoea, a cardiological assessment depending on age and history, a nutritional opinion and a psychological assessment, and states that Medespoir refuses to operate when the work-up is incomplete or the requested technique does not match its findings. Treatment in Tunisia is significantly cheaper than in Switzerland; the exact price is given in a free, personalised quote within 48 hours.

What does the Tunisian package include?

The package includes the pre-operative consultation, tests, the operation with the full team, the operating theatre, hospitalisation, full-board hotel accommodation for the patient and one companion, all transfers, the operative report and remote follow-up after returning to Switzerland. Flights, personal expenses, an extension for convenience, care received in Switzerland on your return, travel insurance (recommended) and bank charges remain at your expense. Consultations and medical documents are in French.

And Turkey?

Medespoir confirms hair transplants in its Istanbul clinics. For bariatric surgery, the quote specifies whether the operation is possible in Turkey and where.

How do I organise follow-up in Switzerland?

Before leaving, identify a family doctor willing to follow you, ideally in contact with a dietitian experienced in bariatric patients. Bring back your operative report, discharge letter and list of supplements. Plan your blood tests at the intervals recommended, and know where you would go in case of an emergency, such as severe abdominal pain, vomiting that prevents drinking, fever or a racing heart in the first weeks.

What should I prepare specifically for travel?

  • Do the liver-shrinking diet exactly as prescribed, even if the operation is abroad.
  • Bring liquid protein supplements and chewable vitamins for the return trip.
  • Ask about blood-clot prevention for the flight home, including compression stockings or injections.
  • Book a flight that allows enough time for the post-operative check-up and discharge authorisation.
  • Take out travel insurance that covers medical care abroad.

FAQ

How long does preparation for bariatric surgery take in Switzerland?

The SMOB guidelines require at least three months of structured preparation between the first contact with the centre and the operation, and often longer.

Is a gastroscopy really necessary?

Yes, it is part of the minimum work-up in the SMOB guidelines and influences the choice between sleeve and bypass.

How long is the liver-shrinking diet?

Often two to four weeks, but it varies between centres and patients. Follow your centre’s instructions.

Can I fail the psychological assessment?

It is not an exam. Some conditions may lead to postponement and treatment first, but the assessment mainly aims to prepare and support you.

When should I stop smoking?

At least four weeks before surgery according to the ERAS guidelines, and ideally permanently.

Do I have to stop semaglutide before surgery?

Not necessarily. Tell your team; recent guidance suggests most patients can continue, with a liquid diet for 24 hours in higher-risk cases.

Will my insurance pay if my BMI is 34?

For bariatric surgery, Swiss basic insurance requires a BMI above 35 and a failed two-year therapy. Metabolic surgery for type 2 diabetes with a lower BMI follows separate SMOB criteria.

Can I eat normally the day before surgery?

Usually not if you are on a pre-operative diet. Fasting rules for the day of surgery are typically six hours for solids and two hours for clear liquids, but your centre’s instructions apply.

Do I need to exercise before surgery?

No formal programme is required, but regular walking and breathing exercises make recovery easier.

Your next step: request a free, personalised quote for bariatric surgery. Medespoir organises the work-up, the operation in Tunisia and follow-up; treatment is significantly cheaper than in Switzerland and the exact price is given in the quote, within 48 hours.

Main sources: SMOB, Guidelines for the surgical treatment of obesity, in force since 1 July 2023 (smob.ch); Federal Office of Public Health, KLV/OPAS Annex 1, edition of 1 July 2026; Stenberg et al., ERAS Society guidelines for bariatric surgery, 2021 update, World Journal of Surgery (2022); Holderbaum et al., Very low calorie diets before bariatric surgery, SOARD (2018); McKechnie et al., Very low energy diets before bariatric surgery, Frontiers in Nutrition (2023); Predictors of marginal ulcer after gastric bypass, Journal of Gastrointestinal Surgery (2023); Pre-operative GLP-1 receptor agonists and bariatric surgery outcomes, SOARD (2026); American Society of Anesthesiologists, multi-society GLP-1 guidance (October 2024); Medespoir, obesity surgery guide, sleeve and bypass.

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