What You Should Know Before Getting Weight Loss Surgery In Another Country


Table of Contents


Introduction 3


Is Weight Loss Surgery Abroad Right For You? 4


Why Travel Out Of Country For Weight Loss Surgery? 7


Going abroad for surgical obesity treatment 9


Comparing the costs of obesity treatment abroad 12


How is obesity surgery abroad regulated? 15


Obesity treatment abroad - how to compare clinics and countries 18


Aftercare and obesity treatment abroad 21


Insurance for obesity treatment abroad 23


What if something goes wrong after obesity treatment abroad? 25


The authors 28




About this guide


More and more people are considering obesity treatment abroad. With increasing numbers of people in Western countries carrying excess weight, obesity has become a major health problem. According to the UK NHS, around 23% of adults are classified as obese in the UK, while the Centre for Disease Control has the figure for US citizens at 36%. (Obesity is defined as having a body mass index or BMI of 30 or more.)

But for the patient considering obesity treatment abroad, there may be some concerns. What are the conditions like in hospitals and clinics overseas? Is the surgeon suitably qualified? Where can I get the best deal? What questions should I ask about the treatment? What happens if I am unhappy with the outcome of the treatment?

This guide attempts to answer these questions and guides the patient through the process of exploring the options for obesity treatment abroad. It has been developed through the experience that we have gained through operating the Treatment Abroad web site and our knowledge of the medical tourism industry in general.


About Treatment Abroad

Treatment Abroad (www.treatmentabroad.com) is a leading web site on medical tourism. The site provides access to information about clinics, hospitals, and specialists globally that are attracting patients from overseas. For many destinations, we provide information covering the healthcare services available, doctor accreditation, treatment costs and travel and accommodation. Get a quote for obesity treatment abroad Treatment Abroad offers a service whereby you can obtain a quotation for obesity treatment abroad from its network of obesity clinics across the world. Visit www.treatmentabroad.com/quote



Obesity treatment abroad - is it right for you?


With increasing numbers of people in Western countries who are overweight, obesity has become a major health problem. According to the NHS, around 23% of adults are classified as obese in the UK, while the Centre for Disease Control has the figure for US citizens at 36%. (Obesity is defined as having a body mass index or BMI of 30 or more.)


What is obesity treatment?

Obesity treatment is any program of treatment aimed at reducing BMI and therefore eliminating or reducing obesity. Obesity treatment can be either non-surgical, such as diets and nutritional programs, exercise plans and behavioural therapy and counselling, or it can involve solutions such as a gastric band or surgery such as a gastric bypass or duodenal switch.

The right kind of obesity treatment for you will depend on your weight and health, as well as your personality type. You should not consider obesity surgery, either at home or abroad, until you have fully explored the non-surgical alternatives.


Is obesity treatment right for you?

Non-surgical obesity treatment carries few risks, and so is usually the first call for anyone who is concerned about weight. Many people find that diet and exercise plans are all they need to tackle their weight problem. Kick starting such a new regime with an obesity boot camp, or a health spa retreat abroad can often be very effective.

Obesity surgery should not be considered unless you have exhausted the other alternatives, or unless your obesity is immediately life threatening and urgent action is required. If that is the case, then the chances are you will qualify for surgery in your own country as part of your medical insurance or within the national healthcare system.

In most cases, obesity surgery will not be considered unless you have a BMI of 40 or above or 35 or above if you have other related medical issues. You will also need to demonstrate that you are psychologically stable. Many clinics require a referral from your regular doctor in your home country before they will perform obesity surgery.


Why go abroad for obesity treatment?

With the rise in obesity in Western countries, there are often waiting lists for obesity surgery, even in private hospitals. Travelling abroad for obesity treatment means you can choose when you have your treatment to suit your schedule and avoid lengthy delays.

For some borderline cases, obesity surgery may not be available in their home country at their BMI level. Some clinics abroad will provide obesity surgery at a lower BMI than the national guidelines in countries like the US and UK. However, while these guidelines are not legally binding, they are well researched and are there for a reason, so you should think carefully before you try to get around them. Obesity treatment is serious surgery and should not be treated as a fix-all solution. The more extensive procedures still require you to completely change your eating habits and lifestyle.

For most people who have decided surgical intervention is for them, the biggest attraction of obesity surgery abroad is the cost saving. Treatments in Mexico and Costa Rica are up to 70% less than they are in the US, and there are huge differences in the price of obesity treatment across Europe, with Turkey and the Czech Republic significantly cheaper than the UK or Western Europe.


The disadvantages of obesity treatment abroad

Obesity surgery involves major surgery and you should consider the procedure carefully before agreeing to have such surgery abroad. This is especially true the larger you are. The most obese patients may be unsuitable for keyhole surgery, and may requires a longer period of recovery.

Even after keyhole surgery, you will still need time to recover, and will probably need someone to help you travel home afterwards. This will inevitably increase the overall cost of the treatment.

