Gastric bypass for the not-so-obese?

June 29, 2016 3:55 PM

I'm slightly overweight (5'3", 150 lbs.) so I don't qualify for gastric bypass in the U.S. However, I have heard of people going abroad to get the operation when they aren't fat enough, or haven't been fat enough for long enough, to qualify for it in the States. How does one do that? If you've had experience with that, how did it go? How much does it typically cost? Thank you in advance.
posted by visenya to Health & Fitness (19 answers total)

You might want to look into gastric sleeve rather than bypass. However, I weighed about 185 at 5'3" and had gastric sleeve surgery. Not even close to insurance paying for it. I self-payed about $8500 total. Glad I had it done but I think I was as borderline as it gets. You may have a hard time finding a US doctor willing to do it at that weight. As far as going out of the US, frequent checkups are essential so that could be a difficulty. I know someone else who self payed at 225 and 5'4".
posted by tamitang at 4:26 PM on June 29, 2016

I'm sorry, but I think you'll be better off in the long run doing it the hard way: changing your diet and exercising. In your case, this is unnecessary surgery that would have life-long effects. It'd limit your intake per meal, probably requiring you to permanently change your habits (multiple small meals rather than two or three larger meals daily), and that's assuming all goes well, there's no infection and/or failure of the device necessitating more surgery to replace or remove it.
posted by easily confused at 4:29 PM on June 29, 2016 [24 favorites]

The reason doctors won't do it is because the risks outweigh the benefits. Knowing that, why do you want it done?
posted by i_am_a_fiesta at 5:25 PM on June 29, 2016 [6 favorites]

I've had a lap band for over seven years. I love my band, and have lost a hundred pounds with it (and still going), but it's not a magic bullet. There's a lot of work to having a lap band, and it takes a lot of effort (and a lot of doctor's visits) to manage the band. My insurance paid for the band, and pays for the follow up visits, so I can't speak to the actual dollar cost, but in addition to the cost of the actual surgery, you should count on paying for monthly doctor's visits for adjustments while you're trying to lose weight. (Less often if you stabilize, or need to stop losing for a while for whatever reason.) Every six months I do an upper GI (barium swallow), so there's that cost too. There's also annual or semi-annual (again, depending on how you're doing) bloodwork to make sure your nutrition is good.

I can't emphasize enough how much personal effort is involved in getting a band. You have to change your entire relationship with food, and the band has to be managed actively. Even after seven years, I have to think about everything that I eat, and whether it will be good or bad for my band. There are certain foods I don't even try to eat anymore. (Everybody will tell you that, but the "no go" foods are different for everybody - some people can't eat pasta, while I have no problem with it.)

It's getting harder and harder to find surgeons who will do lap bands because, supposedly, the post-surgery complication rate is high. I haven't had a single issue with my band, but I suspect that I just got lucky with a very good and very experienced doctor. Also, I'm very compliant, and compliance is critical to managing life with the band, especially in the first year.

Honestly, if I was 5'3" and 150 pounds, I would just be rocking the right wardrobe and not worrying about losing weight at all. In fact, I'm 5'1", and 150 is my goal weight. I have about 30 pounds to go, so maybe another two or three years. It's slow but steady. YMMV, of course. I'm just saying that having a lap band is lot of work, and I wouldn't do it to lose 25 or 30 pounds.
posted by ereshkigal45 at 5:41 PM on June 29, 2016 [21 favorites]

That kind of surgery is major, very risky and invasive, and you're....not really overweight. Surgery is not the answer to your problem.
posted by a strong female character at 8:43 PM on June 29, 2016 [8 favorites]

An acquaintance had a family member who went to Mexico for just this. When the band slipped, cutting off blood supply to a part of her stomach, landing her promptly in the hospital. She went to the hospital in the US and any savings she saw by having the surgery done in Mexico went right out the window and then some.

Before the disaster I heard about the whole routine involved with having the 'band (very small portions, lots of fluids, etc.) and I am not convinced it wouldn't have been easier to lost the weight with some other program.
posted by From Bklyn at 11:59 PM on June 29, 2016 [4 favorites]

Any doctor you find who will do that at your measurements would not be the most . . . scrupulous.There are just too many side effects and too much risk. If you're going to go overseas to seek out sketchy doctors for weight loss treatments of questionable wisdom, then at least mediate the overall risk and skip the major abdominal surgery overseas and find someone to prescribe you phentermine.
posted by Anonymous at 12:00 AM on June 30, 2016

You don't want to go there. Not in the US, not abroad. I'm in the 'morbidly obese' range of BMI and so more than qualify for bypass or lap band. I went to an initial consult with my hospital's surgical weight loss group and noped right out of there.

1. You will no longer be able to enjoy a drink at the same time you are eating. If you want a beverage, you have it, then wait at least 1/2 hour before eating solid food. Another 1/2 hour after that you can have some more liquids. Carbonated beverages are verboten, forever.

2. Your food intake will be reduced to a few ounces of protein. You will have to chew each bite 20+ times. You may experience dumping which is your body not absorbing any of the food and it rapidly being expelled from your colon.

3. You can develop serious reflux issues, more with the lap band. You can also suffer lack of nutrient absorption.

4. I was told that after the surgery I would not be able to take any pain relief medication other than Tylenol. Not ibuprofen, not aspirin, nothing.

