Obesity Treatment Gdynia

Obesity is a chronic disease classified under ICD-10 code E66. The Polish Society for the Treatment of Obesity (PTLO) sets out the principles of its diagnosis and treatment in its 2024 recommendations. Fat tissue releases hormones, so an excess of it affects appetite, the action of insulin and the balance of sex hormones. One of these hormones is leptin, which helps regulate fullness; the response to it may be reduced. After weight loss, changes in appetite and energy expenditure can make a lower weight difficult to maintain. That is why we plan treatment over the long term: the doctor assesses the need for medication and tests, while dietary and psychodietetic support helps patients make everyday changes.

What leads to obesity?

We speak of obesity when there is so much fat tissue that it starts to harm health. The disease develops gradually, usually over years during which the body receives more energy than it uses. At first the surplus energy is stored in fat cells that grow larger, and when weight gain continues, the number of these cells increases. Visceral fat, which collects around the abdominal organs, does the most harm. It releases substances that sustain chronic inflammation and, over time, weaken the action of insulin.

Susceptibility to weight gain largely depends on genes. In twin studies, genes accounted for 40 to 70 percent of the differences in body weight, and in families where the parents have obesity, the children also develop it more often. This susceptibility leads to weight gain when high-calorie food is always within reach and most work and commuting is done sitting down. Short sleep, chronic stress, shift work and quitting smoking add to weight gain, and in women so do pregnancy and menopause. In some patients a medicine or a hormonal disease, such as Cushing's syndrome or hypothyroidism, contributes to weight gain, so before the first prescription we review the list of medicines and order tests when indicated.

What does obesity change in the menstrual cycle, libido and fertility?

Fat tissue also helps convert androgens into oestrogens. Changes in insulin and sex hormone-binding globulin (SHBG) can affect hormone balance. In women, obesity may be associated with irregular cycles and ovulation problems; in men, with reduced libido, erectile dysfunction and abnormal semen parameters. PTLO reports low testosterone in 32.7 to 45% of men with obesity. However, excess weight is not the only possible explanation for a low result. For couples trying to conceive, we coordinate obesity care with fertility assessment and treatment without putting off a needed consultation until weight has been lost.

We start by calculating body mass index (BMI): weight in kilograms divided by height in metres squared. A woman who is 165 cm tall and weighs 84 kg has a BMI of about 31. Overweight starts at 25, class I obesity at 30, class II at 35 and class III at 40. Waist circumference is measured midway between the lowest rib and the top of the hip bone. The thresholds of 80 cm for women and 94 cm for men apply to people of European ancestry. Visceral fat is associated with greater metabolic risk even at a lower BMI.

We ask about weight history, previous diets, sleep, snoring, alcohol, medicines and episodes of binge eating. For women, weight changes around pregnancies, menstrual regularity and a diagnosis of polycystic ovary syndrome (PCOS) are relevant. For men, we ask about libido, erectile function and plans for fatherhood.

When can medication be started, including with PCOS?

For the incretin medicines discussed here and Mysimba, the weight criterion is usually BMI at least 30, or at least 27 with an appropriate weight-related condition, such as hypertension, abnormal blood lipids, sleep apnoea or a glucose regulation disorder. For Xenical, the overweight threshold is 28 with risk factors. BMI alone does not guarantee a prescription: the doctor also assesses contraindications and other treatments.

Neither PCOS nor insulin resistance automatically establishes eligibility for a particular medicine. Insulin resistance means a reduced response to insulin; it is not another name for prediabetes. With BMI 25-27, you can seek advice and start dietary treatment, but waist circumference alone does not override these medicines' authorised BMI thresholds. In Poland, an obesity physician is a doctor who treats obesity, not a separate medical specialty. PTLO runs a certification programme for doctors.

