Last reviewed by Dr. Raj MD on January 12th, 2022.
What is bariatric surgery?
This is a type of weight loss surgery that will help a person achieve a significant loss of weight. When a person has bariatric surgery how much food that they can eat is restricted resulting in lowering their caloric intake. Not everyone one who has a weight problem should have this surgery. It is a surgery that will have implications on your lifestyle and eating habits for the rest of your life so make sure that you think it through before you make such a major decision.
Bariatric surgery is for those whose Body Mass Index (BMI) exceeds forty and several failed diet attempts. A person’s BMI is the number that is calculated from your height and weight that correlates roughly to the percentage of your total weight that comes from fat as opposed to organ, bone, or muscle. A good healthy BMI would ideally be between twenty and twenty-five so having one that exceeds forty means you have a high percentage of fat in your body and are considered obese. If you want to see what your BMI is there are charts online that will help you to figure it out. Most people who have this surgery are normally between the ages of eighteen and sixty years old.
Bariatric Surgery Types
There are several different types of bariatric surgeries a person can choose but in the end they all fall into one of the three categories such as the type that:
- Work to reduce the size of your stomach using such procedures as sleeve gastrectomy, and gastric banding
- Work by restricting the absorption of calories a person takes in such as the commonly used Biliary-pancreatic diversion.
- Are a combination of any type such as gastric bypass, a combination type that limits both caloric absorption and stomach size.
There are many different bariatric surgery procedures that a person can undergo but they all fall into three general categories which include:
Adjustable gastric banding or vertical banded gastroplasty (VBG)
This type is chosen to help decrease the size of your stomach by using an adjustable silicone band which will limit how much liquids and food you can ingest.
Biliary-pancreatic diversion/duodenal switch
This type of bariatric surgery will shorten the length of your small intestine and may also divide your stomach resulting in weight loss and limited storage through the malabsorption (the inability to absorb vitamins and nutrients) from ingested food.
Roux-en-Y gastric bypass surgery
In this type the surgeon creates a small pouch which is then connected to a short length of your small intestine and reduces the size of your stomach from the size of a medium ball to the size of a small ball so the patient will not eat as much food. Since sections of your small intestine and stomach are bypassed during the digestive process, your body will also absorb fewer calories.
In regards to the cost of having bariatric surgery there are many different facts that can affect the cost. Some of those factors include:
- The specific type of bariatric surgical procedure you chose
- The facility where you are having the surgery performed
- The region or country where you have the surgery
- The surgeon who is doing the procedure
- Follow-up care
- Prescription medications
- The pre-op lab fees
- X-ray fees
- Anesthesia and the fee for the anesthesiologist
On average the cost to have adjustable gastric banding with Lap-Band procedure can range from seventeen to thirty thousand dollars. The gastric bypass procedure can cost on average eighteen to thirty-five thousand dollars. The cost also figures in how long the length of recovery is and the extent of the procedure. Even before you have the surgery there is the cost to see a dietician for a dietary plan to help you prepare for the surgery and what dietary restrictions are applied afterwards, behavioral modification which includes a one or more sessions with a psychiatrist to make sure you are having the bariatric surgery done for the right reasons, possibly having a sleep study done to make sure that you do not have sleep apnea, nutritional supplementation like vitamins, and more.
After bariatric surgery you may have to have body contouring surgery(s) to remove any excess skin, treat fat deposits, have a body lift to lift sagging body areas and help to improve loose muscle so all of this can add to the cost of having bariatric surgery. Before and after the procedure you will have many physician and surgeon visits. A person may also have to have plastic surgery procedures but what it will cost depends on how much more fat and skin will have to be removed to tone up your body after bariatric surgery. Most of these follow-up plastic surgeries like breast augmentation, or tummy tuck are delayed until a year or two after the bariatric surgery so you will have some time to save up for these costs.
One important thing to remember is not all insurance plans will cover the cost of bariatric surgery and all that goes with it. Even if they do pay it may not be one hundred percent so you will most likely have some out-of-pocket expenses. If bariatric surgery is medically necessary for your health such as being so obese it could develop into heart disease, diabetes, or even cause premature death your insurance may pay more of the cost, maybe even one hundred percent, if your physician makes a strong case stating so for the insurance company.
There are a variety of different complications that a person can have with bariatric surgery. Some of these various complications can include:
- An infection of the hernia, which is a rupture or hole that appears in the wall of your abdomen, of the incision. If this happens a person could experience a fever, discharge from the site, and nausea.
- Gastric dumping syndrome which is a medical condition where foods that have been ingested bypass your stomach too quickly and enter your small intestine mostly undigested. It is also referred to as rapid gastric emptying. One of the main causes for this to happen is eating too many high-fat and sugary foods which can cause the bowel to flood with fluid. If this happens you may have cramping, bloating, an increased heart rate, and sweats. Usually within sixty minutes after eating this type of food you will have diarrhea
- Blood clots if you have to be confined to a bed while in the recovery period. If a person develops a blood clot it could travel to their lung and cause a pulmonary embolism, which is the medical term for a blood clot in the lung, and this could result in death. Because most people who are obese or overweight have poor circulation they should make sure that they move their legs as much as they can even if they are confined to the bed. The surgeon may have them wear leg wraps to help try to prevent blood clots.
- Ulcers which usually form in the place where the newly form stomach pouch is attached to the intestine.
- Nutritional deficiencies which you can help prevent by taking a multivitamin and vitamin supplements.
- Pneumonia because of the increased stress on your lungs and heart during bariatric surgery
- Incisional hernia which can occur if the cut does not heal properly, making the tissue become weaker and allowing the internal tissue to push through your incision.
If you notice anything that does not seem normal after bariatric surgery you should contact your physician or surgeon immediately or go to your emergency room.