All of the costs associated with weight loss surgery

Around 12.5 million people in Australia are considered overweight or obese [1]. And, a common way to approach weight loss is often through bariatric procedures. When you feel like you've tried every diet in the book, it's understandable that weight loss surgery might feel like the only option available.

There is a lot of information about weight loss surgeries floating around the internet — both good and bad. This can make it difficult to decipher exactly what you need to know — especially when it comes to things like the cost of these procedures.

To help you make an informed decision, we're diving deep into everything you need to know about weight loss surgery.

We're running through all the costs associated with these types of procedures, their eligibility requirements and whether Medicare and private health funds cover any of the costs.

What's the deal with weight loss surgery?

Weight loss surgery is an umbrella term that covers a range of different weight loss procedures [2]. You might see this type of treatment referred to as bariatric surgery, too.

In one way or another, weight loss surgery "changes the function and shape of your digestive system" to help people with a high body mass index (BMI) lose weight when other weight loss methods such as diet, exercise, pharmacology and behavioural therapy have not worked [3] [4].

Bariatric surgery is also used to manage other medical conditions where losing weight is crucial to your health and wellbeing including sleep apnoea.

Types of weight loss surgery

There are various types of weight loss surgery with some procedures making your stomach smaller, some changing your small intestine, and others affecting hormones and bacteria to reduce your appetite [2].

In Australia, the most common weight loss procedures are sleeve gastrectomy, otherwise known as gastric sleeve surgery, gastric band surgery, and gastric bypass surgery [5].

Let's dive into what each weight loss procedure means and what it actually does to the body.

Sleeve gastrectomy

A gastric sleeve surgery permanently reduces the size of the stomach by two-thirds, by removing a large part of the stomach and stapling the rest to form a smaller sleeve of the stomach [6]. As a result of a smaller stomach, the amount of food you can consume is reduced.

A sleeve gastrectomy surgery is irreversible and the most common bariatric surgery procedure because it offers weight loss early on [7].

Gastric band surgery

Gastric band surgery, otherwise known as lap band surgery, places an inflatable band around the top of your stomach. This divides your stomach into two portions: a small upper portion and a larger lower portion [6].

Gastric band surgery helps to slow down the entry of food, which in turn makes you feel full after eating smaller portions of food. The lab band is adjustable and can be changed by your doctor by adding or removing saline solution.

Gastric bypass surgery

Gastric bypass is a major surgical procedure that reconstructs your digestive system by decreasing the size of the stomach and altering how the small intestine absorbs food [6].

Gastric bypass surgery creates a small stomach pouch by stapling the top part of the stomach, which is then attached to the lower end of the small intestine [5]. This means the food you consume essentially bypasses most of your stomach which limits how much you can eat.

These procedures are invasive and do come with a range of hospital costs that need to be considered, too.

Is weight loss surgery painful?

This is a tough question to answer as weight loss surgery affects everyone differently, with varying degrees of pain, and it largely depends on what kind of procedure you received.

Pain on the incision sight or as a result of re-adjusting the muscles during your surgery is a common experience after a weight loss procedure [7]. Carbon dioxide gas is often used in the procedure to inflate the stomach so doctors have better visibility and post-surgery, this can cause shoulder and neck pain in some people.

Other common side effects of weight loss surgery include:

• Stomach pains
• Nausea and vomiting
• Body aches
• Constipation
• Diarrhoea [9].

There are also other associated long-term risks with all weight loss procedures including:

• Low blood sugar
• Ulcers
• Anastomotic leaks: when two ends of a connected channel don't completely seal, resulting in leakages [11]
• Dumping syndrome: a group of symptoms including diarrhoea, nausea, light-headedness or tiredness after a meal [12]
• Bowel obstruction
• Hernias
• Blood clots [9].

Is there a minimum weight for weight loss surgery?

A good indicator of whether weight loss surgery may be required or suggested by your doctor is your body mass index, or BMI (a metric used to measure obesity). People with a BMI over 35 typically find losing weight through diet and exercise alone very difficult, therefore weight loss surgery may be used to support this process.

In Australia, a more comprehensive breakdown of the requirements for weight loss surgery is based on these factors:

• If your BMI is 30 or higher and you have type 2 diabetes with a risk of cardiovascular disease you can be considered for weight loss surgery.
• For a BMI between 35 to 39.9, you must also have one or more health problems associated with obesity.
• For a BMI of over 40, you are eligible for weight loss surgery without any associated health conditions [13].

How much does bariatric surgery cost?

Now onto the part you've been waiting for: diving into the price tag of different types of bariatric surgery.

