Bariatric surgery – referring to medical procedures intended to result in weight loss – is a growing industry. The number of procedures is rising globally, with the market worth over $2B.
Inducing weight loss
There are multiple strategies to promote weight loss, including procedures to physically reduce the size of the stomach (sleeve gastrectomy). Other options are placing reversible bands near the top of the stomach to restrict the movement of food, or endoscopically inserting “balloons” that take up space in the stomach and induce the feeling of satiety. The World Health Organization (WHO) reports that bariatric surgery is the most effective treatment for morbid obesity.
Who is getting the surgery?
A new study published in the Journal of Obesity Surgery has characterised the population of medical tourists seeking bariatric surgery. In this large retrospective survey, 93 surgeons around the world were found to have carried out 3,740 procedures on medical tourists in 2017.
Developing countries were found to have the largest share of medical tourists seeking bariatric surgery, with Mexico dominating this market. The study found that 2,557 (68%) medical tourists had bariatric surgeries in Mexico, with sleeve gastrectomy and gastric bypass reported to be the most frequently undertaken procedures. The main reasons cited for bariatric medical tourism include high costs of surgery in the private sector, long wait times in the public sector, or a lack of adequate bariatric surgery expertise in some regions.
Mexico is dominating the medical tourism market for bariatric surgery due to the relatively large volume of patients arriving from the US. Bariatric surgery in the US is not universally covered by insurance and is otherwise expensive. Multiple sources estimated the cost of bariatric surgery in the US to be more than $20,000 for uninsured individuals. The desire for low-cost bariatric surgery is considered to be the major factor driving Americans to seek treatment in Mexico.
Travel to Mexico for surgery can result in significant savings for US patients compared to procedures in the US. The cost for bariatric surgery in Mexico was determined by the study authors to be $6,400 on average. Cheaper surgeries are estimated at $4,500, while the more expensive surgeries cost $8,000. The more expensive bariatric surgery options in Mexico are still significantly cheaper than in the US. In addition, the study authors revealed that patients from Canada make up another major group of medical tourists seeking bariatric surgery in Mexico. This is mainly due to the long wait times for bariatric surgery in Canadian centres.
The problem with medical tourism
While reduced cost of surgery is an attractive reason to travel abroad, medical tourism is associated with a number of concerns.
One issue is that medical standards in other countries might be lower than the standards in the patient’s country of origin, resulting in corrective surgery being required upon returning home. This concern is especially true for medical tourists looking to have surgeries performed at bargain prices. Ill-equipped facilities and poorly trained staff may result in botched surgeries, and cause major medical issues.
As bariatric surgery is associated with complications, including a small risk of death, follow-up with more well-trained or better equipped surgeons may be necessary. However, recommendations for post-surgery follow up vary depending on the surgeon and clinic. While foreign patients almost always receive discharge documents in their native languages, only 72.6% of surgeons globally were found to recommend medical tourists follow up with a bariatric team in their home countries. Patients who do not maintain contact with health professionals could develop complications related to their surgeries. Venous thromboembolism (blood clot), gastric leakage, and internal bleeding were reported to be the most common side effects of bariatric surgeries experienced by medical tourists.
The study estimated that globally, 2% of bariatric procedures are performed on medical tourists. While less developed countries are the primary destinations for patients seeking bariatric surgery at reduced costs, patients should be cautious when choosing a clinic and need to be aware of the importance of continuing care in their home countries.