Frequently Asked Questions
Answers to the most commonly asked questions. If your question is not answered below please ask using the form below.
How can Bariatric surgery help me?
When combined with a comprehensive treatment plan, bariatric surgery may often act as an effective tool to provide you with long term weight-loss and help you increase your quality of life. Bariatric surgery has been shown to improve or resolve many obesity-related conditions, such as type 2 diabetes, high blood pressure, heart disease, and more. Frequently, individuals who improve their weight find themselves taking less and less medications to treat their obesity-related conditions.
Who is a candidate for Bariatric surgery?
The widely accepted criteria for Bariatric surgery include:
- BMI ≥ 40, or BMI ≥ 35 and with least one or more obesity-related co-morbidities such as type II diabetes (T2DM), hypertension, sleep apnea and other respiratory disorders, non-alcoholic fatty liver disease, osteoarthritis, lipid abnormalities, gastrointestinal disorders, or heart disease.
- Inability to achieve a healthy weight loss sustained for a period of time with prior weight loss efforts
However, there is considerable flexibility in these guidelines according to the medical comorbidities and/or ethnicity.
How does weight loss surgery work?
Weight loss surgery, also known as bariatric surgery, such as gastric bypass, sleeve gastrectomy, and duodenal switch work by changing the anatomy (or position) of the stomach and small intestines. This causes changes in appetite, satiety (feeling full), and metabolism (how the body burns calories).
Many of the hormonal signals that cause weight gain or inability to lose weight are affected by these procedures, and it becomes easier to lose weight. But this still requires a healthy diet and a good exercise routine. These procedures are tools to treat a chronic disease, and cannot work alone.
How long after metabolic and bariatric surgery will I have to be off work?
After surgery, most patients return to work in one or two weeks. You will have low energy for a while after surgery and may need to have some half days, or work every other day for your first week back. Your safety and the safety of others are extremely important – low energy can be dangerous in some jobs.
Will I have to take vitamins after bariatric surgery?
You will need to take a multivitamin for life.
You may need higher doses of certain vitamins or minerals, especially Iron, Calcium, and Vitamin D. You will also need to have at least a yearly blood test.
Will I lose my hair after bariatric surgery?
Some hair loss is common between 3 to 6 months following surgery. The reasons for this are not totally understood. Even if you take all recommended supplements, hair loss will be noticed until the follicles come back. Hair loss is almost always temporary. Adequate intake of protein, vitamins and minerals will help to ensure hair re-growth, and avoid longer term thinning.
When can I get pregnant metabolic and bariatric surgery?
Most women are much more fertile after surgery, even with moderate pre-op weight loss. Birth control pills do NOT work as well in patients who are overweight. Birth control pills are not very reliable during the time your weight is changing. For this reason, having another method of contraception is usually needed. Menstrual periods can be very irregular, and you can get pregnant when you least expect it!
Most groups recommend waiting 12-18 months after surgery before getting pregnant. This allows you to have maximum weight loss and reach a stable weight. You will also be very limited in your nutrient intake for quite some time after surgery.
When can I resume regular exercise?
We highly recommend short walks whilst in the hospital. The key is to listen to your body. As you heal, begin to increase your exercise time and intensity.
Usually our exercise physiologist, Hayley is equipped with the necessary skills and knowledge to provide structured exercise program. Please refer to the complementary Package offer for Exercise Physiology at Fix muscle performance.
How much weight will I lose?
Bariatric surgery is a “tool.” Weight loss success also depends on many other important factors, such as nutrition, exercise, and behaviour modification.
Once you have had surgery, your life will be forever different. Your body has now been modified to give you a better chance to overcome the underlying genetic, metabolic, environmental and lifestyle-induced state of obesity. These are powerful forces that created an unhealthy “weight set point” where your body has likely been stuck or hovering around, almost like a thermostat that is set too high. Your body is very effective at trying to maintain that weight and preventing change. As you lose weight, it is important to know that your body will try to establish a new set point. This leads to periodic plateaus in weight. This is normal and expected. Do not allow yourself to be discouraged when you reach a plateau, as these are normal and necessary parts of the weight-loss journey.
How often do you eat or drink?
Eat 3 meals a day + 1 protein snack/shake a day.
- Meals must include protein (>50g/day), fruits and vegetables and some grains.
- Continue with multi vitamin and mineral supplements
Drink plenty of water in between meals (>8 cups per day or >1.5L/day).
- Avoid water 15-30 minutes before or after a meal.
- Otherwise sip water or sugar free drinks throughout the day, avoid artificial sweeteners also.
How soon do I have to quit smoking before surgery?
We do not recommend surgery for smokers as they are prone to increased risk of anastomotic ulceration and leak.
Can I drink alcohol after surgery?
Alcohol is not recommended after bariatric surgery. Alcohol contains calories but minimal nutrition and will work against your weight loss goal. For example, wine contains twice than regular soft drink does. The absorption of alcohol changes with gastric bypass and gastric sleeve because an enzyme in the stomach which usually begins to digest alcohol is greatly reduced and you will reach the 0.05 with smaller volume.