We treat obesity in a 6-month online programme for PLN 1,799. Before the first consultation, the patient has blood tests and measures weight, waist circumference and blood pressure at home. The doctor reviews the history and results, then decides whether the patient can be treated in the programme. Additional tests are requested as appropriate. The price includes two 30-minute doctor consultations, two 40-50-minute online consultations with a psychologist and five medical reviews of app data without a call, but not the medicine, which the patient buys at a pharmacy with an e-prescription. The patient books all consultations in the Nasz Gabinet app, on dates counted from the first one.

The price also includes an AI assistant and monitoring of body weight and treatment progress.

Between consultations, the patient logs weight in the app every week and body measurements every month. After the injection, the patient takes a photo of the pen, which the medical team checks, and the doctor reviews all these data before the check-up. PTLO recommends that obesity treatment last at least a year. After the programme it can therefore be extended with a continuation package for PLN 350 for 3 months. The package does not include video consultations, and the doctor reviews the results every month and issues an e-prescription.

If pregnancy is possible, we discuss contraception and family plans before medication is started. If pregnancy is planned soon, treatment without medication may be appropriate. The dose is increased according to the product's schedule, depending on effectiveness and tolerability. A check-up does not always mean a higher dose.

Over the following months, we assess weight changes, health and the need for tests. An initial goal may be 5-10% weight loss, but this is not a required result by a fixed date. Criteria for assessing response differ between medicines. Reaching one year is not itself a reason to stop the medicine.

What does the obesity treatment programme include?

• This programme is for adults. Children and adolescents need paediatric care.
• This service does not provide infertility treatment or testosterone therapy. Coordination with a gynaecologist or andrologist is agreed with the patient.
• We do not use weight-loss medicines during pregnancy. During breastfeeding, our programme focuses on nutritional support; this clinic policy does not mean that every medicine has the same restrictions in its product information.

Before choosing a medicine, the doctor may request fasting glucose, glycated haemoglobin (HbA1c), a lipid profile, ALT and AST, creatinine with eGFR, TSH, uric acid and a full blood count. The selection is individual. HbA1c reflects average glucose over roughly 2-3 months and helps identify abnormalities. eGFR estimates kidney filtration, TSH helps assess thyroid function, and ALT and AST may indicate a need for liver investigations; they do not by themselves prove damage caused by fat.

Before the initial consultation, have results from primary care or occupational health checks ready. The doctor assesses how current they are and whether they need repeating. Additional tests can be done in Gdynia or near home. We also need a list of all medicines, supplements and contraception. Some glucocorticoids, diabetes medicines, antiepileptics and psychiatric medicines may contribute to weight gain or interact with treatment; do not stop them yourself.

When are testosterone tests or a gynaecology consultation needed?

Not everyone needs an extensive hormone panel. Wide purple stretch marks, easy bruising, muscle weakness and other concerning symptoms may warrant investigation for Cushing's syndrome. Appearance alone does not establish a diagnosis.

The doctor may test testosterone for reduced libido, erectile dysfunction, fertility problems or appropriate metabolic indications. A low result is confirmed with another morning fasting sample on a different day, alongside assessment of symptoms. Depending on the situation, SHBG, LH, FSH, prolactin and semen assessment may be needed. Investigation should not be postponed for six months while waiting for weight loss.

Irregular periods and excess hair growth may warrant a gynaecology consultation. PCOS is diagnosed after other causes are excluded, usually from two of three groups of features: ovulatory dysfunction, hyperandrogenism and characteristic ovarian morphology. When the first two are present, ultrasound is not always needed; in adults, AMH can replace assessment of ovarian morphology within an appropriate diagnostic algorithm. Acne alone does not establish PCOS. Obesity care can be coordinated with these investigations.

Obesity can affect both partners' fertility. We treat adults with attention to health, age and the time available before a planned pregnancy. This does not replace assessment of the causes of infertility in either partner.

Can weight loss improve ovulation in PCOS?

Losing 5-15% of body weight may help improve cycles and ovulation in PCOS, but does not guarantee pregnancy. In Clark's 1998 study, of 67 women who completed a diet and exercise programme, 60 resumed ovulation, 52 became pregnant and 45 had a live birth. Only 18 pregnancies were spontaneous; the others involved fertility treatment. This was not a randomised study demonstrating that weight loss alone produces these outcomes for every woman.

