Weight loss surgery is a complex topic. For starters, there are several different weight loss surgeries being performed today, and it can be difficult to wade through all options without feeling overwhelmed.
It's a big decision to commit to a weight loss procedure and one that we know isn't taken lightly. But when you get to a certain point with your health, it can feel like there are no other options to help you lose weight and improve your wellbeing.
And, there's no shame in seeking help with weight loss, especially when you take into account that your genetics are largely responsible — in fact, up to 80% of weight is determined by our genes [1].
This is why, despite your best efforts with eating and exercise, your body can work against you and resist weight loss by triggering hormones that increase hunger and slow the metabolism.
With this in mind, we've created a handy guide on everything you need to know about weight loss surgery and the costs associated with these procedures. And, we'll also explore a less invasive, more affordable and effective medical pathway to weight loss. Let's dive in.
Different types of weight loss surgery
There are a few different types of weight loss surgery, which is also referred to as bariatric surgery.
Each one differs in application, but the end result is to limit the amount of food your stomach can hold to encourage the consumption of fewer calories.
Gastric sleeve
Gastric sleeve surgery, also known as sleeve gastrectomy, involves removing a sizeable section of the stomach in order to reduce the amount of food you can eat [2].
By reducing the size of the stomach, the body also naturally produces less of the hunger-stimulating hormone ghrelin.
This form of bariatric surgery is successful in helping patients achieve weight loss in a short amount of time and can reduce their chances of experiencing several obesity-related diseases [3].
The most common risks associated with gastric sleeve surgery are bleeding and leakage from the stomach as well as nutrient deficiencies [3].
It's also important to note that long-term success following a gastric sleeve operation does involve making lifestyle changes to ensure you can keep the weight off into the future as the stomach is capable of stretching again, leading to weight regain [4].
Gastric band
Gastric band surgery, also known as a lap band, involves implanting an inflatable tube around the upper part of the stomach to restrict how much you can eat [5].
The band, which is made of flexible silicone, is filled with salt water and is connected to a port underneath the skin that a bariatric surgeon can access to make it larger or smaller [6].
Gastric band surgery is reversible and has one of the lowest complication rates following surgery as no permanent change is being made to the stomach and intestines. The expected weight loss after gastric band surgery is about 40% of your body weight over 2 years.
While it is effective in aiding weight loss, there are also risks associated with this surgery.
Complications associated with the lap band include food intolerance, where patients develop issues with swallowing, severe nausea and vomiting, as well as heartburn, reflux and esophageal dilation, where the food can become stuck in the esophagus [7].
Gastric bypass
One of the most common forms of weight loss surgery, the gastric bypass procedure involves dividing the stomach and creating a small pouch at the top, which is then connected to the small intestine [8].
The idea here is that when you consume food, it goes into the small pouch before moving into the small intestine, bypassing the bulk of the stomach.
This means that you feel fuller with less food and in turn, absorb fewer calories, which encourages weight loss. Gastric bypass surgery can also help reduce your risk of developing weight-related issues [8].
A side effect that can occur following gastric bypass surgery is anastomotic leaking, which happens in 1-6% of these procedures. This complication occurs when the two ends of a channel that have been connected don't seal properly and the content begins to leak.
This is a serious risk as substances that don't belong in certain areas of the body can make their way there through the faulty connection.
If left untreated, long-term complications of anastomotic leaking can include ulcers and scarring as well as the creation of a fistula (a drainage tract) between the gastric pouch and stomach [9].
Gastric balloon
Another weight loss option is the gastric balloon. While not strictly a surgery, this procedure is often recommended to those who may need to lose weight to be eligible for a more permanent bariatric surgery.
This procedure involves inserting a silicone inflatable balloon into the stomach in order to make you fuller with less food [10].
Unlike the other procedures, a gastric balloon is only a temporary option and can't be left in place for longer than 9 months.
This procedure isn't as invasive as the others and can be inserted without the need for traditional surgical procedures. The balloon is inserted into the stomach with an endoscopy, which involves inserting a camera down the throat and oesophagus.
There are still side effects associated with gastric balloons, including developing acid reflux, constipation or diarrhoea, bowel obstruction and the perforation of the stomach or oesophagus.
What are the risks involved with weight loss surgery?
As with all surgical procedures, there are several risks associated with each weight loss surgery and this is something to be considered when weighing up options.
The most common post-operation side effects associated with these procedures include [11]:
- Acid reflux
- Chronic nausea
- Vomiting
- Inability to eat certain foods
- Infection
- Stomach obstruction
There are also long-term effects of weight loss surgery. These can commonly include:
- Malnutrition
- Vomiting
- Ulcers
- Bowel obstruction
- Hernias
There are a few things you can do to help reduce your risk before surgery. These include decreasing your body mass index (BMI), exercising, and quitting smoking.
All of these changes can increase your overall health and well-being and help lower the occurrence of these potential side effects.
How common is weight gain following bariatric surgery?
Initial weight loss following surgery can range from 47-80% of excess weight [4].
And, while the intention behind bariatric surgery is to help with weight loss and improve health, it's also common to experience weight gain in the 12-18 months after surgery, with 15-25% of the lost weight often regained [12].
While the reasons behind the weight gain can differ for people, it's usually because the stomach has stretched or due to food or lifestyle choices.
