Specialized Obesity Center
There are 37 centers specializing in the management of severe obesity in France (mainland and overseas) , including 2 in Normandy (Caen and Rouen). These specialized centers are entrusted with 2 missions:
- provide multidisciplinary management of severe and/or complex obesity
- organize the “obesity” care sector in the territory.
The Specialized Obesity Center ( CSO ) in Caen Normandy covers the Manche, Orne and Calvados departments.
It has 3 sectors: pediatric, adult medical and adult surgical.
Coordination is ensured by a pair:
- Medical coordinator: Dr Véronique Savey
- Administrative coordinator: Ms. Élise Vastel
- Email: center-obesite@chu-caen.fr
Bariatric surgery meetings.
You are being monitored by the Specialized Obesity Center at Caen University Hospital and you would like to be able to interact with patients who have already had surgery, these meetings are organized for you!
Next dates: to come
More information and registrations: click here!
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Hospital Practitioner
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Hospital Practitioner
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Psychologist
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Dietician
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Hospital Practitioner
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Hospital practitioner
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Psychologist
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Psychologist
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APA educator
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Dietician
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Dietician
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Dietician
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APA teacher
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Medical administrative assistant
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Hospital practitioner
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Hospital practitioner
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Nurse Coordinator
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Nurse Coordinator
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Medical administrative assistant
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What is a Specialized Center for Obesity?
Obesity, a common chronic diseaseThe problem of obesity currently affects almost all of the planet.
In the world
According to a press release March 1, 2024 of the WHO, in 2022, 1 in 8 people worldwide lives with obesity . A new study published in Lancet shows that in 2022, more than 1 billion people worldwide now live with obesity. Obesity in adults has more than doubled on a global scale since 1990 and obesity in children and adolescents (aged 5 to 9) has quadrupled. Data also shows that 43% of adults were overweight in 2022.
Note that overweight and obesity are classified in 4th place in death risk factors, after high blood pressure, food risks and tobacco. Indeed, chronic, multifactorial, evolving disease ranging from simple obesity to severe and/or complex obesity, it is a major risk factor for the most frequent pathologies (cardiovascular diseases, type 2 diabetes, etc.) . The psychological and social consequences, such as mesestime of oneself, depression, stigma, are substantial and deleterious.
In France
In 2024, almost 1 in 2 French people (48.8 %) was in a situation of overweight and/or obesity. 18.1% of adults in metropolitan France and DROM-Coms are in a situation of obesity representing almost 10 million people. In mainland France, the obesity rate reaches 17.9% (LCO EFEO 2024 study).
The call for projects conducted by regional health agencies following the instruction of July 29, 2011 relating to the implementation of the National Nutrition Nutrition 3 plan and the obesity plan made it possible to identify 37 centers specializing in the management of severe obesity, centers present in metropolitan France and overseas.
Normandy one of the most affected regions
The stakes are high, especially in Normandy.
More and more Normans suffer from obesity. According to the latest LCO OFEO 2024 Study Survey, Normandy is the 3rd most affected French region (after Hauts de France 22.2%; Val de Loire center 21.6%) by obesity with 20.2% of adults in obesity, against 18.1% for the national average. Going from 19.8 % in 2020 (OBEPI 2020) to 20.2 % in 2024 (OFEO 2024), Normandy experienced a moderate increase. Pediatric obesity is also a problem.2 reference centers in Normandy
The Normandy region, particularly affected by obesity, has been awarded 2 specialized obesity centers: CHU Caen Normandy and CHU Rouen Normandie. Everyone has the appropriate expertise and equipment required for the reception of people in the most complex adult or pediatric obesity, in medicine as in surgery.Missions of CSOs : 3rd level of appealThe CSOs 3rd level regional appeal described by the High Authority for Health. Details on the three levels of appeal.
In order to make the care offer accessible and understandable for patients with obesity, these specialized centers are entrusted with two missions carried out within the framework of national specifications. They intervene in 3rd level regional appeal:
- 1st mission _ : ensure multidisciplinary management of severe and/or complex obesity
Relying on :- specific skills: medical teams (nutritionists, endocrinologists, paediatricians, psychiatrists, etc.) , paramedical (dieticians, adapted physical activity professionals, psychologists, nurses, etc.) and surgical teams (team of surgeons and anesthetists-resuscitators specializing in surgery bariatric) .
- and an adapted technical platform.
- 2nd mission : organize the “obesity” care sector in the territory
This is done in a process of animation and coordination of the multidisciplinary actors involved in the management of the disease, whether they are health establishments, liberals , medico-social and associations in conjunction with the networks and attending physicians and under the aegis of the ARS .
This work requires creating a dynamic and formalizing partnerships by implementing actions that are not directly related to the care of a patient but which aim to organize the offer and disseminate information. skills (raising awareness, information, training, dissemination of best practice recommendations, etc. ).