By far the biggest issue with obesity treatment abroad is the need for planned aftercare for weeks, or even months, following your surgery. For example, gastric bands, one of the most popular obesity surgeries, often need adjusting after a few weeks, and can develop complications months after they have been inserted. If you have this surgery abroad, then it may be difficult to obtain aftercare from the foreign clinic unless this is pre-arranged. Local hospitals may also lack the detailed medical records required to treat you in an emergency situation if you have had surgery abroad.


Think it through... consider the travel options

By its very nature, travelling abroad for obesity surgery requires more consideration than travelling for other surgeries, such as dental or cosmetic work. For example, flying abroad is not always easy, or comfortable if you are particularly overweight. Add to this the pain and irritation of fresh surgical scars, and you could be in for a very uncomfortable return journey. Thus, some UK patients opt for obesity treatment in European countries such as Belgium which can be accessed by high speed rail services.

Budget hotels may not be the most comfortable for larger travellers, and again this will be magnified by post operative issues. You need to think through every aspect of your trip and your treatment before deciding if obesity treatment abroad is right for you.


Get a quote for obesity treatment abroad

Treatment Abroad offers a service whereby you can obtain a quotation for obesity treatment abroad from its network of obesity clinics across the world. Visit www.treatmentabroad.com/quote to “get a quote”.



Weight loss programmes abroad - what do they offer?

Before considering a gastric band or more drastic weight loss surgery such as a gastric bypass, you should make sure that you have tried every other possible route to bring about weight loss. These routes include diet, exercise, psychological and motivational methods. There are both advantages and disadvantages in seeking such treatment abroad.


Diet and nutrition programmes abroad

Diet and nutritional programmes are a long term solution to obesity problems and as such are best undertaken in your home country. Groups such as Weight Watchers in the UK or Slimming World in the US are ideal for providing motivation and support on a weekly basis.

However, for many people, the problem is one of getting started, and here is where weight loss programmes abroad can help. Isolating yourself from all the temptations of home by attending a retreat or health spa in a foreign country can be climates that boost your morale just when you need it. Such retreats can include expert advice on diet and nutrition, as well as a kick start diet such as juices or vegetarian food for the week.

You should research the methods used by these clinics and retreats before signing up, to ensure that they are created or run by doctors and specialists with the correct training and medical or scientific background. Retreats offering the latest medically and scientifically based nutritional advice.


Exercise programmes as part of weight loss

Exercise is most effective as part of a weight loss programme if it is introduced as a long term lifestyle change, rather than as a quick fix solution. That said, just as a health and wellness spa can kick start diet changes, a boot camp or similar exercise retreat abroad can be an ideal starting point for your new, more active way of life.

Often, exercise programmes abroad bring together a wide range of experts, in subjects such as exercise, yoga and physiotherapy, giving you a broad overview of the changes you could make to your physical routine and how best to make those changes. It can allow you to try out different ways of exercising and strengthening your body and your willpower so that you can approach weight loss more confidently when you get home.


Lifestyle coaching abroad

Many retreats abroad offer lifestyle coaching to improve your confidence and self-esteem. Again, this is often best done away from home, in a totally new environment that is dedicated to your wellbeing. Such retreats will often combine lifestyle coaching with diet and exercise techniques as part of a complete package.

Retreats may also offer psychological techniques, such as neurolinguistic programming (NLP), cognitive behavioural therapy (CBT) or hypnosis, to try and establish if there are any emotional or psychological triggers to your poor eating and addressing the underlying issues that cause this can often provide a lasting solution to weight issues.


Advantages of a kick-start weight loss programme abroad

Weight loss programmes abroad bring together a number of people with similar obesity issues in a largely anonymous setting. Unlike a weight loss club in your home town, you will never have to see these people again if you fail, so you have nothing to lose. This can reduce the embarrassment factor that stops many people from joining such programmes.

Weight loss programmes abroad also help to focus the mind on the changes you want to make. Instead of just being a small part of your weekly routine, as a club at home would be, your programme takes over a full week or more of your life, bringing your weight loss issues into the kind of sharp and honest focus they my never achieve at home.

Often, with weight loss programmes abroad, simply having paid for your week, and made the effort to travel, will give you the motivation to try harder to succeed. It is so much harder to say no when you are part of these programmes, than it is when you are sat on your own couch at home.


Keeping up your weight loss at home

Ironically, for some people, the fact that you will never see your fellow course members again can also be a disadvantage of weight loss programmes abroad. If you are someone who knows you make friends easily and will miss out on the ongoing support when you get home, think seriously about attending a local club.

This may overcome the temptation to slip into bad habits and will encourage you to maintain the programme once you return home. focus your mind for a short period of time while you are following a short weight loss kickstart programme abroad but that focus can quickly be lost again once you return to the pressures and temptations of home.

The fact that you will need to put aside a reasonable budget to travel abroad for your intense start should be an incentive to carry on and many people plan another trip within a few months, perhaps a more luxurious spa break to give them a timescale for their weight loss.