In a small 2023 study, 27 women with PCOS received semaglutide 0.5 mg weekly. Average weight loss after three months was 7.6 kg. The 21 women who lost more than 5% continued for another three months: at six months, average loss was 11.5 kg, BMI changed from 34.4 to 29.4, and cycles became regular in 80% of this group. There was no control group; regular cycles do not establish a pregnancy rate. The study dose is not a plan for self-treatment.

In a trial of 72 women, liraglutide 1.8 mg daily for 26 weeks produced a weight difference of around 5.2 kg versus placebo. This differs from Saxenda 3 mg dosing and does not establish effectiveness as infertility treatment.

How does obesity affect IVF outcomes, and when should treatment not be delayed?

A 2019 meta-analysis of 21 studies found an approximately 15% lower relative live-birth rate after IVF at BMI at least 30 compared with BMI 18.5-24.9. This is not a 15 percentage-point difference or proof that losing weight before treatment improves outcomes by that amount. Planning with the fertility clinic takes account of age, ovarian reserve, diagnosis and pregnancy safety.

Fertility assessment usually starts after a year of trying for women under 35, after six months from age 35, and sooner above 40 or when a problem is already known. We do not recommend a six-month delay for everyone. Coordinated care does not mean immediately starting medication during ovarian stimulation: treatment must be agreed with the clinic beforehand, including because of anaesthesia for egg retrieval.

Poland's government programme covers women up to age 42 using their own eggs or donor sperm, up to 45 using donor eggs or embryos, and men up to 55. It provides six individualised procedures in different combinations, including up to four cycles with the couple's own reproductive cells or donor sperm. A year of trying does not automatically establish eligibility: the centre checks, among other conditions, a documented absolute cause of infertility or unsuccessful treatment in line with standards during the preceding 12 months.

Low testosterone with obesity: assessment and treatment for men planning fatherhood

A meta-analysis of 21 studies involving 13,077 men found abnormal sperm counts more often with obesity. In another review of 24 studies, testosterone rose by an average of 2.9 nmol/L after dietary treatment and 8.7 nmol/L after bariatric surgery. These are group averages, not individual predictions. A review of 32 studies in a 2026 journal volume highlights the limited quality of evidence on improvements in semen; hormone changes do not establish the likelihood of pregnancy.

Testosterone supplied from outside the body can suppress sperm production, so men planning fatherhood should not use it on their own. A low result needs confirmation and investigation of its cause. Obesity treatment can proceed alongside appropriate andrology or endocrinology assessment.

When should medication be stopped before pregnancy, and can it affect contraception?

If pregnancy is possible, effective contraception is agreed before treatment. The last dose is timed relative to planned conception, not only embryo transfer: natural conception may also occur.

European Mounjaro product information does not require adjustment of oral contraceptive doses. However, our clinic recommends an additional barrier method for four weeks after starting tirzepatide and after each dose increase, or considering a non-oral method. This is a precaution consistent with US information, not a requirement in the EU product information. Vomiting and severe diarrhoea can affect the pill's effectiveness with other medicines too; follow its leaflet.

An intrauterine device or implant may be suitable, but the method should be chosen individually with a gynaecologist. Seek help promptly if emergency contraception is needed. Evidence on the effect of higher body weight on its efficacy is inconsistent; 70 kg is not an established cut-off and should not delay advice.

What happens if a patient becomes pregnant during treatment, and how is pregnancy managed with obesity?

After a positive pregnancy test, stop semaglutide or tirzepatide and contact your doctor and gynaecologist promptly. Give the medicine's name, dose and date last taken. If you use another preparation, also seek prompt advice; our programme does not use medication to promote weight loss during pregnancy.

In a 2026 observational analysis of 429 women exposed to semaglutide in early pregnancy, some complications were more frequent than among nonusers, but no significant differences were found compared with women who stopped before pregnancy. The authors considered effects of discontinuation as a possible explanation. The study does not prove that appetite rebound alone caused the findings or that the medicine has no effect on the fetus. Evidence remains limited and requires individual assessment.

