I had weight loss surgery via gastric sleeve surgery (aka VSG) on March 14th 2018. I get asked questions about it all the time so here’s some FAQ answered for you below.

WHERE DID YOU GET weight loss surgery?

I had gastric sleeve surgery at Mercy Ascot Hospital via Auckland Weight Loss Surgery.

WHAT MADE YOU CHOOSE GASTRIC SLEEVE SURGERY OVER GASTRIC BYPASS, GASTRIC BALLOON OR EVEN GASTRIC BAND SURGERY as your weight losss surgery?

On my initial consult with the surgeon, he recommend that he believed the best option for me was Gastric Sleeve Surgery, otherwise known as Vertical Sleeve Gastronomy (VSG). He advised that it was the best for my age, could be adapted to gastric bypass later in life should I need it and also said it was the least invasive with the least complications.

WHAT PROCESS DID YOU FOLLOW TO GET GASTRIC SLEEVE SURGERY?

When I make my mind up on something, I am very determined so the process from me deciding to get the surgery to getting the surgery was very quick.

I decided in December 2017 that I was going to get the surgery so I booked an appointment with a surgeon at Auckland Weight Loss Surgery. Given it was Christmas/New Years holidays coming up and they book well in advance, I couldn’t get an appointment until the start of February 2018. I still needed approval from the surgeon that he thought that I was a good fit for the surgery however my GP had given her support and I knew I fit the requirements. After my initial appointment on February 7th once approved by the surgeon, I booked the next available appointment for the surgery which was just over a month later on March 14th. I already had a trip planned for Valentines Day (I took the photo below to the left on this trip) so I extended it an extra week and then had a mandatory 3 week pre-op diet pre-surgery.

The entire process from deciding to the appointment was around 3 months.

HOW MUCH WAS GASTRIC SLEEVE SURGERY?

I paid a total of $19,540.00 NZD for the surgery at the time which was paid in full prior to the surgery. There were also additional fees prior to and after the surgery fo mandatory consults.

WAS YOUR SURGERY SPONSORED? HOW DID YOU PAY FOR IT?

Despite the common misconception that my surgery was sponsored or contra, I paid for my surgery in full, myself, out of my savings account. I was saving for a house but instead took the money out of this account to fund the surgery as I believed it was a better investment in my future at the time.

I DON’T HAVE THE MONEY TO GET WEIGHT LOSS SURGERY - WHAT ARE MY OPTIONS?

This all depends on where you’re from. I live in New Zealand so can only speak of what I know and here are a few options:

Public Health System
Here in New Zealand, there is the option to go through the public health system and therefore is publicly funded. You must still meet all the criteria for the surgery itself as well as additional requirements depending on each BHD. As there are a limit on the number of publicly funded surgeries available there’s an assessment and selection system in place. Patients are prioritised using a tool provided by the Ministry of Health to identify who would benefit most from the surgery. You can read more about the process via the Auckland DHB website here. You may not be eligible to get publicly funded surgery if you weigh more than 170 kg, are younger than 18 or older than 70, have been a smoker or ex-smoker for less than six months or have previously had weight loss surgery.
Health Insurance
Those who have health insurance may have the option for their weight loss surgery to be funded in full or part funded depending on their cover. If you can get health insurance, you will need to meet the criteria needed for weight loss surgery and each health insurance policy will have its own criteria in addition.
Withdrawal of Superannuation
Another option is that you can use your superannuation, otherwise known as Kiwisaver here in New Zealand as an option. This is a lot harder to withdrawal given you commonly need sign off from your GP however I have known many people who have had their funds released by applying for financial hardship or serious illness.
Heading Aboard
Getting weight loss surgery abroad may be an option for you if you are wanting to save on costs and don’t mind traveling. There’s two main countries that I know people have gone to which is Mexico and Thailand. A family friend of mine went to to Tijuana, Mexico and it only cost her under $10,000 NZD for the surgery, flights and accommodation. She went with a group which is run by two women who have already had weight loss surgery via this method and take groups over there. Having this surgery in Bangkok is around $15,000 NZD including surgery, flights and accomodation.

