Obesity and Weight Loss
Professor Lord performs weight loss (bariatric or metabolic) surgery at St Vincent’s Private Hospital and Macquarie University Hospital for individuals who meet standard eligibility criteria and are highly motivated to improve their health.
Am I eligible for weight loss surgery?
There are many factors involved in deciding who is suitable for weight loss surgery, but the main ones are:
- Previous serious efforts with diet and exercise which has not provided adequate long term weight loss
- Morbid obesity (BMI > 40 kg/m2), alone, or severe obesity (BMI > 35 kg/m2) with a weight related health problem such as:
- Type 2 diabetes mellitus
- Dyslipidaemia, for example high cholesterol
- Obstructive sleep apnoea
- Osteoarthritis affecting the weight bearing joints of hips, knees or ankles
- Gastro-oesophageal reflux disease
- Weight related low mood or depression
- Polycystic ovarian syndrome
- Weight related difficulty in achieving pregnancy
In some individuals, especially if they have Type 2 diabetes mellitus, weight loss surgery may be considered for BMI between 30 and 35.
Professor Lord's bariatric surgery experience
Professor Lord has extensive experience with weight loss surgery. Through working with the originator of the gastric sleeve operation (Dr Gary Anthone at the University of Southern California), Professor Lord was one of the first few surgeons worldwide to perform gastric sleeve, more than 15 years ago.
Professor Lord will discuss with you the advantages and disadvantages of each operation. The decision regarding the choice of operation type is best made in consultation with detailed discussion, but a brief outline of some factors to consider is provided below.
What is the cost of the procedure?
From 9 June 2018, the following fees apply for weight loss surgery:
- Removal of gastric band - "no gap" payment
- Gastric sleeve, gastric band, gastric bypass - $4,000 out-of-pocket
However, if you have had previous weight loss surgery, this fee may be increased.
Professor Lord performs weight loss surgery at St Vincent’s Private Hospital and Macquarie University Hospital. His fees are standardised across these facilities. The anaesthetic and hospital fees are separate and additional to the surgical fees. Patients with health insurance will be able to claim a partial rebate on the fees from their health fund and from Medicare.
Patients who do not have health insurance are generally encouraged to join a health fund, after which they have to wait twelve months before the health fund will cover the costs of the operation and hospitalisation.
Patients who do not wish to wait twelve months can opt to pay all surgical, anaesthetic and hospital costs themselves.
Please contact us for more information on (02) 8382 6671. Alternatively, you can email us at firstname.lastname@example.org.
More information on surgical options
Gastric sleeve (laparoscopic sleeve gastrectomy)
The gastric sleeve (laparoscopic sleeve gastrectomy) operation is a keyhole operation with typically a two or three night hospital stay. It has the advantage of reliably excellent weight loss and reliable resolution of weight related health problems, such as type 2 diabetes in most patients. It provides reduced appetite which makes weight loss easier. It has the advantage that people are generally able to eat all types of food, although only in small quantities. It has the advantage that, unlike the gastric band, there are no adjustments to be made after the operation.
The disadvantage of the sleeve is that most of the stomach is removed permanently and the operation is therefore not reversible. Individuals must accept that they will only be able to eat small meals after this operation. Eating small meals is generally tolerated better than expected because there is a feeling of satiety or fullness with small meals due to the greatly reduced stomach volume. There is also the reduced appetite noted above.
Gastric band (laparoscopic adjustable gastric band)
The advantage of the gastric band (laparoscopic adjustable gastric band operation, LAGB) is that it is a straightforward keyhole operation with on average only a one night hospital stay. A silicone ring is placed around the upper stomach and connected to a port which sits under the skin on the abdominal wall.
The operation is fully reversible and no part of the stomach is removed. The laparoscopic gastric band operation appeals to individuals who wish to lose weight and improve their health but irreversible sleeve gastrectomy operation.
In Professor Lord’s experience the amount of weight loss with the gastric band is more difficult to predict than with the laparoscopic sleeve gastrectomy. Some individuals do extremely well with the band but some others have disappointing results and fail to achieve adequate weight loss. In this circumstance the band is often removed and another operation such as laparoscopic sleeve gastrectomy or gastric bypass is performed as a second operation to achieve further weight loss and health benefits. Other disadvantages of the laparoscopic gastric band operation are the long-term complications of band slippage (the band moves lower down the stomach) and band erosion (in which the band erodes into the stomach) necessitating band removal. Overall, Professor Lord performs far fewer gastric band operations compared to sleeve gastrectomy operations and the great majority of band surgery now is laparoscopic band removal (a "no gap" surgeon fee operation).
Gastric bypass (Laparoscopic roux-en-y gastric bypass)
The gastric bypass (laparoscopic roux-en-y gastric bypass) operation and the duodenal switch operation (see publication on duodenal switch) are popular in the United States where patients tend to be on average far larger than Australian patients. These operations involve some malabsorption of food. Since some well designed studies have demonstrated very similar weight loss with laparoscopic sleeve gastrectomy compared to laparoscopic gastric bypass, Professor Lord performs more sleeve gastrectomy operations than bypass operations, but Professor Lord will advise if you should consider bypass surgery instead of sleeve surgery.