In addition, Obesity centers are engaged in research . In this context, the CSO of CHU Caen Normandie can rely on:
- The Directorate of Clinical Research and Innovation of the CHU Caen Normandy
- on the so-called “integrated” Center (CIO) of the CHRU of Lille
- On the Force (French Obesity Research Center of Excellence) which is a French network of excellence in clinical research on obesities and associated pathologies.
- 1st mission _ : ensure multidisciplinary management of severe and/or complex obesity
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Our care at the CSO of Caen Normandy
overweight in adults
The measurement tool commonly used to diagnose obesity is the body mass index ( BMI ). The body mass index ( BMI ) takes into account the weight and size according to the following formula: BMI
= weight (kg) / size² (m)For overweight in adults ( BMI between 25.0 and 29.9 kg/m²) , there is no indication for hospital treatment. The management of overweight is carried out by the attending physician. International recommendations emphasize the need to stabilize weight, through regular physical activity and a balanced diet (see the website www.manger-bouger.fr ). Physical activity is the most important element.
- Calculate your body mass index ( BMI ) online
- www.mangerbouger.fr
- HAS , Guide to overweight care course and adult obesity
- "My Psy Support" system which allows anyone from an anxious, depressed or trying a discomfort, to benefit from 12 psychological support sessions in a partner psychologist with 60 % care by health insurance
adult obesity
- If your BMI is between 30 and 35 kg/m² : you must first discuss this with your doctor. He can refer you to liberal professionals in his network: a nutritionist or dietician, a specialist or a structure offering adapted physical activity and, if necessary, to a psychiatrist or psychologist.
- If your BMI is greater than 35 kg/m²:
The 1st contact is made through a telephone interview with the secretary of the CSO . Depending on the data of this exchange, care at the CHU may be offered to you.
You will then begin your care with a check-up hospitalization within the CSO of the CHU Caen Normandie. As part of the week hospitalization you will be accompanied by a multidisciplinary team for comprehensive and personalized care . Indeed, you will benefit from an individual medical and paramedical assessment (nurse, psychologist, dietician and adapted physical activity), as well as group workshops.
The objective of the stay is to screen for diseases linked to obesity and to assess your individual situation. You will then be offered a care plan adapted to your needs in conjunction with your attending physician. This can be consultations at the CHU (medical, paramedical) and/or care via the PLANETH Patient therapeutic education platform and/or care in a follow-up and rehabilitation care establishment ( SSR : stay reimbursed in partly by social security and partly by your mutual insurance company) or with liberal professionals with dietary, psychological and physical activity support.
- Calculate your body mass index ( BMI ) online
- CSO national website
- HAS , Guide to overweight care course and adult obesity
- "My Psy Support" device which allows anyone from an anxious, depressed or trying a discomfort, to benefit from 12 psychological support sessions in a partner psychologist with a https: // www socket. Has -Sante.fr/upload/docs/application/pdf/2023-02/Synthese._Parcours_surpoids-obesite_de_ladulte.pdfen loads at 60 % by health insurance
If you have a request for surgical management of your obesity
This treatment is reserved for the most severe forms of obesity, in the event of failure of well-conducted medical treatment.
The recommendations of the High Authority for Health authorize to initiate with a project to surgery of obesity adult patients bringing together a set of strict conditions ( BMI ≥40 kg/m2 or IMC ≥ 35 kg/m2 with complications likely to be improved after surgery ... within the framework of a badly balanced diabetes it can be envisaged for people with a BMI ≥ 30 kg/m²).
Information brochure for patients considering bariatric surgery
This brochure includes explanations of:
- the conditions for benefiting from obesity surgery;
- the different surgical techniques (gastric bypass (bypass); longitudinal gastrectomy (sleeve)…)
- the organization of care, from the first interview with the doctor to follow-up after the operation;
- the precautions to be taken to ensure the best chance of success.
Pre and post-operative follow-up :
As part of bariatric surgery you will benefit from medical and paramedical monitoring not only pre-operative but also post-operative for life, in accordance with the recommendations of the High Authority for Health. Optimal pre and post-surgery management (adapted physical activity, dietetics, psychological) conditions the success of long-term bariatric surgery , in particular a lasting weight loss and a reduction in the occurrence of surgical, nutritional and psychological complications.
Note that you may be offered a RAAC . The CHU Caen Normandie has also obtained the GRACE (Francophone Group for Improved Rehabilitation after Surgery) for obesity surgery. This quality label is the reward for multidisciplinary teamwork whose objective is to accompany the patient before, during and after his hospitalization, in order to help him recover his functional capacities more quickly after his surgery. obesity, and this, in complete safety.
Several reasons to maintain lifelong follow -up:
- Regular monitoring is associated with a lasting success of obesity surgery
- Detect possible complications occurring at a distance from the intervention: surgical complications, nutritional deficiencies, psychological difficulties, weight recovery, presence of eating disorders, etc.
- Treatments must be adapted during weight loss or even for some contraindicated. Sometimes during resumes of weight and recurrence of diseases initially present during obesity, other treatments can be introduced.
