Adult obesity: medical care or surgery?
Morbid or severe obesity is defined as “abnormal or excessive fat accumulation that presents risk to health” (WHO). Body mass index (BMI = weight/height²) is an indicator frequently used by medical teams. When a person is obese, their BMI is too high. Treatment is medical, multidisciplinary and prolonged, involving a dietician, a nutritionist, a psychologist, doctors, etc.
Surgery may be considered if medical care fails to achieve results, or if the multidisciplinary team and the patient consider that there is a benefit to reducing the size of the stomach. Other non-surgical techniques, such as an intragastric balloon, may also be offered.
Bariatric surgery
In France, the French National Authority for Health (HAS) determines whether bariatric surgery is appropriate, based on clinical studies that evaluate the risks and benefits of such.
Bariatric surgery is reserved for:
- Patients with very high body mass index (> 35kg/m²)
- Patients aged between 18 and 60
- Patients who present no psychological contraindications
- Patients who present no particular operative risk.
The operation can only be considered if the person has failed to lose weight after several months of specialised medical care (dietary monitoring, physical activity and psychological care).
The decision to operate is taken jointly by your GP, surgeon, endocrinologist, nutritionist and psychologist. If you live abroad, you must organise your follow-up arrangements before your stay in hospital.
What does weight loss surgery involve : what are the types of bariatric surgery?
A number of surgical techniques are used for treating obesity, and your surgeon will explain the pros and cons of each.
“Restrictive" surgery limits the ability to ingest food by placing an adjustable gastric band or by removing a part of the stomach (longitudinal gastrectomy).
“Mixed” surgery associates gastric restriction with the creation of a gastric bypass. The top part of the stomach is joined to the central part of the small intestine, thus preventing the absorption of food.
These procedures are most often performed under laparoscopy. They require solid physical and psychological preparation, as well as good post-operative follow-up and an educational programme that focuses on diet and physical activity.
What happens after obesity surgery?
The permanent monitoring of patients is essential to ensure that the benefits of bariatric surgery last, and to avoid the appearance of side effects (iron, calcium or vitamin D deficiency, etc.).
Your follow-up treatment will be organised in coordination with your medical-surgical team.
Regularly taking supplements, especially vitamin D, vitamin B12 and iron, is essential after a gastrectomy. Dosage will be decided based on the biological results of tests taken after the gastric band has been fitted.
If you have had bariatric surgery for obesity, medical monitoring is crucial for your health.
Preparing for your hospital stay with ELSAN in France
How can I make an appointment ?
FAQ
How can I obtain a visa?
To obtain your visa for France, you will need to apply to the French Embassy in your country of residence. Once you have paid the care cost estimate provided by the ELSAN International Patients Department, you will be sent a letter of invitation and a certificate of payment signed by the hospital where your procedure will take place. These documents should be attached to your visa application.
What about follow-up treatment?
Depending on your personal situation, your medical team may recommend a rehabilitation hospital stay. This will be discussed with you.
How long before I can fly?
Your doctor will make specific recommendations. We suggest that you ask them to issue a Fit to Fly certificate, as depending on your medical situation, it may be necessary to respect a certain time limit in the interest of your health.
Will I be reimbursed?
For patients not covered by French health insurance, we provide an estimate of the cost of treatment. You should submit this estimate, along with your treatment plan, to your insurer to obtain their prior agreement, in accordance with your insurance policy.
In some cases insurers will pay directly (avoiding any advance payments by the policyholder) or reimburse the policyholder on proof of payment (paid invoice). This will depend on your insurance policy.