Going abroad for surgical obesity treatment

If you have exhausted all the non-surgical techniques for weight loss and you need to lose a significant amount of weight, you may consider surgical obesity treatment abroad.

A range of treatments are available; some are less invasive, requiring an laparoscope. Most treatments need some degree of follow up, as well as support and ongoing monitoring and treatment once you return home.


Having a gastric balloon fitted

If all goes smoothly, this procedure is quite well suited to treatment abroad as it is fitted in a short procedure involving only endoscopy. It is important to realise that a gastric balloon is always a temporary weight loss solution. Wherever you have it fitted, it will need to be removed after six months. This will mean a return visit to the clinic of your choice, which may be offered as part of your clinic package, so you will need to factor in additional travel costs if you travel abroad.

A gastric balloon is fitted endoscopically. That means that you are sedated, but not put under anaesthetic, while the uninflated balloon is placed into the stomach via the throat and oesophagus. The gastric balloon is then inflated using a saline solution. The presen uncomfortably bloated as the available volume of the stomach is reduced.

Most people experience sickness in the first few days after a gastric balloon is fitted, but this is usually temporary. In some cases, however, the stomach cannot tolerate the balloon and nausea and vomiting may not subside for several days, extending the length of time you need to spend at the clinic. If it persists beyond that, the balloon will need to be removed as it is clearly not going to suit you.


Having a gastric band fitted abroad

A gastric band, or lap band, is an inflatable cuff that is placed around the stomach around three quarters of the way up. This creates a small pouch at the top of the stomach, which then fills quickly making you feel very full after only a few mouthfuls. Food slowly passes into the rest of the stomach over the next few hours.

The band is filled with saline and can be loosened or tightened by adjusting the saline pressure through a small port in the skin of your abdomen. If you are losing weight slowly in the weeks and months after the procedure, you may need more saline to be injected into the band to tighten it.

You will need to follow a strict diet of liquid foods during the first few days, followed by about 5 weeks on pureed food and it may be 3 months before you can eat tiny portions of food that you actually chew.

Fitting a gastric band is a common procedure done using a laparoscopic “keyhole” technique under general anesthetic.  It is normally done as a day case with more surgeons abroad offering a service every year. A well fitted band can last fifteen years or more. However, even under ideal circumstances, around one in ten patients will require a second surgery to correct or replace their band, and around one in four bands will slip from their original position, causing complications.


Gastric sleeve surgery

Gastric sleeve surgery, or sleeve gastrectomy, involves cutting away up to 75% of the stomach using a vertical division but leaving the overall structure of the digestive system intact. Food will pass into the much smaller stomach, which becomes more like a thin tube, making you feel full quickly. Food will then leave the stomach and enter the small intestine for digestion as normal.

Gastric sleeve surgery can usually be performed using laparoscopic or keyhole surgery and is usually done with a 2-3 day stay in hospital. It takes longer than a gastric band fitting and requires longer under anaesthetic. It is still suitable for medical tourists but you will need to plan a stay in the country of your choice so that you can recover sufficiently to travel home. Two weeks is probably the minimum.


Gastric bypass surgery

A gastric bypass is major abdominal surgery that changes the structure of the digestive system permanently. Most of the stomach is removed and then an opening in the remaining smaller stomach is made and joined directly to the small intestine further along from the point where food normally exits. This means that you feel fuller much more quickly but also that you absorb food less efficiently because a stretch of the small intestine is bypassed.

Gastric bypass surgery is a more complex operation but is still usually done by laparoscopic surgery. It is not safe to attempt in people with a BMI of over 50 so be wary of any obesity clinic abroad that offers this as an option. if you are morbidly obese.

Having a gastric bypass abroad is possible and surgeons all over the world offer the procedure and perform it safely and well. The main problem is follow up; you need constant checks on your nutrition and you will need to follow a special diet and take nutritional supplements. It can, however, have a dramatic effect on type 2 diabetes, which tends to disappear within days of surgery.


Duodenal switch surgery

While the duodenal switch is believed to be the most effective of all obesity surgeries in the very obese, it is also the most complex and risky. It involves two stages; in the first, a modified sleeve gastrectomy removes most of the stomach. In the second stage, the remaining stomach is reconnected with the small intestine, but at a position much further along than in a gastric bypass. In very obese patients, the first stage will precede the second by several months. Only after significant weight loss is achieved does it become safe to do the second stage.


Aftercare should not be an afterthought

Once both stages are complete, virtually no food absorption takes place in the small intestine, making weight loss rapid and sustained. It also means you need life-long nutritional monitoring and support.

It is usually possible to perform a sleeve gastrectomy and duodenal switch using a laparoscopic technique, but the larger you are, the greater the risk of complications. Going abroad is an option, but somewhere not too far from home will be safer, and you must have your aftercare in place for the weeks, months and years to follow.