- In the event of a pregnancy project which will require specialized care. Note that it is recommended to wait for significant weight loss to be completed, that is to say between 12 and 18 months after the intervention. Nutritional deficiencies during weight loss are frequent and aggravated by pregnancy. It is best to have effective contraception before and in the months following the intervention. Pregnancy video after bariatric AP-HP surgery
- In the event of a reconstructive surgery project
Association of patients : moreover, if you wish, you can meet the members of a patient association who holds permanence in the surgery service and who can support you throughout your journey.
Restorative surgery : Finally, plastic and functional surgery may possibly be offered. Indeed, significant weight loss can associate with a skin relaxation and skin surpluses which can lead to considering restorative surgery with the aim of remodeling the silhouette.
Obesity drugsSeveral drugs are intended for people in obesity. They aim to help the patient lose weight.
Drugs currently having the marketing authorization (AMM) in the treatment of obesity, are drugs based on GLP-1 analogues mimicking the action of digestive hormones to have an effect on appetite and gastric emptying often resulting in weight loss. They come in the form of a pre -filled pen of the subcutaneous injectable solution:
- Liraglutide (Saxenda®)
- semaglutide (Wegovy®)
- TIRZEPATIDE (MOUNJARO®)
These weight loss drugs are only prescribed under certain conditions . These drugs must be associated with changes in lifestyle to optimize their effectiveness and avoid resumption of weight.
These are not miracle solutions, their effects are limited and they dissipate after the end of treatment. Each medication has advantages and risks, and must be discussed with your doctor in order to choose the drug that best suits your needs. Sustainable weight loss requires changes in long -term life (balanced diet and regular physical activity, etc.), and drugs must be seen as support for the weight loss process, not as a replacement of healthy lifestyles .
These drugs are said to be “second-line treatment”, that is to say that a medical care alone will be systematically proposed to you before you can consider, in the event of failure, the implementation of a drug treatment.
Childhood obesityThe probability that a child in a situation of obesity will remain so in adulthood varies according to studies from 20 to 50% before puberty, and from 50 to 70% after puberty.
It is recommended to monitor the body mass index systematically in all children and adolescents:
- regardless of their age;
- regardless of their apparent corpulence;
- whatever the reason for the consultation;
- at least 2 or 3 times a year.
Some warning signs to look out for:
- Early adiposity rebound (the earlier it is, the higher the risk of becoming obese) .
- Continuous rise in the BMI since birth.
- Rapid change of corridor of the BMI upwards.
If the waist circumference / height ratio is > 0.5, the child has excess abdominal fat associated with increased cardiovascular and metabolic risk.
The goal of care is to improve quality of life and prevent complications in adulthood.
Regular and prolonged follow-up of at least 2 years is recommended.
It is recommended that support:
- is based on the principles of therapeutic patient education;
- take into account diet, physical activity and sedentary lifestyle, the balance of lifestyles, psychological and socio-economic aspects;
- involves the parents and/or responsible adults of the child or adolescent;
- Obtain the support of the child or adolescent and his family, taking care not to make people feel guilty, hurt or stigmatize.
3 levels of support:
- 1st resort : uncomplicated overweight. Local care by the usual doctor.
- 2nd recourse : complicated overweight or simple obesity. Multidisciplinary care organized on a territorial scale, calling on specialized professionals.
- 3 rd resort: obesity + severe comorbidities / disability. Support organized on a regional scale and coordinated by a specialist doctor and team.
Areas of support:
Always in contact with the attending physician, whether pediatrician or general practitioner:
- dietetic
- physical activity
- psychological
- Therapeutic stays in SMR according to various methods (day hospitals, more or less long stays)
- bariatric surgery in certain very limited indications and only in specialized centers
The Pediatrics Department of CHU Caen Normandie
Medical and paramedical consultations
- Multidisciplinary consultations bringing together pediatrician, dietitian +/- psychologist
- Common transition consultations: pediatrician and adult nutritionist within pediatrics in order to optimize the adult relay
- HDJ with complete assessment of obesity and its complications with a proposal for a care project adapted to the needs of the child/family in connection with the attending physician. This can be followed by the CHU team and/or via the NPO network (Normandy Pediatrics obesity) and/or in a pediatric medical care center ( SMR ) specialized in nutrition or with liberal professionals with dietary, psychological and physical activity.
Useful links :
- CSO national website
- The “Mission: find your CAP” program (MRTC) , a device that allows children from 3 to 12 years old overweight or at risk of becoming it, to benefit from early and multidisciplinary care (dietetics, psychological, physical activity). This care is reimbursed 100 % by health insurance without the advance of costs by the family, or exceeding fees. You will find an explanatory video presentation of the device The list of referenced structures updated monthly.
- "My Psy Support" system which allows anyone from an anxious, depressed or trying a discomfort, to benefit from 12 psychological support sessions in a partner psychologist with 60 % care by health insurance
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Public Hospital Center of Cotentin Cherbourg Octeville
Rue du Trotecubq, 50100 Cherbourg-en-Cotentin