Bariatric surgery costs can be pretty expensive and it often depends on a variety of factors including the weight loss clinic or private hospital you go to and whether you have private health insurance.

The costs of bariatric surgery cover a bunch of associated fees including surgeon's fees, your initial consultation, postoperative dietetic support (which helps to reduce post-surgery risks) the hospital fee, radiology and pathology fees, anaesthesiologist, and surgical assistant fees [14][15].

In general terms, the three main bariatric surgeries offered in Australia can cost:

• Sleeve gastrectomy: anywhere between $12,500 and $20,000.
• Gastric band surgery: around $20,000.
• Gastric bypass surgery: generally, costs for this procedure range between $14,000 and $18,000 [16].

Does Medicare cover weight loss surgery?

Weight loss surgery is considered a health intervention, therefore, Medicare does cover a portion of the costs. However, the amount covered is very minimal.

Surgical procedures are under a large medicare directory called the Medicare Benefits Schedule (MBS) with their own unique Item Numbers [17]. Medicare reimburses a portion of the costs of the three of the most popular weight loss surgeries, including:

• 31575 - Sleeve gastrectomy: $673.65 [18].
• 31369 - Gastric band surgery: $221.00 [19].
• 31572 - Gastric bypass surgery: $828.90 [20].

Unfortunately, these amounts are fairly low, which means that there is an out-of-pocket cost in the thousands even with Medicare rebates.

Private health insurance for weight loss surgery

Most of the coverage for bariatric procedures is covered by the private health system in Australia, where private health funds cover the associated costs of procedures that have a corresponding MBS Item Number.

Each insurance company offers differing levels of coverage, which also depends on your private health cover plan. There are also out-of-pocket expenses to be aware of as both Medicare and private health insurance won't cover all of the associated expenses — meaning you will have to pay some out-of-pocket costs.

Typically, health insurance for bariatric surgery is covered with a gold-tier hospital policy, which can be pretty expensive (costing upwards of $160 a month) [21]. There is also a 12-month waiting period to get approval for bariatric surgery and to receive this private health insurance cover.

However, with a premium health insurance plan, your health fund could cover most of the procedure leaving you with a smaller gap to pay out. For example, HCF's breakdown of gastric band surgery costs is calculated as:

• 82 per cent is covered by HCF
• 14 per cent is paid by Medicare
• Your out-of-pocket weight loss surgery cost is four per cent [23].

All up, your private health fund is paying $13,399 and you'd be covering $500.

Non-surgical options for weight loss

Surgical options for weight loss come with some pretty hefty surgery fees, recovery times, and side effects. While it can be a medically necessary option for people who have already tried diet, exercise and lifestyle changes, these procedures aren't the right fit for many people.

There are various non-surgical and less invasive weight loss methods that can greatly assist in losing weight.

Weight loss shakes

Weight-loss shakes are liquid meal replacement drinks. They are intended to be used as a part of a weight-loss program that replaces one or more meals out of your day. When using meal replacement shakes, it's important to find ones that are filled with nutrients and offer high-quality nutritional value.

Juniper's Nourish Shakes are dietitian-approved meal replacement shakes that support lasting weight loss while still having all the nutritional benefits of a balanced meal.

Each shake is packed with 20 vitamins and minerals along with nearly 30g of high-quality protein (and no bad stuff like added sugar, laxatives, preservatives or empty fillers). These shakes can be a powerful way to kick start your weight loss journey while nourishing your body with everything it needs to stay fit and healthy.

Vagal blocking therapy

Vagal blocking therapy places a device comprised of two electrodes connected to a neuroregulator in your abdomen [23]. This blocks the nerve signals between your brain and stomach so that it reduces the feelings of hunger.

This is typically used as a form of therapy for obesity for patients who have not been successful in other weight loss methods such as medications and behavioural therapies but who also don't want to undergo more invasive bariatric surgery [23].

Holistic weight management programs

Juniper's Weight Reset Program is designed for long-term weight management, and conducted by a range of medical experts and health coaches. Get treatment that targets weight gain on a biological level, plus a dietitian-led program that supports long-term weight maintenance.

Health coaching is used to assist you with lifestyle changes including sticking with a routine and a support system of other women on the journey with you, so you feel less alone, while one-on-one health tracking gives you a personalised experience.

Weekly check-ins with your health practitioner are used to track your physical, mental and biometric health, where adjustments can be made to suit your individual needs. If you want to be supported through every step of your weight loss journey, this is how to do it.

When it comes to navigating weight loss, invasive and costly surgical procedures aren't your only option. While these treatments might be right for some people, it's always best to do your own research and look for cost-effective, sustainable programs that can help you change your habits and set up yourself for long-term success.

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