Get a quote for obesity treatment abroad

Treatment Abroad offers a service whereby you can obtain a quotation for obesity treatment abroad from its network of obesity clinics across the world. Visit www.treatmentabroad.com/quote



Comparing the costs of obesity treatment abroad

One of the biggest attractions of obesity treatment abroad is the price, but how do you know if you are getting a good deal? How should you go about comparing the cost of obesity treatment in different countries, and what factors should you consider when making those comparisons? Perhaps most importantly of all, how can you be sure that the savings you make by travelling abroad for obesity treatment are worth the risk of having such treatment away from home?

Obesity treatment abroad can be less costly

There is no doubt that significant savings can be made by travelling abroad for obesity surgery. For example, a gastric bypass procedure would cost around $25,000 in the USA or £15,000 done privately in the UK. The same surgery would cost just $10,000 (£6,400) for medical tourists heading to Mexico or Costa Rica, around £6,350 ($9,950) for Europeans travelling to Belgium, and as little as $6,000 (£3,850) for patients opting to go as far afield as India.

Clearly the further you travel, the higher the cost of flights and transfers, but often this increase is offset by low priced local accommodation and living costs. You should always remember to fully price up the total cost of your trip, rather than simply comparing clinic costs at home with obesity surgery costs abroad.


What is included in the price?

Obesity surgery is much more complex than the dental work or cosmetic procedures that many people travel abroad for, and so you should pay close attention to exactly what is included in your package price. For example, you will need a thorough consultation, the services of an anaesthesiologist, drugs and theatre time. You will also need one or more nights in hospital following your surgery, regular reviews by your surgeon and pain medication and nutritional supplements afterwards. For gastric band surgery, you will also need the gastric band itself. It is worth reading up on this technology to ensure that your surgical team are using the best product available and not compromising on quality to save money.


What extras do you need to consider?

Given the serious nature of obesity surgery, you will need to be accompanied by a responsible adult and you need to add the cost of their transport and accommodation to your calculations. You will both need a hotel for the duration as your companion will need to remain at the hotel while you are in hospital.

You also need to consider a contingency fund to cover any extra costs if there are complications that involve a longer stay. Even something as simple as a gastric balloon can have complications that involve extra nights in hospital and therefore extra hotel nights for your companion.

Many clinics will offer all-inclusive packages for obesity surgery abroad. This will include flights, airport pick up, and accommodation for two people, as well as all your medical costs. These packages are often worth considering as the clinics can access special rates with local hotels that may not be available to you directly.


Follow up treatment after obesity surgery abroad

Aftercare is a very important factor in obesity surgery and you should always ask what arrangements are included in the price you have been quoted. Ideally, you should have direct access to your surgeon, or a similarly qualified expert, for around two years following your operation, as well as comprehensive nutritional and lifestyle advice that you can access online or by telephoning the clinic.

Aftercare is an expensive part of the procedure, and it is not uncommon for clinics abroad to cut back on this aspect to reduce their costs. The press has highlighted stories of patients who have received little or no aftercare following their surgery, and suffered unnecessarily as a result. If you are not satisfied with the aftercare plans, choose another clinic.


Will you need plastic surgery?

A significant cost that is often overlooked by patients undergoing obesity surgery abroad is the cost of plastic surgery to remove excess skin following weight loss.

If your treatment is as successful as you hope, you will inevitably need some cosmetic work done as a result, and you should make sure you take these costs into account. If you use your entire budget on your weight loss surgery abroad, and do not leave enough for this essential follow up, then you could be left feeling as bad about your body as you did before the operation.


Are the savings worth the risk?

Safety is by far the most important factor of all when it comes to obesity surgery abroad, and it is simply not worth compromising this just to save money. It is no exaggeration to say that your life is at risk if you are in the hands of a poor quality or inexperienced surgeon, or if the clinic does not meet the strictest hygiene standards. You need to consider these risks carefully when choosing obesity surgery abroad.

If you do your research carefully, choosing a reputable surgeon and clinic that is not too far from home, it is possible to have a very good experience. Having a successful procedure if you are very overweight can literally save your life and then give you your life back. By taking the opportunity to have private obesity surgery abroad before your weight becomes completely out of control can be an empowering step forward.


Get a quote for obesity treatment abroad Treatment Abroad offers a service whereby you can obtain a quotation for obesity treatment abroad from its network of obesity clinics across the world. Visit www.treatmentabroad.com/quote



How is obesity surgery abroad regulated?

In some countries, obesity surgery, often referred to as bariatric surgery, is regulated in the same way as other surgical specialties. Surgeons may be required to undergo training in obesity surgery at an approved institution before being granted a licence to practice. Hospitals and clinics carrying out surgical procedures are registered and monitored by their government health department.


Surgical training in bariatric surgery

To become a bariatric surgeon requires many years of study, including basic medical training lasting between four and six years to become a doctor, further training as a surgeon and additional specialist training in bariatric surgery techniques. The overall training package and number of years of study will vary between countries. If your surgeon cannot demonstrate this level of training, move on and find one who can.

