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This is how much gastric sleeve surgery costs (with and without insurance)

Gastric sleeve surgery is becoming one of the most sought-after weight loss methods.

Written by
Rachael Belfield
Medically reviewed by
Last updated
September 19, 2023
6
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This is how much gastric sleeve surgery costs (with and without insurance)
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Bariatric surgery has become one most common elective surgical procedures in Australia in the last 10 years. It wouldn't be surprising if it overtook cosmetic surgery in popularity, as it can vastly change your quality of life in terms of your long-term physical health.

For people experiencing morbid obesity, surgery may seem like an efficient, effective and long-term approach to rapid weight loss. While it can be all of these things, bariatric surgery can also be costly, invasive and will change the way you approach food forever.

There is nothing to be ashamed of if you're experiencing obesity: there are many ways to exist in a body, and there are many reasons why we put on weight throughout life.

We do know that obesity is associated with an increased risk of a number of common diseases including diabetes, high blood pressure, high blood cholesterol levels and cardiovascular disease, and the more we understand the implications of obesity, more and more people will be turning to bariatric surgery to help manage their weight.

Gastric sleeve surgery is a low-risk but life-changing weight loss surgery that allows for rapidly losing weight and is becoming one of the most sought-after weight loss methods on the market. Here's what you need to know.

What is gastric sleeve surgery?

Gastric sleeve surgery, also known as a sleeve gastrectomy, is surgery for weight loss that involves the removal of a large part of the stomach and replaces it with a long, tube-like pouch. This smaller stomach can't hold as much food as you would have been able to previously, allowing you to lose weight quite easily with your stomach's new restrictions.

Approximately 80 per cent of the stomach is removed in a sleeve gastrectomy, leaving a long but considerably smaller tube-like pouch. Gastric sleeve surgery works well, is safe, effective, long-lasting and offers significant weight loss without rerouting your intestines, which is the method doctors use for a gastric bypass.

Gastric bypass surgery is the rerouting of the intestines using staples to create a small pouch in the top part of the stomach.

What is the purpose of gastric sleeve surgery?

Gastric sleeve surgery aims to change your food consumption dramatically, with a view to losing weight in the long term and keeping it off. After surgery you will start to feel full after eating a small amount of food.

What's more, a smaller stomach will produce lower levels of a hormone called ghrelin, known as "the hunger hormone", which stimulates appetite, increases food intake and promotes fat storage.

The purpose of a gastric sleeve is not to limit ghrelin completely; it's a vital hormone for as we need it for proper food digestion, but lowering the production of this hormone can help manage feelings of hunger.

Weight loss surgery will lower the risk of diabetes, cancer, stroke and heart attacks. It can also provide joint pain relief, improved cardiovascular health and can even improve mental health. But, it is a drastic, last-resort option: your weight loss surgery cost alone is something to consider carefully before taking the surgical plunge.

Who is eligible for a gastric sleeve?

A GP may refer you to a bariatric physician to discuss your weight loss needs, but this will only be after ensuring that other options such as diet and lifestyle changes aren't working for you. It will also depend on comorbid issues you're experiencing that are caused, or exacerbated, by obesity.

To be eligible for bariatric surgery, you must be between 16 and 70 years of age (with some exceptions) and have a BMI of 40 or higher. A BMI of 40 will qualify you for aid with or without other related health issues.

But, if you are experiencing other comorbid health concerns, a BMI of 35 is the lowest a GP will consider you for gastric sleeve surgery.

What makes someone ineligible for a gastric sleeve?

Gastric sleeve surgery is effective for weight loss for those considered morbidly obese, and is readily available for those who have a BMI of 40, or other severe lifestyle diseases that are made worse by obesity.

Bariatric surgery is not done for cosmetic purposes, it is for patients who are experiencing lower quality of life or are at a serious risk of developing heart attacks, diabetes, strokes and cancer.

As effective as a gastric sleeve can be for weight loss, your GP will likely not refer you to a bariatric surgeon if there is any chance you can lose weight through lifestyle changes. In fact, you will often have to show a history of trying to lose weight through diet and exercise before being approved for a bariatric procedure.

Speak to your doctor about your weight loss journey and what it could look like for you. Remember, it will a different experience for every person and there are lots of different ways to lose weight.

What are the risks associated with gastric sleeve surgery?

Every operation has risks. You could have a bad reaction to the anaesthetic, experience blood loss and, there is always a risk of infection, which is the case with any surgical procedure.

While gastric sleeve surgery is considered safe, it does have a small number of specific risks. Patients can experience bleeding or leakage of fluid from the stomach post-surgery. Some studies suggest that nutrient absorption also decreases after this particular surgery (especially vitamin D, B12, folate and iron), however, more research needs to be done in this area.

Is gastric sleeve surgery reversible?

No, gastric sleeve surgery is not reversible. Once that part of your stomach has gone, there's no going back. But, there is always a risk with the addition of a gastric sleeve that the stomach can expand again old eating habits are continued. Surely it's impossible to put on weight again if the stomach is shrunk to a considerably smaller size?

If you lost weight initially and then gained some back, it was most likely caused by your smaller sleeve stomach stretching out as a result of poor diet or lifestyle habits, including overeating.

However, the sleeve stomach has also been known to stretch for patients with more balanced diets and exercise habits. Dangerous weight gain will cause many issues for your stomach and the sleeve, so speak to your doctor about the risks involved in weight gain after surgery.