WHAT ARE THE REQUIREMENTS FOR WEIGHT LOSS SURGERY?

In my experience, there are strict rules on being applicable for weight loss surgery whether you’re going through the public system or getting it privately. It’s a lot stricter through our public health system but privately you still have minimum requirements.

These include:

A BMI of over 40 which puts you in the morbidly obese category (otherwise known as Obese Class 2) or have a BMI of 35+ (in the Obese category) and have underlying health conditions such as heart disease, type 2 diabetes or obstructive sleep apnoea.
Issues with obesity for longer than 5 years.
Failed attempts at weight loss for more than 2 years.
Understand what the surgery involves, what to expect before and afterwards and are committed to a permanent lifestyle change (diet and exercise)
You are required to go onto a pre-op diet. In some cases, the patient will be required to lose a set weight whereas others will just be doing a pre-op diet to prepare.
You may also be required to be pre-approved by a psychologist to ensure you are mentally fit and dedicated to the process.

SO how does gastric sleeve surgery actually work?

Gastric Sleeve Surgery works by reducing the size of the stomach from a sac to a narrow tube. Approximately 80 per cent of the stomach is removed via key hole surgery.

Loss of weight occurs because the patient now feels fuller earlier after eating, largely due to the smaller size of the stomach as well as the reduction in appetite stimulating hormones called Ghrelin. This is produced and released mostly by the stomach with the main gland located at the bottom of the stomach. It is termed the 'hunger hormone' because it stimulates appetite, increases food intake and promotes fat storage so reduction of this can be significant for weight loss.

For the most part, the stomach digests calories and nutrients in a mostly normal way.

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WILL I BE LEFT WITH large incision SCARS POST OP?

Gastric Sleeve Surgery is done using key hole surgery meaning it is not open surgery therefore there are small incisions done instead which are around 1cm-5cm max. I had 5 incisions, 4 of them were small incisions used for cameras and the other was used for the device used for the surgery and this incision which was the largest. Most people have 3-6 incisions which will scar as they heal but they are minimal and should fade over time.

WHAT HAPPENS AFTER WEIGHT LOSS SURGERY?

I’ll do another Q&A on this so I can get more into details on specifics but in short, we’re given a smaller stomach size as shown above which gives the rare opportunity to re-teach the stomach how to eat while implementing healthy habits.

I found this process incredibly valuable as I could easily distinguish between “head hunger” vs whether my body needed food which a bad habit I’d developed through an unhealthy relationship with food throughout the years that I could now correct myself on.

I like to describe the process of the early stages of post gastric sleeve surgery similar to that of a babies stomach. We are required to learn how to digest food again, starting with a liquid diet, then a pureed food diet followed by a soft food diet and finally can reintroduce solids over the first 6 months.

HOW MUCH WEIGHT CAN I LOSE WITH WEIGHT LOSS SURGERY?

For gastric sleeve surgery, most people typically will lose 65-75% of their excess weight which is deemed as good to excellent weight loss results following the surgery. This is usually achieved within the first 12-18 months before weight stabilises and some weight man be regained but it’s usually minor.

As an example, I started at 126 kg (278 pounds) with a BMI of 43.6. If I were 70 kg (154 pounds) I would have a BMI of 24 and be classed in the healthy range. 100% of my excess weight would be 56 kg (123 pounds) but on average, the goal is between 65-75% of your excess weight within the first 18 months. That meant my goal was a loss of 42 kg (93 pounds) within the first year.

No amount of weight loss is guaranteed as it is up each patient on the success of their surgery.

HOW MUCH WEIGHT DID YOU LOSE FROM THE SURGERY?