Many surgeons in Central American countries have trained and qualified in the USA and are members of the American Medical Association (AMA) or American College of Surgeons, while similarly, many Eastern European surgeons have trained in the West and are members of bodies such as the General Medical Council (GMC) or Royal College of Surgeons in the UK.

Government regulation of bariatric surgeons

Hospitals, clinics and specialist surgery centres should all be registered, licensed and regulated by the national health body in their country. The clinic should be able to prove such registration; if you have any doubt, contact the relevant health authority for confirmation.

Unlicensed clinics are rare, even in less developed countries. However, the terms of such licences will vary widely between the strict regulation of the West and the more lax legislation in places like Latin America, so government registration is no guarantee of anything beyond the most basic of standards.

National associations of bariatric surgeons

Many countries have their own bariatric surgery societies that strive to share best practice and raise standards among their members. Again, the qualification for membership will vary from country to country with some applying strict membership criteria and others simply requiring membership fees. Nonetheless, membership does imply that the clinic is keen to offer transparency to patients coming from abroad.

Most of the national bariatric surgery societies are on the register maintained by the International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO). The societies for some of the more popular obesity destinations are:

·         Belgium - BeNeLux Association of Bariatric Surgeons (BABS)

·         Czech Republic - Czech Society for the Study of Obesity (CSSO) www.obesitas.cz

·         Hungary - Hungarian Bariatric Surgery Foundation

·         India - Obesity Surgery Society of India (OSSI)

·         Mexico - Mexican College for the Surgery of Obesity and Metabolic Diseases www.cmcoem.org

·         Turkey - Turkish Obesity Surgery Society (TOSS)

To attract US visitors, many Central American clinics are also registered with the American Society for Metabolic and Bariatric Surgery (ASMBS) www.asmbs.org.


What does IFSO do?

The International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) represents and coordinates the activities of over fifty national federations and associations, and welcomes members from countries that do not yet have a national body.

Their website lists all the member associations, and gives contact names and email addresses for each country, so you can check the qualifications and credentials of each clinic on yoru shortlist.   The IFSOP website also provides a “find a surgeon” service.


IFSO centres of excellence for bariatric surgery

For added peace of mind, patients in Europe can select the very best surgeons and obesity surgery clinics based on the IFSO-EC Centres of Excellence Program. To become a centre of excellence, both the surgeon and the clinic must meet very strict criteria. For surgeons these include:

·         Full training, including gastrointestinal surgery and bariatric surgery

·         Testimonials by mentors on their competence in bariatric surgery

·         Demonstrable experience of at least 25 bariatric surgery procedures per year

·         A commitment to life-long post op follow up for all patients

For clinics, the criteria include:

·         The provision of specialised nurses, dieticians and counsellors

·         Trained anaesthesiologists who have experience with obese patients

·         Facilities and equipment that can cope with morbidly obese patients

·         Access to intensive care facilities that can deal with morbidly obese patients

IFSO European Centres of Excellence are accredited by the European Accreditation Council for Bariatric Surgery (EAC-BS), which provides a full list of its accreditation criteria.

More recently, Mexico has introduced its own IFSO Centres of Excellence program, administered by the independent Surgical Review Corporation. This has similar aims and qualifying criteria to the European version, and so offers similar peace of mind.


Legal issues and bariatric surgery abroad

However well regulated the industry, mistakes are always possible with complex surgery, and infection risks are a fact of life in even the cleanest of clinics, so you need to check your rights carefully in the event that anything does go wrong. You should always ask for a legally binding agreement and be very careful what you sign in the way of consent forms or waivers.

Most medical treatment abroad will be legally regulated under the local laws of that country, and you may find that compensation for negligence does not match up to what you might expect at home. You should always check that the surgeon and the clinic have malpractice insurance in place.


Get a quote for obesity treatment abroad

Treatment Abroad offers a service whereby you can obtain a quotation for obesity treatment abroad from its network of obesity clinics across the world. Visit www.treatmentabroad.com/quote



Obesity treatment abroad - how to compare clinics and countries

Having made the decision to have weight loss surgery abroad, how do you choose between the many hundreds of clinics that have sprung up to attract international patients? How can you maximize your safety while at the same time minimizing your costs? How do you compare surgeons and standards? And what else should you consider when comparing clinics?


Talk to the clinics offering weight loss surgery

Most obesity clinics abroad will have a website that will contain detailed information about their facilities and the treatments and procedures that they offer. However, there is no substitute for talking to them in person. If nothing else, you will get a feel for how well they speak your language and how much they understand about your requests and requirements.

Talking to the clinics may cost a little more in international phone calls, but the peace of mind this personal contact can give you is priceless. If possible, you should arrange to speak to your surgeon in person to discuss your treatment.


Comparing experience and expertise for obesity treatment abroad

Perhaps the most important element you should consider in your choice of clinic will be the calibre of surgeons available to perform your operation. You should ask for proof of their training and qualifications, including specialist training in the field of bariatric surgery. You should also ask for details of their experience in performing the particular operation that you require. The more experienced they are, the safer you will be and the lower the risk of mistakes or complications. Ideally, your bariatric surgeon should be doing multiple procedures each week for most weeks of the year.