For a singleton pregnancy with prepregnancy BMI at least 30, the usual recommended total weight gain is 5-9 kg; this is not advice to lose weight. Nutritional support helps limit excessive gain after stopping medication. PTLO 2024 recommends 800 micrograms of folate daily before pregnancy for women with obesity; agree the dose and preparation with your doctor, especially after bariatric surgery. With obesity, the doctor arranges early glucose assessment, including an OGTT for those at risk. A normal early result does not replace repeat testing at 24-28 weeks. Some bariatric operations require another way of monitoring glucose.

GLP-1 and GIP are gut hormones released after meals, involved in processes including insulin secretion. GLP-1 also affects appetite and gastric emptying. Semaglutide and liraglutide activate the GLP-1 receptor; tirzepatide activates both GIP and GLP-1 receptors. The medicines may increase fullness and make smaller portions easier. They are not interchangeable: injectable semaglutide and tirzepatide are taken weekly, liraglutide daily. Dose escalation depends on the product and tolerability.

How should trial results be interpreted, and when is response assessed?

In STEP 1, semaglutide 2.4 mg was associated with average weight loss of 14.9% after 68 weeks versus 2.4% with placebo. SURMOUNT-1 found 20.9% versus 3.1% with tirzepatide 15 mg after 72 weeks. SCALE found 8.4 kg versus 2.8 kg with liraglutide 3 mg after 56 weeks. Participants did not have type 2 diabetes and received lifestyle support. These were separate studies, not a direct comparison of the medicines.

For illustration, 14.9% and 20.9% of 84 kg are around 12.5 and 17.6 kg. These are not promised outcomes for a woman of that weight or results after exactly one year. Response criteria depend on the product: in adults, Saxenda is stopped if weight loss is below 5% after 12 weeks at 3 mg daily, Xenical after 12 weeks without a 5% loss, and Mysimba after 16 weeks without that response. These timings do not automatically apply to other medicines.

With PCOS, we also record cycle regularity, but a period alone does not confirm ovulation or fertility. Weight loss may slow over time; the point of stabilisation varies, and maintaining the result is also a treatment goal.

Weight regain after stopping medication and preparation for pregnancy

In the STEP 1 follow-up subgroup, around two thirds of the lost weight returned within a year after semaglutide and lifestyle intervention ended, and cardiometabolic measures moved towards baseline. The study did not test whether tapering prevents regain. Any decision to stop is planned individually, with continued weight monitoring and nutritional support.

Before pregnancy, the required interval from the last dose must be respected. Weight at conception cannot be guaranteed to match weight at discontinuation. Restarting treatment after childbirth requires reassessment, consideration of breastfeeding and a dose appropriate to the length of the break.

We discuss five medication options: Wegovy, Mounjaro, Saxenda, Mysimba and Xenical. Selection depends on indications, associated conditions, other medicines and tolerability. This is not an exhaustive list of all therapies or formulations.

Why do we choose Wegovy rather than Ozempic for a woman without diabetes?

Wegovy is authorised for weight management, whereas Ozempic and Rybelsus are authorised for type 2 diabetes, although all contain semaglutide. Saxenda contains liraglutide used at 3 mg for obesity; Victoza is a liraglutide product for diabetes. Mounjaro is indicated for both conditions. Use outside an authorised indication requires a separate medical decision; it is neither automatically prohibited nor automatically reimbursable. Our programme selects a product authorised for obesity treatment.

Injectable Wegovy starts at 0.25 mg weekly and is usually increased gradually to 2.4 mg over 16 weeks. Product information also allows 7.2 mg in adults with an initial BMI of at least 30, after at least four weeks at 2.4 mg if further weight loss is needed. EU authorisation also includes oral Wegovy for adults; this does not establish availability of a particular formulation or dose in Polish pharmacies.