My insurance requires that I diet for 6 months pre-surgery (and also test non-prescription drug free for 6 months in a row). I decided that if I could change my eating habits for a surgical procedure (which I wasn't 100% certain I really, truly wanted. It's still surgery. You can still suffer very serious side effects) then I could change them for good. I've got ~150lbs to lose.
posted by noxetlux at 12:19 AM on June 30, 2016 [9 favorites]

I note that this question is your first post, visenya - and that you choose not to give any further information about your life. That is absolutely fair - but it does strike - given that detail, and your question, that maybe your weight is something you are ashamed of. You have tried a number of diet's unsuccessfully and you would like a solution that would be unobtrusive and yet effective at making you lose weight.

If this is the case, then be aware that successful management of a lap band, requires everybody who eats with you or who cooks for you regularly to be aware of your situation - you simply can't eat or drink in the same way that you did before or on the same schedule as people around you. To successfully manage life with a lap-band you need to be pretty up front with people in the same way as if you had, say, a severe nut allergy. This is pretty fundamental stuff because, if you get it wrong, it can severely damage not only your health but also the relationship of those who are closest to you (and who are likely to be those who you eat with).

If you do choose to go abroad then you would need to travel there for an initial assessment. You would then need a follow up visit for the surgery itself: not quite so serious for a lap band but more so for a bypass. After that you would need a few days (minimum) in a local hospital and a few months to completely recover. Then you would need somewhere local to get any adjustments done. Finally, if anything were to go wrong - or if you were to decide that you wanted a lap-band removed. Then you would need to be prepared for that.
posted by rongorongo at 2:07 AM on June 30, 2016 [2 favorites]

5'3", 150 lbs isn't very overweight. You're only about 10 pounds off a normal BMI (criticism of BMI as a measure aside.) Gastric bypass for 10 pounds seems a little extreme.
posted by Borborygmus at 4:16 AM on June 30, 2016 [4 favorites]

Yeah, no qualified doctor is going to do this procedure on you. If they're willing to, run! Also of note, follow ups have shown that weight loss surgery is not as effective in the long run. I highly recommend trying to cultivate a positive relation with your body. Also food and excersise, but you are bearly overweight (if you're fit, this BMI can be fine). Now is not the time for drastic measures.
posted by Kalmya at 4:20 AM on June 30, 2016 [4 favorites]

Another thing to consider, and I don't know your age or sex, but after gastric bypass surgery you are no longer a good candidate for oral contraception.

Any pregnancy you have becomes higher risk and you often have to take vitamin/mineral supplements (in addition to the supplements which most people have to take routinely after this type of surgery because your gut no longer effectively absorbs them) so that your fetus will get sufficient stores.
posted by eglenner at 4:22 AM on June 30, 2016

Any doctor that would give a gastric bypass to a person who is only 10lbs overweight is not a doctor I would want going anywhere near me.

I think you should seek therapy to discuss why you think you need a gastric bypass
posted by missmagenta at 5:02 AM on June 30, 2016 [1 favorite]

(also, if you've so little to lose, its probably cheaper and safer to get lipo)
posted by missmagenta at 5:03 AM on June 30, 2016 [2 favorites]

Your BMI is so low it's at a level that bariatric surgeons consider it success if their patients achieve it. It's waaaaaay too low for this surgery.

And I'm not anti weight loss surgery. Best thing I did for my health. But I have over 100 pounds to lose and ever increasing complications associated with morbid obesity. At your weight and height therapy would be a much better use of money.
posted by kitten magic at 5:36 AM on June 30, 2016 [2 favorites]

$15,000 to $35,000 is the pricing range across the country.
$23,000 is the most often quoted average surgery price.
$25,571 is the average cost of gastric bypass.


If a doctor is willing to forgo what amounts to an average yearly salary for 1 surgery you may want to consider that there is a reason you can't get the surgery in America.

As others have said, there are other ways to cut down your weight. They may not be quick but they'll be far fewer risks and less costly than surgery.
posted by 2manyusernames at 7:44 AM on June 30, 2016

I just saw a piece on a new device for "non-surgical" weight loss that is essentially a balloon filled with saline inserted into the stomach to displace stomach volume -they said the target user would be looking to lose 25-35 lbs, the device stays inside your stomach for about 6 months and costs around $10k (and no insurance covers it).

No idea if you would qualify or could get a Dr to insert one, but there are option out there at the sub-surgical level.
posted by Exceptional_Hubris at 8:41 AM on June 30, 2016 [1 favorite]

Another thing to consider, and I don't know your age or sex, but after gastric bypass surgery you are no longer a good candidate for oral contraception.

Damn. I wasn't warned of that. Glad I decided against surgery!
posted by noxetlux at 1:22 PM on June 30, 2016 [1 favorite]

When I had my sleeve gastrectomy I had to sign a waiver stating that I knew that I would be much more susceptible to getting drunk off small amounts of alcohol and that it would be much easier for me to get pregnant, and that the pill would not be a trustworthy sole source of BC for me.

Bariatric surgery can be lifechangingly great in the right circumstances.

Your circumstances are NOT the right circumstances. The risks and drawbacks far, far outweigh any benefits. Any doctor who would perform bariatric surgery on you at your size is at best dangerously unethical and more likely downright criminally negligent.
posted by oblique red at 1:54 PM on June 30, 2016