Always make sure that the surgeon that the clinic tells you about is actually the surgeon who will perform your operation. Some clinics have a well qualified lead surgeon, but still some operations are carried out by junior staff.

Don’t just take the clinic’s word for their expertise, ask for personal recommendations and testimonials wherever possible, and follow these up if you can to check their authenticity. This may sound like a lot of work, but it is well worth it when you consider you are placing your life in their hands.


Comparing facilities for obesity treatment abroad

If you are seeking treatment at a specialist obesity centre, then you can safely assume that they have the necessary equipment and facilities to cater for morbidly obese patients. However, if you are considering a non-specialist centre, then you need to check that they have appropriate facilities. For example:

·         Do they have wheelchairs for obese patients?

·         Are their hospital beds suitable?

·         Do they have recovery beds for obese patients?

·         Do they have, or have access to, intensive care facilities that can take morbidly obese patients?

·         Do they have CT scanners, X-ray machines and other essential equipment that will fit morbidly obese patients?

It may feel embarrassing to ask, but it is better than getting there and finding the intensive care unit cannot cope with a patient your size when you need it.


Comparing standards for obesity treatment abroad

Clinics should also be prepared to show you independently verified records of their success rates and their infection rates. No clinic will be completely free of infections, and these are a risk you have to take. However they should strive to keep infection rates low and should be proud to show you their record. If in any doubt, contact the local health authority, or the national association in their country.

Don’t assume that less developed countries, such as India and Central American countries, will automatically have lower standards. Often these clinics will have state of the art equipment and the highest standards in order to attract foreign customers. On the other hand, some smaller clinics in developing countries may not measure up to the standards expected in the west.


Comparing travel for obesity treatment abroad

Accessibility is a major consideration when comparing obesity treatment clinics abroad. For patients in the US, clinics in Mexico and Costa Rica are a relatively short trip away, and Mexico can even be reached without flying from southern states. For European patients, countries such as Belgium are easy to reach, with budget airlines offering cheap and regular flights, and direct Channel Tunnel trains from London for UK patients.

The further away your clinic, the more arduous your journey is going to be, especially on the return flight when you are nursing wounds from your operation. Long haul travel in economy seats is never comfortable for the larger traveller, and will be even less so after surgery when you may also have special dietary requirements.

Clearly there will be a trade off between the cost of staying at home for your treatment and the savings to be made by travelling abroad. It is up to you to decide where that line is for you and how much discomfort you are prepared to put up with to save money.


Comparing prices for obesity treatment abroad

Obviously, price will be a major consideration when comparing clinics for obesity treatment abroad, however this involves much more than simply comparing the headline price. See the detailed article in this guide on comparing prices for full details.


Go with your instincts

Weight loss surgery is a major operation, and you need to have complete faith in the team that are performing your procedure. The risks from complications and mistakes can be genuinely life threatening and so you will naturally be worried enough without adding to that with concerns about the clinic or the staff. This is why it is important to speak to each clinic personally and to feel comfortable with the responses you get. If anything rings an alarm bell, even if this is for no rational reason, you should walk away. There are plenty of other clinics to choose from.


Get a quote for obesity treatment abroad

Treatment Abroad offers a service whereby you can obtain a quotation for obesity treatment abroad from its network of obesity clinics across the world. Visit www.treatmentabroad.com/



Aftercare and obesity treatment abroad

Aftercare is a crucial part of obesity surgery abroad as well as at home. Many surgeons say that aftercare is as important, if not more important, than the surgery itself. Aftercare covers everything from problems with the surgery to changes in your diet, psychological issues with your new lifestyle to physical issues such as excess skin.

One of the disadvantages of obesity surgery abroad is that the levels of aftercare can vary widely. Some leading clinics provide a full programme of aftercare back in your country of origin, while others may expect you to arrange your own aftercare or they will provide support via email and phone.


Correcting problems arising due to obesity treatment abroad

All types of obesity surgery come with potential problems, many of which may not manifest for weeks or even months after your operation. If you have your surgery at home, it is easy to return to the hospital for a check up and remedial work. However, if you have travelled abroad for obesity surgery, this is not so simple. You should always ask the clinic where you stand if anything does go wrong and who will pay to put it right.

It is important to get a full set of medical notes from your clinic abroad, so that if you do encounter problems on your return, you will be able to let the medical team at home know what they are dealing with.


Nutrition advice is a vital part of obesity treatment

Following obesity surgery, your eating habits will need to change radically. If you have had a gastric balloon or gastric band fitted, you will need to be told how to ease from liquid to pureed to semi-solid food and to ensure correct nutrition from much smaller volumes of food.

If you have had gastric bypass surgery, or a duodenal switch, then your nutrition will be even more complex as you will need to monitor and maintain your levels of the essential vitamins and minerals that you are no longer absorbing naturally.