I lost a significant amount of weight in the first 12 months dropping from 126 kg (278 pounds) down to 58 kg (128 pounds) before intentionally gaining around 5 kg of mainly muscle the following 3-6 months and maintaining a healthy weight since.

Do you think i should tell people about my plans to get weight loss surgery? im scared they won’t support my decision.

I think this answer is really up to the person getting the surgery but my advice would be to do what you think is best for you. When I first decided to get weight loss surgery, I was in two minds about whether to tell anyone. I had talked about it with my parents and decided that it was what I was going to do but letting anyone else know was something that took more than a couple of months of deliberating. I knew I was either going to tell everyone or no-one at all. I ended up telling people progressively and looking back, it was the absolute best decision for me.

HOW DID YOU TELL PEOPLE THAT YOU WERE PLANNING TO GET WEIGHT LOSS SURGERY AND DID YOU DEAL WITH NEGATIVE OPINIONS FROM FAMILY AND/OR FRIENDS?

I told the people closest to me first - that was my boyfriend at the time, my parents, my closest friends and my flatmates who were like family to me. I told them progressively starting with one person before gauging their reaction and support and then figuring out how to better approach the situation with others.

I found when I talked about my decision positively by sharing my excitement along with what I want from it e.g. “I’m so excited that I’ve chosen to get gastric sleeve surgery which I think will be a great tool to help me get to where I need to go health wise to live a happy healthy and fulfilling life. It’s an investment into my future self and I just wanted to share that with you in the hopes you can support me in my journey” then I found my friends and family were excited for me too.

Whenever I came at it from an uneasy perspective or had reservations, my friends were doing what they do best and would also have concerns because that’s what I was projecting. If you have negative opinions from others, generally it has absolutely nothing to do with you or you choice and everything to do with that person. I only had two negative opinions from people close to me.

WHY DID YOU SHARE YOUR WEIGHT LOSS SURGERY JOURNEY SO PUBLICLY?

I did a lot of research prior to getting this surgery and realised that negative opinions were largely due to the lack of knowledge about the surgery and what it entailed in the process so it was really important for me to educate people by sharing my journey openly.

HOW DID you know weight loss surgery was the right option for you? did you try losing weight yourself?

Despite knowing about gastric sleeve surgery for a long time, I never thought it was even an option for me because I knew I could lose weight on my own. Even though I had always been a bigger girl my whole life - that was my normal.

I had tried to lose weight myself and succeeded but for the past 6 years of my young adult life, I was in a continual loop of losing weight only to gain it back again, trying every diet and exercise regime out there to find something that worked for me.

Despite all my efforts, nothing stuck and I found myself continually back at a crippling 130 kg, a size 28 and morbidly obese. I knew I didn’t want this to be my life. I didn’t want a life of debilitation, fear and limitation but one that gave me back control and allowed me to make the most of my life. I felt like I had exhausted all my options and knew if I didn’t make serious changes soon, my future looked unhealthy and short-lived.

For me, getting gastric sleeve surgery was a last resort option that I took after hearing the surgery also reduced the hunger hormone known as Ghrelin as I believed this could be the root cause of my issues and allow me to make long-term lifestyle changes for a healthier me.

DO YOU THINK YOU TOOK THE EASY WAY OUT WHEN IT CAME TO WEIGHT LOSS SURGERY?

I can guarantee if you ask anyone who has had weight loss surgery will tell you it is far from easy. It looks easy because all you see is the before and after without truly understanding all that goes into the process.

There is a huge stigma around weight loss surgery and it being chosen as a weight loss tool which I find disheartening. Obesity is associated with many health conditions including Type 2 diabetes, ischaemic heart disease (IHD), stroke, several common cancers, osteoarthritis, sleep apnoea and reproductive abnormalities in adults.

The surgery has the potential to see significant long-term weight loss success and is a last resort option for many. In any other situation where one could improve their quality and length of life, I feel like it’s supported so why is this any different? It still requires constant investment, discipline and motivation to succeed in.