Key points
- Obesity care can combine several treatments over time. Medication and surgery can complement each other within a personalised care pathway, discussed with the team and reviewed regularly.
- A combination is discussed according to your needs: it is never routine.
- Your treatment can change as your needs change.
Depending on your situation, these treatments may be combined or follow one another. No sequence is compulsory: their place is discussed with you and reviewed during follow-up.
- Before an operationA treatment may be discussed to support preparation, as needed.
- After an operationIt can complement care if your health goals call for it.
- If weight is regainedOne option to assess among others, with the team.
One care pathway, several treatments
Obesity is a chronic disease: its care is long-term. The Swiss guidance published in 2026 states that the different treatments are often combined, one after the other or at the same time1.
Depending on your situation, medication and surgery can follow one another or complement each other, always alongside nutritional support, physical activity and, if needed, psychological support. To find out more: medication for obesity and obesity surgery.
Three situations where a combination may be discussed
Before an operation
Medication may be discussed to support preparation and improve the metabolic situation, depending on needs. It is not a compulsory step: the experts brought together by the International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) recommend deciding case by case2, 3.
If you take such a medicine, let the team know: the medical team and the anaesthesia team adapt the treatment to your situation before the operation2, 4. See also preparation and assessment.
After an operation
Medication can complement your care when your health goals call for additional treatment. As with other chronic diseases, treatment is adjusted over time: recent recommendations provide for this possibility, for example when weight stabilises before health goals have been reached2, 5. The timing is chosen with the team, according to how you are doing.
See also: you have already had surgery.
If weight goes back up
Medication is one of the options to assess, together with nutritional support, physical activity and, if necessary, an assessment of the surgical anatomy. Professional societies recommend presenting all available options and building individualised, multidisciplinary care2, 6. See Weight regain.
When BMI is over 50, or when a staged approach is being considered, a combination may also be discussed: see What care is available when BMI is over 50? and Other procedures and new approaches.
How the decision is made
The choice of medicine, when to start it and how long to take it are discussed with the team, taking into account your health, your goals and your preferences. The treatment is then reviewed regularly: it can be adjusted, continued or stopped.
These medicines are prescription-only and require medical follow-up. Their precautions for use are described on the page Medication for obesity.
Reimbursement by basic health insurance
Whether a medicine is useful for you and whether it is reimbursed are two separate questions.
In Switzerland, when semaglutide or tirzepatide is prescribed for weight management, the reimbursement conditions of basic health insurance exclude people who have already had obesity surgery or for whom such an operation is planned7, 8. These limitations concern the “weight management” indication: a prescription for another indication, for example type 2 diabetes, is subject to other conditions. The team explains what this means in your situation.
More about these conditions
Medicines are reimbursed by basic health insurance under conditions set by the Federal Office of Public Health (FOPH) in the list of pharmaceutical specialities (SL). For semaglutide and tirzepatide used for weight management, these conditions apply to people without previous, planned or imminent obesity surgery7, 9, 8.
For the treatment of type 2 diabetes, other reimbursement conditions apply; they are set separately for each medicine.
These conditions are granted for a limited period and may change; they were checked on 15 October 2026.
Frequently asked questions
What does it mean if medication is added after the operation?
That your treatment is adapting to your needs. Obesity is a chronic disease: medication can be added when your health goals call for it, without calling the operation into question.
Do I have to take medication before having surgery?
No, it is not compulsory. The decision is made with you, according to your needs.
How can I tell whether a combination could be useful for me?
Ask during a consultation: the team reviews your situation and your goals with you. You can write this question down with your other questions on the checklist Questions to ask before obesity surgery.
What next?
A first consultation is an opportunity to review your situation and ask your questions. Possible treatments are then discussed with you. Your request is received by the Centre’s appointments team, who will organise the next steps with you.
Medical review of the French version: Dr Pierre Fournier
Scientific sources and references
Sources accessed on 15 October 2026. Reimbursement rules and information on medicines change over time.
- Gerber PA, Collet TH, Favre L, et al. Swiss obesity clinical practice guidance. Swiss Med Wkly. 2026;156:5415. View source
- Cohen RV, Busetto L, Levinson R, et al. International consensus position statement on the role of obesity management medications in the context of metabolic bariatric surgery: expert guideline by the International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO). Br J Surg. 2024;111(12):znae283. View source
- Cohen RV, Park JY, Prager G, et al. Role of obesity-management medications before and after metabolic bariatric surgery: a systematic review. Br J Surg. 2024;111(12):znae284. View source
- Kindel TL, Wang AY, Wadhwa A, et al. Multi-society clinical practice guidance for the safe use of glucagon-like peptide-1 receptor agonists in the perioperative period. Surg Endosc. 2025;39(1):180-183. View source
- American Diabetes Association Professional Practice Committee for Obesity. Pharmacologic treatment of obesity in adults: Standards of care in overweight and obesity. BMJ Open Diabetes Res Care. 2026;13(Suppl 1):e005729. View source
- Vosburg RW, Carter J, Azagury D, et al. American Society for Metabolic and Bariatric Surgery statement on the treatment options for patients with non-response and weight recurrence after metabolic and bariatric surgery. Surg Obes Relat Dis. 2026;22(7):699-706. View source
- FOPH. Wegovy: amendment of the limitation as of 1 May 2025 (adult limitation valid until 28 February 2027), with the text of the limitations (in German). View source
- FOPH. Mounjaro: extension of the limitation to weight management as of 1 January 2026 (limitation valid until 31 December 2027), with the text of the limitations (in German). View source
- FOPH. Letter of 26 November 2025 to ASEMO, SSED and SMOB on the new limitations (prescribers and centres) (in German). View source
- Author
- Prepared for the Centre from the sources cited
- References
- See “Scientific sources and references” on this page