This nutritional advice needs to be an ongoing thing, as you will need help over several months as you adapt to your new lifestyle and diet. At the very least, your clinic abroad should offer nutritional advice and guidance either by phone or online.

Regular visits to a nutritional specialist in your home country are preferable, as they can run blood tests to check for essential elements of your diet. Many nutritional deficiencies build up over a long period of time, and without expert supervision, the damage may already be done by the time the symptoms become serious enough for you to notice. Any aftercare package should make you aware of what to look for so that you can spot these signs early.


Psychological issues and obesity treatment abroad

Obesity surgery provokes several psychological issues, especially with people who have eaten in response to stress or as and more positive either. Many people need a helping hand through this difficult time, as they come to terms with not being able to eat as they once did.

As time goes by, and the treatment begins to work, there can sometimes be other psychological issues that come to the fore. People who thought that they were unhappy or depressed due to their weight, may find help even though their general health is improving dramatically.

It may be they have deeper problems that will only respond to expert counselling and guidance. These can be crucial to help you cope with the wide range of emotions and feelings that come with rapid weight loss and sudden, extreme dietary change.


Plastic surgery after obesity treatment abroad

One often neglected aspect of aftercare is the need for plastic surgery to remove excess skin following rapid weight loss. Gastric bypass patients can expect to lose 70% of their excess weight in two years, while duodenal switch patients can expect to lose even more. This will inevitably lead to unsightly folds of skin that need to be removed with further surgery.

You will need to bear the costs and inconvenience of this in mind when planning your weight loss programme. If your experience of obesity surgery abroad was positive, it is worth checking whether the same clinic offers plastic and cosmetic surgery for formerly obese patients.


Don’t compromise on aftercare

Aftercare is a very expensive part of obesity surgery and so it is often the first to be cut in order to save money and cut prices. However it is vitally important and you should not compromise on aftercare under any circumstances.

Always ask your clinic about aftercare before you make your choice and make sure that you will have continued access to your surgeon, as well as a complete team of other healthcare professionals, for at least two years after your operation. Not only will this help to make your surgery more successful, but it is essential for your safety too – and that’s well worth spending a little extra money for.




Insurance for obesity treatment abroad

Insurance for “Medical tourism” which covers obesity treatment abroad is a developing area. New medical travel insurance products have begun to appear in recent years. Many of the new products are aimed at European and US based medical travellers.

There are two types of insurance that you should consider before travelling for obesity treatment abroad: travel insurance which is designed for the specific requirements and risks of medical travellers, and complications insurance which covers you against the risk of something going wrong during your obesity surgery.

Medical travel insurance

A standard travel insurance policy does not provide cover for people who are going for obesity surgery abroad, if the surgery is planned as part of the travel. i.e. you are travelling specifically to have obesity treatment in another country. When travel insurance is taken out for travel which involves "medical tourism" or obesity treatment abroad, the travel agent, tour operator, medical tourism agency or medical provider should point out this lack of cover. But few will tell you, even on cover that they may help arrange or suggest, that standard travel insurance policies will in general automatically exclude ALL cover, if you are travelling for obesity treatment.

So, if you take out standard travel insurance (or use your annual multi-trip insurance) and the purpose of your trip is for some form of surgery, then the travel insurer may refuse your claim, even if it is related to something non-medical such as the loss of your luggage or a cancelled flight

Medical travel insurance is simply normal travel insurance designed for medical travellers.  


Medical complications insurance

An overseas surgeon and the obesity clinic may be legally responsible if medical negligence can be demonstrated. This is known as medical malpractice. Not every operation or treatment succeeds. There can be many reasons for this, of which malpractice is only one. So insurance for medical complications is a good idea for medical travellers.

For any form of surgery, it may be difficult to prove medical negligence. As a result, the patient may need to meet the cost of corrective treatment from their own pocket. Medical Indemnity Insurance is not compulsory in some countries, and even if it exists, may be limited in amount, or exclude international medical tourists.

Medical complications insurance provides you with some reassurance that the costs will be covered, if the treatment has to be remedied or corrected.

Medical complications insurance is not medical negligence insurance, and does not enable you to sue clinics, hospitals, dentists, doctors or medical tourism agencies.



What if something goes wrong after obesity treatment abroad?

Obesity surgery may be growing in popularity, but it remains a relatively new area of surgery and some techniques have only been used for fifteen years at most. It is important that you take these potential problems into account when considering obesity treatment abroad so that you know what to do if something goes wrong. You need to know in advance who will pay for remedial treatment and where you stand if you want to make a claim against the clinic.


Knowing what to expect after obesity surgery

As with any medical treatment, it is important to discuss your obesity surgery with your surgeon in advance. You understand how you should expect to feel afterwards as part of your recovery and what symptoms may indicate a problem.

It is not unusual, for example, for gastric band patients to experience nausea and vomiting as they get used to the eft the clinic, you could quickly become dehydrated and face serious medical problems. Understanding when to get help is an important part of dealing with problems.