Tirzepatide starts at 2.5 mg weekly, increases to 5 mg after four weeks, and may increase further in 2.5 mg steps at intervals of at least four weeks only if needed. Maintenance doses are 5, 10 or 15 mg. Liraglutide starts at 0.6 mg daily, increasing in 0.6 mg steps at intervals of at least a week to 3 mg, depending on tolerability. The doctor determines dosing.

What determines the monthly cost of obesity medicines?

The medicines discussed here are paid for in full when used for obesity. Cost depends on brand, strength, pack size, number of doses and pharmacy. A pack price is not always a month's cost, and a lower price does not necessarily mean a starting dose. Other liraglutide products do not have Saxenda's price; the cost of Wegovy up to 2.4 mg does not establish the cost of 7.2 mg. Check current prices and availability with a pharmacy once treatment is agreed.

When might we prescribe Mysimba or Xenical instead of an injection?

Mysimba contains naltrexone and bupropion. In COR-I, alongside lifestyle support, average weight loss at 56 weeks was 6.1% versus 1.3% with placebo. In addition to the 16-week review, the doctor reassesses benefits, cardiovascular risk and maintenance of at least 5% weight loss after one year and annually thereafter. Contraindications include uncontrolled hypertension, seizures, bipolar disorder, a history of anorexia or bulimia, opioid use and acute alcohol withdrawal. All medicines must be reviewed, including any containing bupropion or naltrexone.

Xenical is a hard capsule containing orlistat 120 mg. It inhibits lipases and reduces absorption of some dietary fat; oily stools and urgency can occur, particularly after fatty meals. An oral preparation may be considered according to indications, tolerability and preferences, but interactions must still be checked. A shorter interval before trying to conceive does not by itself determine that orlistat is the best choice.

Nausea, vomiting, diarrhoea and constipation are common side effects. In STEP 1, 4.5% of semaglutide users stopped because of gastrointestinal symptoms. Smaller portions, fewer fatty foods and adequate fluids may help. The doctor can postpone a dose increase if treatment is poorly tolerated; do not change it yourself. A late period with nausea is also a reason to take a pregnancy test.

When is caution needed, and might other treatment have to change?

A history of pancreatitis calls for caution and individual assessment, not automatic exclusion from all these medicines. Report a family history of medullary thyroid cancer and heart disease too; US contraindications should not be equated with EU information. Breathlessness at rest needs investigation. Recommendations for advanced heart failure, such as NYHA IV, depend on the product.

Wegovy and Saxenda are not recommended in severe kidney impairment, including eGFR below 30 mL/min/1.73 m², or severe liver impairment. Mounjaro does not require dose adjustment for impairment of these organs, but severe disease requires caution. Saxenda is not recommended from age 75; experience with Wegovy and Mounjaro from age 85 is limited. Pregnancy and breastfeeding are addressed separately in the table.

For insulin or sulphonylureas, the doctor assesses whether a dose reduction is needed to limit hypoglycaemia; it is not automatic for everyone. They also check specific interactions and monitoring needs, such as INR with vitamin K antagonists. Not every oral medicine requires adjustment. Inform the anaesthetist before anaesthesia, including for egg retrieval. Delayed gastric emptying may increase aspiration risk; the procedure team determines the plan.

Abdominal pain, jaundice and sudden visual changes: symptoms that should not wait until a routine review

Severe persistent upper abdominal pain, including pain spreading to the back, may indicate pancreatitis even without vomiting. If these symptoms occur, do not take the next dose and seek urgent medical assessment. If acute pancreatitis is confirmed, do not restart the medicine you were taking when it developed. Pain under the right ribs with fever or jaundice may indicate gallstone complications. Sudden deterioration in vision needs urgent eye assessment; NAION, an ischaemic optic nerve injury, is a very rare adverse effect of semaglutide.

Check blood glucose if hypoglycaemia is suspected. Someone who is conscious and able to swallow should take rapidly absorbed carbohydrate, usually 15 g of glucose, and check again after 15 minutes; repeat if the reading remains low. Impaired consciousness requires immediate medical help; do not give anything by mouth to someone in this state. A doctor decides subsequent medication doses. Severe vomiting, inability to keep fluids down, little urine or marked weakness require urgent help; do not wait for a full day.