What do I need to check with my private health fund?
Private patients undergoing any operation in a private hospital do not have to pay any hospital expenses, as these are covered by their health fund. Some health funds will charge an excess which vary from $0 to $500 depending on your fund and level of cover. Often a 12-month waiting period will apply before you can use your health insurance.
It is recommended to check with the health fund whether or not you are covered for bariatric surgery. The common item numbers we use are:
- Laparoscopic sleeve gastrectomy: 31575
- Laparoscopic gastric bypass: 31572
- Laparoscopic removal gastric band: 31584
- Laparoscopic revisional bariatric surgery: 31584, 30393
You will be charged a single expense for the surgery. This fee covers:
- Surgeon’s fee for the procedure
- Follow up appointments for 12 months
There will be an out of pocket costs for the common weight loss procedures but if any additional consultations or operations are required from problems that may arise from the procedure, there will be no further charge.
These will vary according to the type of operation, the length, and any medical co-morbidities you have. We have a close working relationship with a group of anaesthetists experienced in the specific medical problems of obesity. Your anaesthetist will contact you prior to the operation and you can discuss specifics of payments then. Often the charges will be of the range $600-$1800 which are partially rebatable.
You will be required to commence a low calorie meal replacement diet (Optifast) for 2 weeks prior to the operation. You will need to pay for these meal replacements. They are generally available at a pharmacy and for a 2 week course cost about $150.
If we arrange for you to see any other specialists prior to your surgery, such as endocrinologists, cardiologists, or respiratory physicians they may charge you for these visits.
There may be additional costs such as blood tests or x-rays required before or during your stay, depending on your health fund.
Reasons for GAP payments
Unfortunately, the full costs involved in providing quality medical care are not adequately covered by medicare. Most common surgical procedures performed by experienced surgeons in the private health system involve a gap payment. Weight loss surgery has even more costs, as multiple professionals are involved in your care, and care by your surgeon needs to be lifelong.
Not Privately insured
If you do not have any private insurance, the expenses of weight loss surgery will depend on the specific procedure, equipment used, the cost of the prosthesis, theatre fees, Surgeon’s fee, Assistant fee, Anaesthetist’s fee, Intensive care fees if this is required, the number of days spent as inpatient and the choice/location of hospital. You could expect to incur expenses of roughly $10,000 for one-night stay in hospital and $1800/day afterwards. You must also be aware that if there are any surgical or other complications during the admission, these would not be covered by any insurance providers, and the expected costs could dramatically escalate. We are happy to discuss your options if you do not have private insurance.
Access to superannuation
It is possible to access your superannuation to help pay for your weight loss surgery. This requires applying to The Department of Human Services for early release of their superannuation funds. You can find details of this on the Department of Human Services website
Refunds from the Australian Taxation Office
It is possible to claim a rebate form the ATO when you submit your end of year tax return. Weight loss procedures qualify for the medical expenses safety net. If the net total of all of your medical expenses for the financial year exceed $2120, you can claim a tax offset of 20% of your net medical expenses over $2120. This is not means tested and there is no limit on the amount you can claim.
If your total out of pocket expense is $5000: You may get a tax rebate of $576
($5000-$2120) X 20% = $576 you can claim back as a rebate.
Check with your accountant if this applies to you.
I don't have private health insurance can I still have surgery?
Yes, you can still have surgery. Patients can choose to either self fund through their own means or access their superannuation through the ATO website This requires patients to apply via the ATO and MyGov websites requesting an early release of funds. Patients will need supporting letters, reports and documentation that our practice can supply to help with that process. You will also need supporting documentation from your GP.
Please speak to our Practice Manager who will advise and assist you with any queries.
What are the costs?
Weight loss surgery costs and associated fees are made up of several components:
- Professional fees charged by the surgeon, anaesthetist and surgeon assistants
- Hospital charges for bed stay
- Hospital charges for operating theatre session
- Equipment used in the operating theatre session.
Patients with an appropriate level of private health insurance cover will find most hospital and equipment charges will incur a “no gap” fee. The out of pocket expenses for insured patients relate mostly to professional and clinic fees charged by the surgeon, anaesthetist and their assistants.
Occasionally, in your operation, there may be certain equipment used which is “non-rebateable,” such as the lap band device.
Most health funds cover bariatric (weight-loss) surgery, however you will usually need to be in a high level of cover. To check, simply contact your health fund and quote the relative surgery “item numbers” listed below.
Sleeve Gastrectomy Item No. 31575
Gastric Band Item No. 31569
Gastric Bypass Item No. 31572
SIPS Surgery (Loop duodenal switch) Item No. 31581
• Band to Sleeve Item No. 31584 & 31575
• Band to Bypass Item No. 31584 & 31572
If you are NOT INSURED for weight loss surgery, you still have the option to either upgrade your level of insurance so you are covered or find a new insurer that will provide the appropriate cover. In most cases, the insurance company will apply a waiting period of 12 months to qualify you for surgery.
Self funded or non-insured patients have the option of accessing funds through super annuation or a variety of other methods. Please contact us for further help and advice.
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