And, just like most surgeries, there will likely be some pain involved as you recover. Gastric sleeve surgery is quite drastic and is considered a major procedure. Your GP and bariatric surgeon can answer your questions about further risks to your health, and any other issues you may face in the lead up to weight loss procedures.

How much does the gastric sleeve cost?

Bariatric surgeries are not performed in the public system, despite having a Medicare item. Therefore, costs will certainly be incurred.

Gastric surgery costs will add up to anywhere between AUD $15,000 to AUD $20,000 in Australia. That is a lot of money, but there are ways you can approach bariatric surgery to ensure you are keeping costs as low as possible.

Does Medicare cover my gastric sleeve surgery cost?

Gastric sleeve surgery is on the Medicare benefits schedule as it considers weight loss surgery to be a genuine health intervention.

However, Medicare will not cover the full gastric sleeve costs of your procedure. According to the Medicare Benefits Schedule online, sleeve gastrectomy and gastric bypass operations incur a benefit of AUD $663 and AUD $815.95 respectively.

You will have to pay an out-of-pocket fee, the size of which is dependent on your private health insurance cover. Medicare plus private health cover will reduce the costs incurred.

Gastric sleeve surgery with private health insurance

A private health fund will contribute to a large chunk of the hospital fees from a procedure with an item number on the Medicare benefits schedule, including weight loss surgery. You will need a referral from your GP to a bariatric physician or bariatric surgeon for your private health to be used.

A private health fund will offer varying degrees of cover depending on the premium you pay.

But typically, this can range from anywhere between AUD $1,700 and AUD $5,300 after the Medicare rebate. Sometimes it can go higher, but it rarely exceeds AUD $8,000 or so. This covers hospital costs usually include:

  • Bed stay
  • Operating theatre costs
  • Anesthetist fees
  • Surgical assistant fees
  • Diagnostic testing
  • Other specialist input.

As with any insurance company, you might have to wait for the surgery. Since obesity is considered a pre-existing condition, there will almost certainly be a waiting period of 12 months between before your health fund covers anything relating to bariatric surgery costs.

Gastric sleeve surgery without private health insurance

In looking at self-funded obesity surgery, the surgical fee alone, along with anaesthetists, hospital stay, initial consultation and subsequent specialist care will be very costly. Without private health insurance, you would be looking at paying between AUD $12,000 to AUD $20,000 for hospital cover, depending on the surgeon's fees.

If you do not wish to take out private health insurance, and if you meet the right criteria, you may be able to pay from your superannuation funds. Superannuation funds are accessible for people on "compassionate grounds", according to the Australian Tax Office. It will involve a lot of paperwork, but it could be an alternative payment method that works for you.

Weight loss surgery alternatives

Bariatric surgery is an innovative and effective way to lose weight and improve your health but, there are many other weight loss methods available that do not involve surgery, painful recovery periods, high surgery fees and additional hospital costs. Bariatric procedures are massive, invasive undertaking that can interrupt your life.

Even with a high BMI, weight loss is certainly possible. We know: it's really, really, really hard to lose weight. In fact, it can feel like your body starts working against you. But, even if that mountain seems impossible to climb, you can always get help along the way: there is no expectation that you do this on your own.

A weight loss program

Pilot's Metabolic Reset Program is a less-invasive and cost-efficient alternative to gastric sleeve surgery that can help you make real changes to your health and well-being through weight loss and behavioural changes.

We have created a program that works with, not against, your biology by using a breakthrough medication that resets your metabolic patterns, regulates your digestion, decreases appetite and changes your mind and body's approach to food, alongside health coaching and one-on-one health tracking with a Pilot practitioner.

When you take into consideration that up to 80 per cent of your weight is determined by your genes, it no longer becomes a question of willpower but rather, genetics. In fact, your body can actually resist weight loss and trigger hormones to keep weight on by increasing hunger and slowing your metabolism.

When this happens, diet and exercise are never going to be enough to make a significant change to your health. That's why the Metabolic Reset Program includes a daily medication that introduces hormones produced by your gut to decrease appetite and help you lose weight.

At the same time, you also learn the lifestyle habits that allow you to maintain your new weight for life.

While the amount of weight with this treatment will vary from person-to-person, clinical research from studies of these medications provides a small insight into what you can expect, with research from 2017 finding that a quarter of patients lost more than 10 per cent of their body weight after five months.

A study from 2020 found that patients lost 12.1 per cent of their body weight in 52 weeks using this class of medications, combined with behavioural changes (nearly twice as much versus behavioural changes alone).

Losing weight can be tricky but there are ways you can approach weight loss without surgery and with the help of healthcare professionals. Take our quiz today to see if this treatment is suitable for your needs.

References

  1. https://www.yourhormones.info/hormones/ghrelin/
  1. https://www.racgp.org.au/afp/2017/july/bariatric-metabolic-surgery-a-guide-for-the-primar
  1. Barnes AS. The epidemic of obesity and diabetes: trends and treatments. Tex Heart Inst J. 2011;38(2):142-144.
  1. Cercato C, Fonseca FA. Cardiovascular risk and obesity. Diabetol Metab Syndr. 2019;11:74. Published 2019 Aug 28. doi:10.1186/s13098-019-0468-0
  1. Sarkhosh K, Birch DW, Sharma A, Karmali S. Complications associated with laparoscopic sleeve gastrectomy for morbid obesity: a surgeon's guide. Can J Surg. 2013;56(5):347-352. doi:10.1503/cjs.033511
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