Why should medicine come from a pharmacy, not an advertisement?

A pharmacy verifies a pack's authenticity in the verification system; this involves more than its batch number. In October 2023, Poland's pharmaceutical inspectorate withdrew specified falsified Ozempic packs, while severe hypoglycaemia after insulin-containing counterfeits was reported in Austria. This did not mean every genuine pack carrying a given batch number was falsified. Products sold as research peptides are not substitutes for pharmacy medicines. Have prescriptions dispensed at a pharmacy and agree dose changes with your doctor.

Nutrition and activity help limit muscle loss during weight reduction. A daily deficit of 500-750 kcal and around 1-1.5 g of protein per kilogram of a reference weight chosen by a professional may be starting points, but must be adapted to health, especially kidney function. This does not always mean current body weight or a compulsory three meals. When appetite is lower, plan nutritious meals and remember fluids. Resistance exercise, such as bands twice weekly, is adapted to ability.

No single diet has been shown to be best for everyone with PCOS. Food quality, preferences and a sustainable plan matter; health benefits extend beyond weight loss. Before pregnancy, discuss folate and possible deficiencies with the doctor. During breastfeeding, weight-loss pace must account for lactation, maternal nutrition and the child's growth; one calorie limit cannot guarantee milk supply.

What can a psychodietitian do when someone eats because of stress?

Medication may reduce appetite, but does not replace work on behaviour. After an unsuccessful fertility treatment cycle or a night shift at the port, food may become a way to manage tension. A psychodietitian (a dietitian trained in the psychology of eating) helps identify these situations and plan a response, such as a short walk or a meal prepared in advance.

Repeated loss of control over eating, secret eating and associated shame need assessment by an appropriate professional. One description is not enough for a diagnosis. Eating disorders may require psychological or psychiatric treatment. Reception confirms the format, availability and fees for dietary and psychodietetic consultations.

A gram of alcohol provides 7 kcal. Two large beers may contain around 450 kcal and a bottle of wine around 600 kcal, depending on strength and composition. These calories can substantially reduce a planned deficit. Alcohol may also worsen gastrointestinal symptoms; insulin and some other diabetes medicines make hypoglycaemia a particular concern. Its symptoms can be mistaken for intoxication.

We advise avoiding alcohol during dose escalation as a precaution. There is no single safe daily portion for everyone. Avoid alcohol when planning pregnancy and during pregnancy; no safe amount in pregnancy has been established. Heavy use can impair both partners' fertility, but identical effects cannot be attributed to every amount.

Naltrexone is also used for alcohol dependence, but Mysimba does not replace that treatment. Its product information advises minimising or avoiding alcohol; acute alcohol withdrawal is a contraindication. A dependent person should not plan sudden withdrawal without medical support. In a 2025 trial, 48 participants received semaglutide or placebo for nine weeks, with reductions in craving and consumption on drinking days. This is an example of research, not an authorisation for treating alcohol dependence.

If cutting down is difficult, seek alcoholism treatment in Gdynia, or addiction therapy for other substances. Addiction and obesity care can be coordinated; when a particular medicine can be started depends on health.

The initial and final doctor consultations and the two psychologist consultations take place by video. The five monthly medical reviews use the data in the app and do not involve a call. Skin changes, such as dark thickening around the neck, can warrant metabolic investigation but do not by themselves confirm insulin resistance.

Before a video appointment, prepare current weight, blood pressure readings, a medication list, results and a description of symptoms. Blood tests can be done near home. A prescription depends on the doctor's assessment, not merely completion of the call.

When pregnancy is planned or fertility treatment is underway, the plan is coordinated with the gynaecologist or andrologist. A positive pregnancy test during medication requires prompt contact; severe symptoms require help locally rather than waiting for a scheduled consultation. Records are shared according to the agreed arrangements for ongoing care.

