Treatment
Obesity is a chronic disease. For treatment that means two things: it works while it runs, and it needs care that does not stop after twelve weeks. We therefore plan in years from the outset, not in courses.
Every course begins with an assessment — history, metabolism, comorbidities, current medication and what you have already tried.
01 — Foundation
Nutrition, movement, behaviour
These elements remain when medication or surgery joins them — they do not become redundant, they become more important. Most people who come to us have lost weight before, often repeatedly. The problem was rarely losing it but keeping it off.
- Nutritional medicine
- Not a diet sheet but an approach that fits your day: working hours, family, eating out. Counselling takes place in the same building, and reports go straight to the treating physician.
- Movement
- The aim is to preserve muscle mass, not to burn calories. What is reasonable depends on joints, heart and starting point — not on an off-the-shelf training plan.
- Behaviour and daily life
- Sleep, stress, meal rhythm, medication that affects weight. Much of what holds weight in place has little to do with eating.
- Comorbidities
- Treatment has a positive effect on blood pressure, blood sugar, lipids, sleep apnoea and the liver.
02 — Medication
Medication
GLP-1 and GLP-1/GIP receptor agonists have changed treatment. They act where obesity arises: in the regulation of hunger and satiety. They do not replace everything else — and they are not right for everyone.
- GLP-1
- They mimic a gut hormone released after eating. It slows gastric emptying and dampens the drive to keep eating. Hunger becomes quieter — it is not forbidden.
- GLP-1 + GIP
- These also act on the GIP receptor. In the licensing trials mean weight loss was more pronounced than with GLP-1 alone; individually the range is wide.
Three things to know beforehand
The effect lasts as long as the treatment does
After stopping, weight returns for most people. That is not failure but the course of a chronic disease — and the reason we plan for the long term.
Side effects mostly concern the gut
Nausea, fullness and constipation are common at the start and ease with slow dose increases. Anything unusual we discuss immediately.
Muscle mass needs attention
Rapid weight loss also costs muscle. Protein intake and strength training are therefore part of it, not an optional extra.
Indication and insurance cover are two different questions
Indication means treatment is medically appropriate. A physician decides that after the assessment.
Limitatio means the Federal Office of Public Health has set the conditions under which basic insurance pays for a medicine. Those conditions are narrower than the medical indication, and they change. A refusal by your insurer is therefore not a medical statement about you.
If the limitatio is not met, treatment remains possible — then at your own expense. We discuss that openly too, including whether it is worth it for you. We handle the application for cover.
03 — Surgery
Bariatric surgery
An operation changes the conditions, not the disease. For some people with severe obesity it is the most effective treatment currently available — particularly alongside type 2 diabetes. For others it is not the right route. Telling these apart is the real content of the assessment.
We assess and prepare, the operation takes place at the partner hospital, and follow-up returns to us. That split has a reason: follow-up lasts decades, the operation one morning.
Assessment
Internal medicine, nutrition and psychology. It includes the question of whether surgery is the right step at all — “no” is a result too.
Preparation
Weight stabilisation, dietary change, and clarification of insurance cover and its requirements.
Operation
Performed by experienced visceral surgeons at the partner hospital, as a rule minimally invasive.
Follow-up
Lifelong and with us again: laboratory checks, vitamin and protein status, weight course, mental health.
Who we work with
Prof. Dr. med. Ralph Peterli
Visceral and bariatric surgery
Prof. Dr. med. Andreas Thalheimer
Visceral and bariatric surgery
Prof. Dr. med. Dr. phil. Marco Bueter
Visceral and bariatric surgery
External · viszeramed.ch
Evaluation for surgical treatment
You arrange the evaluation for surgical treatment directly with ViszeraMed. For the assessment with us, which comes first, please register with us.
This information is for general orientation and does not replace medical advice.
For physicians and medical staff
Journal club, bedside teaching and referral
Continuing education, diagnostics and a short route into our clinic.