Surgical Options for Long-Term Appetite Control: Costs and Considerations

Surgical Inquiry

Hello, doctor.
I would like to ask if there are any surgeries that can help me control my appetite long-term, considering I am 157 cm tall and weigh 98 kg, and I can eat up to 4 meals a day.
What would the approximate cost be? Thank you.

Ding Dong, 20~29 year old female. Ask Date: 2016/04/20

Dr. Ke Fangxu reply Surgery

Taiwan's National Health Insurance (NHI) coverage for weight loss surgery is primarily based on the standards published by the National Institutes of Health (NIH) in 1991, which must meet the following criteria: 1.
BMI ≥ 40, or BMI ≥ 35 with obesity-related comorbidities.
2.
Age between 18 and 55 years.
3.
Failure of medical weight loss treatment for more than six months.
4.
No endocrine disorders or other diseases that may cause obesity.
5.
No substance abuse or mental health disorders.
6.
No significant organ dysfunction and able to accept surgical risks.
If the above criteria are met, patients only need to cover the costs of laparoscopic materials, room differences, and the portion not covered by NHI, which ranges from tens of thousands to over a hundred thousand New Taiwan Dollars.
Since laparoscopic surgery significantly reduces surgical risks and helps patients recover quickly, almost all weight loss surgeries are currently performed using minimally invasive laparoscopic techniques.
The variation in surgical costs is mainly due to the different policies of hospitals and the types of surgical methods and instruments used.
It is recommended that patients communicate extensively with their physicians before surgery to choose the most suitable treatment option for themselves.
If a patient's weight does not meet the NHI standards or if they choose to pay out-of-pocket for surgery due to diabetes, the current costs in Taiwan range from over a hundred thousand to over two hundred thousand New Taiwan Dollars.
The purpose of weight loss surgery is not to suppress appetite but to reduce food intake by decreasing stomach capacity.
It is advisable to consult with a specialist in weight loss surgery for more professional information.

Reply Date: 2016/04/20

More Info

When considering surgical options for long-term appetite control, it's essential to understand that these procedures are typically part of a broader approach to weight management, often referred to as bariatric surgery. Given your height of 157 cm and weight of 98 kg, you may qualify for such procedures, especially if you have a Body Mass Index (BMI) that classifies you as obese.

Surgical Options
1. Gastric Bypass (Roux-en-Y): This is one of the most common bariatric surgeries. It involves creating a small pouch from the stomach and connecting it directly to the small intestine, bypassing a significant portion of the stomach and the first part of the small intestine. This not only reduces the amount of food you can eat but also alters hormone levels that affect hunger and satiety.
2. Sleeve Gastrectomy: In this procedure, about 80% of the stomach is removed, leaving a tube-like structure. This significantly reduces the stomach's capacity and also affects hormones that regulate hunger, leading to reduced appetite.

3. Adjustable Gastric Banding: This involves placing a band around the upper part of the stomach to create a small pouch. The band can be adjusted to control the amount of food that can be consumed. However, this method is less commonly performed today due to lower long-term effectiveness compared to other procedures.

4. Biliopancreatic Diversion with Duodenal Switch (BPD/DS): This is a more complex procedure that involves both sleeve gastrectomy and a bypass of a significant portion of the small intestine. It is effective for significant weight loss but comes with a higher risk of nutritional deficiencies.

Costs
The costs of bariatric surgery can vary widely based on several factors, including the type of procedure, the surgeon's experience, the facility, and whether or not you have insurance coverage. In the United States, the average cost for bariatric surgery can range from $15,000 to $25,000.
- Gastric Bypass: Approximately $20,000 to $30,000.

- Sleeve Gastrectomy: Around $15,000 to $25,000.

- Adjustable Gastric Banding: Typically $10,000 to $15,000.

- BPD/DS: Can exceed $30,000 due to its complexity.

It's important to check with your insurance provider, as many plans cover bariatric surgery if you meet specific criteria, such as having a BMI over 40 or over 35 with obesity-related health conditions.

Considerations
1. Eligibility: You will need to undergo a thorough evaluation by a healthcare team, including a surgeon, dietitian, and possibly a psychologist, to determine your eligibility for surgery.

2. Lifestyle Changes: Surgery is not a quick fix. It requires a commitment to lifestyle changes, including diet and exercise, to achieve and maintain weight loss.

3. Potential Risks: As with any surgery, there are risks involved, including complications from the surgery itself, nutritional deficiencies, and the possibility of weight regain if lifestyle changes are not adhered to.

4. Follow-Up Care: Post-operative care is crucial for monitoring your health, managing any complications, and ensuring you are meeting nutritional needs.

5. Support Systems: Engaging in support groups or counseling can be beneficial for emotional and psychological support during your weight loss journey.

In conclusion, bariatric surgery can be an effective option for long-term appetite control and weight management. However, it is essential to have a comprehensive discussion with your healthcare provider to explore the best options for your specific situation, including the potential benefits, risks, and costs associated with each procedure.

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