NFZ-funded care includes primary care, indicated investigations, specialist clinics and bariatric treatment after assessment. A metabolic clinic does not necessarily treat adults with obesity: search results for Pomerania include paediatric services and a phenylketonuria clinic. Confirm the clinical scope and current appointments with the provider. A specialist clinic generally requires a referral from a doctor providing publicly funded care.

Wegovy, Mounjaro, Saxenda, Mysimba and Xenical are paid for in full for obesity treatment, even when prescribed at an NFZ clinic. Ozempic reimbursement covers defined cases of type 2 diabetes and does not automatically include other semaglutide products. Obesity alone does not provide access to a dietitian in coordinated primary care; an appropriate associated condition requires assessment for a pathway at a practice that offers it.

The IVF programme pays for eligibility assessment and mandatory tests, not just the procedure itself. This does not mean it funds all separate obesity care. The obesity treatment programme, tests and medication should be budgeted separately. The programme costs PLN 1,799 for 6 months, and the fee for additional letters is confirmed through the price list or reception.

A bariatric centre determines eligibility based on health, previous treatment and funding rules. Traditional thresholds are BMI at least 40, or 35 with complications. ASMBS/IFSO 2022 recommendations include BMI at least 35 regardless of complications and consideration at BMI 30-34.9 in defined situations. This does not mean every Polish centre has identical assessment rules.

Psychological assessment helps establish readiness for surgery. Addiction, depression and binge eating require assessment of severity and treatment needs; the diagnostic label alone is not automatic exclusion. We support preparation according to the surgical team's plan, including weight reduction if recommended.

The Polish surgical society's bariatric centre list includes three facilities in Gdańsk and centres in Wejherowo, Kościerzyna and Słupsk. The list does not confirm current appointments or each provider's funding contract. The KOS-BAR pilot ended on 30 June 2026; this does not mean public bariatric treatment ended. The centre confirms preoperative and postoperative care.

Pregnancy after surgery should be planned after weight stabilisation and nutritional assessment with the gynaecologist and bariatric team. PTLO 2024 cites Polish surgical recommendations referring to 24 months; international consensus relates timing to procedure and stabilisation, usually around one year after sleeve gastrectomy or bypass and two years after gastric banding. This is not automatic permission or a prohibition for an individual woman. Effective contraception is needed until the agreed time because fertility may improve.

Deficiencies, including iron, vitamin B12, folate and vitamin D, require monitoring; supplements and tests depend on the procedure and results. During pregnancy, checks may be needed every trimester. After bypass, sleeve gastrectomy and some other operations, OGTT may be poorly tolerated or unreliable; the doctor chooses another glucose monitoring approach. Follow-up continues after surgery. If weight increases again, there is no need to wait several years: further treatment, including medication after assessment, can be considered.

There is no need to travel for the programme, because the doctor and psychologist consultations take place by video. The five monthly medical reviews use app data without a call. The programme is open to patients from Gdańsk, Sopot, Rumia, Reda and Wejherowo, as well as Puck, Władysławowo, Kartuzy, Żukowo, Kościerzyna, Pruszcz Gdański, Tczew and Starogard Gdański.

Tests can be done near home. Before the initial consultation, prepare results, measurements and a medication list.

If you attend a fertility clinic in Gdańsk or elsewhere, we coordinate obesity treatment with that care. Sharing records helps coordinate tests, but another clinician may consider repeat testing necessary. The method of sharing results and any letters is agreed with the patient.

A metabolic clinic in Gdynia reported 742 people waiting and an average waiting period of 229 days to NFZ for July 2026. These are historical provider statistics, not the date a new patient will be offered. Confirm current availability and the conditions treated directly with the clinic.

Pomeranian metabolic clinic search results also include paediatric services and a phenylketonuria clinic. Their queues should not be compared as equivalent options for adult obesity treatment. You can look outside your home area, checking the age groups and conditions accepted.

Initial assessment can begin in primary care or at the initial consultation in a private online programme. The choice depends on needs and availability, not on a promise of a particular weight loss while waiting. The medicines discussed here for obesity are paid for in full even when prescribed at an NFZ clinic.