This can feel incredibly disheartening but know that you're not alone and it's good to have all of this information before deciding to undergo bariatric surgery.
This also helps highlight the importance of making a lifestyle change at the same time as bariatric surgery to ensure the results are long-term.
What is the cost of weight loss surgery?
Bariatric surgery costs vary on several factors but it is major surgery and does come at a high cost.
We've rounded up the prices associated with each surgery in Australia — all of these prices exclude assistance from private health insurance.
Gastric sleeve
The cost of gastric sleeve surgery is usually around the AUD $20,000 mark but it can vary depending on the clinic you use for the bariatric surgery [13].
Gastric band
The cost of gastric band surgery costs between AUD $14,000 and AUD $18,000.
Gastric bypass
The gastric bypass surgery cost depends on where you have the surgery performed but the average cost of gastric bypass surgery can range from AUD $12,500 and AUD $20,000.
Gastric balloon
Given the gastric balloon is not considered to be on the same level as the above bariatric procedures, the cost is significantly lower, coming in around the AUD $6,000 mark [14]. Keep in mind that this procedure is only a temporary one and the balloon needs to be removed after 9 months.
Why does weight loss surgery cost so much?
There are a lot of costs associated with bariatric procedures, which is why the out-of-pocket expenses are quite steep. These are the costs that make up the final fee [13]:
- Pre-operative appointments
- Surgeon and surgical assistant fees
- Anaesthesist fees
- Theatre costs
- Booking fees
- Hospital stay
It's good to know that the costs aren't just associated with the actual surgery itself but you might need to attend a number of appointments before surgery, in addition to follow-up appointments after, and these could attract out-of-pocket costs.
There is also the possibility that patients may have to work with a dietitian before the surgery in order to meet a goal weight that will ensure the procedure is less of a risk.
Does Medicare cover any weight loss surgeries?
In Australia, Medicare does cover a portion of some weight-loss surgeries but only under certain circumstances.
To qualify for coverage from Medicare for a weight loss surgery, a patient would have to meet some of the following criteria [15]:
- Have a body mass index (BMI) of over 30 and be able to demonstrate weight-related health problems
- Have a BMI of 35 to 39.9 and be able to demonstrate related health issues like hypertension, metabolic syndrome, osteoarthritis or asthma
- Have a BMI of 40 and higher, which qualifies you without proving related health problems
Patients would also have to demonstrate that they have tried to lose weight in the past but have been unsuccessful [16].
It's important to keep in mind that the whole cost of the surgery won't be covered by Medicare, but rather just a portion of it.
It's difficult to ascertain exactly how much you'll need to pay after Medicare foots some of the bill, but it could be anything from AUD $12,000 to AUD $18,000 depending on the procedure and where it is performed [17].
Does private health insurance cover weight loss surgery?
Most private health funds cover bariatric procedures like gastric bypass, gastric sleeve and lap band but these procedures are often only covered in the gold-tier private health insurance policies [11].
There is also usually a 12-month waiting period with these health fund policies before you're covered and a private health insurer won't cover the whole cost of the weight loss surgery but, depending on your policy, should take care of a large chunk.
In saying this, patients can still pay up to AUD $6,000 in out-of-pocket expenses for bariatric surgery.
As we mentioned above, if the weight loss surgery is considered to be medically necessary, Medicare may also contribute towards covering some of the costs alongside the health fund.
Can you get weight loss surgery for free in Australia?
While it's not easy to have the costs of bariatric surgery completely covered in Australia, there are ways to get weight loss procedures for free.
One way is through the regionally-based Metabolic Obesity Service (MOS), which is offered by NSW Health.
This service offers a pathway to bariatric surgery and combines support and education that focuses on behaviour change in order to make a lasting difference in a person's life post-surgery.
There are 4 phases included in the MOS, which include weekly workshops and monthly appointments to learn new behaviours and how to put these skills to use before undergoing a surgical consultation and eventually, the weight loss procedure.
There are also post-surgery follow-up appointments as well as support and coaching for at least 2 years after the bariatric surgery.
The MOS program has been designed to guide patients through the whole process so that behavioural change is achieved alongside physical weight loss.
Several inclusion criteria need to be met to take part in a service like this, including obtaining a GP referral, having tried to lose weight in the past with little success and having a BMI of 40-55. You must also live in a rural or remote area of NSW to qualify.
And, the total weight time to begin the process is around 2 years. This is a good example of how difficult it is to have surgical procedures for weight loss performed without having to financially contribute.
A less-invasive alternative to weight loss surgery
Deciding to go down the path of bariatric surgery takes a lot of courage. It's a huge decision to make and one that you can labour over for years.
And, it's understandable why this is the case, especially when you take into account the cost, the surgery itself and the recovery. It's an emotionally, physically and financially demanding experience.
It can also feel like you've run out of options when you get to a point where you feel like your body is working against you.
When you take into account that up to 80% of weight is determined by your genetics, it no longer becomes about willpower as your biology is getting in the way [1] — no matter how much physical activity you do or the low-calorie foods you eat.
This is why Pilot created the Metabolic Reset Program.
Our Metabolic Reset Program combines clinically proven treatments with community support from our medical team and health coaches, while also connecting you with a supportive community of like-minded men to help keep you motivated and accountable to your weight loss goals.
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