Diabetes, obesity, cancer, metabolic syndrome, heart disease… these clearly aren’t cosmetic problems, yet weight loss surgery often gets labelled as a cosmetic procedure. While there can be positive external changes that come with weight loss surgery, the aims are internal—better health, better well-being and potentially a longer life.

Obesity is becoming the largest preventable cause of death in our society. When lifestyle changes are not enough to reverse the effects of morbid obesity, other options need to be considered.

The most effective, safest and best-proven method of medical weight loss is weight loss surgery.

There are several options for medically supporting a weight loss program.

For those who cannot maintain a healthy weight with diet and exercise—and unfortunately the success rate of non-surgical weight loss programs is less than we would like—surgery may be the best way of improving health and reversing the medical complications of morbid obesity. Used in combination with dietary optimisation, an exercise program, vitamin supplementation and regular follow up, surgery offers the most predictable results and the most reliable means of managing complications of obesity such as diabetes and sleep apnoea. The options include:

Lap Band surgery

The laparoscopic adjustable gastric band reduces the sensation of hunger and reduces the size of meals and the rate at which food can be eaten. It is a useful part of a weight loss program because it addresses three of the major points of failure of non-surgical programs: hunger; uncontrolled eating behaviours; and the feelings of helplessness and futility that can accompany lapses in diet and exercise programs.

Lap Band surgery is performed laparoscopically—keyhole surgery, usually with a single night stay in hospital. The band itself is a soft, hollow silicone cuff that is placed around the top of the stomach. It is attached to a fluid reservoir (the “port”) that sits under the skin on the abdomen. The port makes the band adjustable—fluid can be put in or taken out with a small needle, so the degree of pressure on the stomach can be adjusted depending on the needs of the individual. Generally several “fills” are used over a period of a few months. Ongoing supervision is important, as the lap band only works to its potential when adjusted properly and when combined with an appropriate diet and lifestyle program.

Gastric bypass

Gastric bypass surgery reduces the size of the stomach, thereby reducing hunger and meal sizes, and also bypasses the first part of the small intestine, adding a degree of metabolic control. It is effective in patients with type I diabetes and it may be a better option than a Lap Band if the level of obesity is very high. Because no band remains in the body, there is no chance of problems with a band or its tubing; however, there is a higher chance of complications during surgery.

Our experienced surgeons can perform bypass surgery laparoscopically. Gastric bypass surgery can be reversed, although this may require an open operation with a large incision. As with all weight loss surgery, ongoing follow up is important, although no further adjustments are required after surgery.

Sleeve gastrectomy

The sleeve gastrectomy (gastric sleeve) decreases hunger and meal size by reducing the size of the stomach. Originally used as the first stage of a gastric bypass procedure, it has become popular because a proportion of people maintain weight loss without needing to proceed to a gastric bypass—the smaller size of the stomach is often enough to assist with weight loss.

Because no band is required, there is no need for ongoing adjustments following a sleeve gastrectomy, although as with all bariatric surgery the results are more predictable when a regular follow-up program is in place. Because part of the stomach is removed, the sleeve gastrectomy is not reversible. It does, however, have a lower complication rate than gastric bypass surgery in most patients.

Private Health Insurance?

If you have appropriate private health insurance, you could be covered for Bariatric (weight-loss) Surgery.

The out-of-pocket expense for those with private health insurance depends on your insurance cover and the procedure to be undertaken.

Most levels of private health insurance cover weight-loss procedures, but some of the more basic levels of cover may not. There may also be a waiting period, especially if you have recently joined a health fund.

What is usually covered includes:

  • 2 weeks of Optifast prior to your surgery
  • All consultations & LapBand adjustments are bulk billed with no out of pocket cost to patient
  • Post-operative appointments are included
  • Ongoing support pre & post-operatively
  • An initial consultation fee with the surgeon paid on the day
Item numbers used include:

  • Sleeve Gastrectomy 31575
  • Lap Band 31569
  • Gastric Bypass 31572
There are out of pocket expenses for the surgeon, assistant, anaesthetist, hospital, physician and dietitian. Some of these have a rebate depending on the insurance you have. You will need to ask your health insurance.

If you would like more information about fees, please contact our rooms.

The above options are suitable when weight loss is important to reverse or prevent medical complications of obesity. Surgery carries some risks, so at lower levels of overweight and obesity surgery may not be the best option. The information provided here is for general educational purposes only. Before proceeding, you should discuss your particular situation with the doctors at Weight Loss Victoria.

Intragastric Balloon

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An intragastric balloon is another option that is suitable for lower levels of obesity (BMI 28 to 33) without medical complications. The intragastric balloon is a fluid-filled balloon that reduces hunger and meal size. It is placed endoscopically—under sedation, through the mouth with the aid of a flexible telescope, with no incisions at all—and is removed after six months. Along with a supervised diet and exercise program, it can help re-balance body weight and metabolism and re-program eating behaviours to improve the chances of achieving and maintaining a healthy weight.

Clinical Guidelines

Mr Geoff Kohn has been involved in an expert panel charged with writing guidelines for this operation to help direct surgeons all around the world to provide gold-standard evidence-based care. They are highly technical guidelines, directed towards surgeons.

Clinical application of laparoscopic bariatric surgery: an evidence-based review
Timothy M. Farrell, Stephen P. Haggerty, D. Wayne Overby, Geoffrey P. Kohn, William S. Richardson, Robert D. Fanelli

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