Problems after obesity treatment

The commonly occurring problems with obesity surgery include:

·         A gastric band that slips and ceases to be effective; around 25% of gastric bands will slip at some point. In rare cases, the band can damage the stomach because it is too tight.

·         A gastric bypass that leaks at the point where the small intestine is attached, or around the staples or stitches of the stomach, leading to peritonitis.

·         Digestive disturbances after a gastric sleeve or gastric bypass because you don’t follow the recommended way of eating.

Each of these problems will require further assessment and sometimes remedial surgery. There are also many problems associated with major surgery at large, which also apply to obesity surgery, including:

·         Perforation of the gut, bowel or stomach

·         Damage to major blood vessels

·         Damage to the liver or spleen

·         Blood clots

Of these, blood clots may be a particular concern to patients facing a long haul flight following a major operation, as they can lead to a fatal pulmonary embolism.


Discuss how potential problems will be managed

Since problems can occur at any time during and immediately after your surgery, especially in patients who are overweight and in generally poor cardiovascular health, you should ensure that the clinic you choose is equipped to deal with such emergencies. If they do not have intensive care facilities themselves, you need to make sure that a local hospital is close by and able to cope with morbidly obese patients.


Act quickly if you experience problems

Once you are home and no longer under the care and supervision of the surgeon who carried out your obesity surgery, you need to keep a close eye on your own health and wellbeing. If you believe that something has gone seriously wrong it is important that you act quickly and attend your local accident and emergency department or emergency room. Do not let the fact that you have had your surgery abroad stop you from seeking emergency treatment at home.

It will help enormously if you have obtained detailed medical records from your clinic abroad, as this will ensure that your home medical team know what surgery you have had and what may have gone wrong. Without this information, they could waste valuable time diagnosing the problem, when they could be helping you.


Contracts and insurance for obesity treatment abroad

You should ensure that you get a written contract detailing who is responsible for what if something goes wrong. Without this, you could wake up from your surgery to find yourself facing a huge bill. Even minor complications will involve extra nights in hospital for you, and extra hotel nights for your companion, and you need to be clear who will pay for these and under what circumstances. You should also check who pays for any treatment you need once you return home.

Be careful not to sign any consent forms or waivers at the bedside without checking them carefully, as you may find that you have inadvertently signed away any rights to claim against the surgeon or clinic if something does go wrong.

Any reputable clinic should have malpractice insurance to cover the cost of problems that occur as a direct result of their own fault, and you should ask for proof of this in advance. It is unlikely that ordinary travel insurance will cover problems from medical treatment abroad, but you can find specialist policies that will cover certain problems and emergency situations see the next section on insurance for obesity treatment abroad.


Making a claim

Remember, if you are making a claim for medical negligence against a clinic abroad, as a result of problems following obesity surgery, then it is highly likely that you will have to take such action in the courts of that country. This can be complex, expensive and drawn out, and even in the best case scenario, may not give you the level of compensation that  you would expect at home. This is an important consideration when comparing the cost of treatment abroad to treatment in your home country.


Get a quote for obesity treatment abroad

Treatment Abroad offers a service whereby you can obtain a quotation for obesity treatment abroad from its network of obesity clinics across the world. Visit www.treatmentabroad.com/quote



The authors

This guide to obesity surgery abroad has been written by Dr Kathryn Senior with input from Keith Pollard.

Dr Kathryn Senior is an internationally acclaimed medical journalist and is Director and Senior Writer at Freelance Copy.

Keith Pollard is the Managing Director of Treatment Abroad and spent more than ten years working in the private healthcare industry before setting up Intuition Communication, a web publishing business that specialises in the medical tourism and healthcare sector.


For more information about Treatment Abroad visit www.treatmentabroad.com or contact:

Intuition Communication Ltd 3 Churchgates Wilderness Berkhamsted Herts HP4 2UB Tel: 01442 817817 Fax: 01442 817818 Email: info@privatehealth.co.uk


Copyright © 2012 Intuition Communication Ltd


Get a quote for obesity treatment abroad

Treatment Abroad offers a service whereby you can obtain a quotation for obesity treatment abroad from its network of obesity clinics across the world. Visit www.treatmentabroad.com/quote


Disclaimer While Intuition Communication Ltd has no reason to believe that there are inaccuracies or defects in any of the information published in this guide, it makes no representations or warranties, express or implied, including but not limited to the fitness of the information for any purpose whatsoever. In providing the information to users, no contractual obligation is or has been constituted between the user and Intuition Communication Ltd and no duty of care is owed to the user. If a court rules that Intuition Communication Ltd in fact owes a duty of care to the user, Intuition Communication Ltd will not be liable for any direct or indirect consequences, loss or damages arising from use of this The information in this guide should not be used as a basis for diagnosis, choice of treatment or choice of medical practitioner. It is intended that the information published in this guide shall enable users to conduct their own research into medical tourism services.




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