The decision in favour of bariatric surgery is often made after a long process and is not an "easier" route than conservative weight loss attempts. It should be considered if these attempts have failed. Those affected must be aware that this entails considerable changes to their lifestyle.

• In Germany, there is a medical guideline for the surgical treatment of obesity: the AWMF guideline "Surgery for obesity and metabolic diseases".
• For patients with a BMI of 35 to 39, bariatric surgery can be considered if obesity-associated comorbidities (such as type 2 diabetes, heart failure, sleep apnoea, etc.) are present and conservative therapy has been exhausted.
• With a BMI of 40 or more, bariatric surgery is possible if there are no concomitant diseases or contraindications and conservative therapy has also been exhausted, provided that comprehensive information is provided.

MMK stands for the multimodal concept for the treatment of morbid obesity. According to the German guideline, obesity patients should first undergo multimodal treatment before surgery is planned. This includes nutrition, exercise and behavioural therapy as well as examinations by specialists such as endocrinologists and ENT specialists.

We will be happy to provide you with personalised support in planning and help you to find the right partners for multimodal therapy.

The multimodal concept usually extends over 6 months.

The key to success, i.e. sustainable weight loss, lies in the combination of different therapies, with nutrition, exercise and behavioural therapy playing a central role. We are happy to provide you with personalised support to help you plan and find the right partners for implementing multimodal therapy.

If you are unable to carry out an exercise programme due to your illness, try physiotherapy or rehabilitation sports. There you will receive professional support and an individually adapted programme.

If this is also not possible, you will need a statement from an orthopaedic specialist explaining the reasons for this.

Not everyone feels comfortable talking in a self-help group, and that is completely understandable. However, self-help forums offer an excellent opportunity to get in touch with other sufferers anonymously.

After your presentation at our bariatric centre, you will begin the multimodal concept, which lasts at least six months. If you fulfil the conditions for bariatric surgery, you can have the operation performed without a prior health insurance check. After the operation, we will bill your health insurance company for the operation, as with any other inpatient treatment.

Depending on their state of health, our patients stay in hospital for around 1 to 3 days.

In the first 24 hours after the operation, pain may occur in the shoulder and chest region due to the gas used. The wounds may also be uncomfortable at first. Effective pain medication is available to help you get back on your feet quickly. The need for pain medication is individualised and you can contact us at any time if you are in pain. Many patients report that the abdominal wall feels like sore muscles or a muscle cramp after the operation. If you experience severe pain, you should inform us or, if you are already at home, visit the emergency department.

• Mild nausea may occur more frequently at the beginning. Medication is available for this, which your GP can prescribe. If the nausea occurs several times, you should contact the operating theatre again.
• If you suspect that one of your wounds is infected, please contact your GP or our clinic immediately. Early treatment can help to avoid more serious problems.

The return to work depends heavily on the physical strain. It is advisable to discuss this with your surgeon. After laparoscopic surgery, you should refrain from lifting weights over 5 kg for about 4-5 weeks. In the case of open surgery, this period should be at least 6 weeks.

As a rule, you can walk for up to 30 minutes after about a week. You should then gradually increase your activity. After 4 to 6 weeks, all types of sport are possible. If you experience discomfort during exercise or already have pain, it is advisable to reduce the intensity of the exertion.

We strongly recommend that you wait around 1.5 to 2 years after the operation before becoming pregnant in order to minimise the risks for you and your unborn child. However, if an unwanted pregnancy occurs immediately after the operation, we recommend that you visit our centre regularly.