Patients going overseas for weight-loss surgery are returning with potentially life-threatening complications and clogging up an already overburdened public health system, says a Waikato bariatric surgeon.
Rowan French says overweight Kiwis are being targeted by medical tourism companies and often do not fully understand the risks involved or the need for post-operative care after returning home.
New Zealand was now the third most obese country in the world, but only about 500 bariatric surgeries were publicly funded each year.
At a cost of $29,000 to go private, a gastric bypass or gastric sleeve was out of reach for many who were turning to Mexico, Thailand and Turkey for operations as cheap as $8000.
New Zealand is now the third most obese country in the world. Photo / 123RF
One Waikato woman – who did not want to be named – said gastric sleeve surgery in Tijuana was not a decision she made lightly.
“I definitely weighed up everything. I felt I didn’t have a lot of other co-morbidities or extra risk factors that perhaps if I had had, I may not have gone overseas.
“Being a health professional myself I kind of weighed it up and also said to myself look it could go wrong. It could wrong in Hamilton, it could go wrong in Tauranga, it could go wrong in Mexico.
The mum said she paid $12,000 including flights, accommodation and a holiday, but she didn’t use a medical tourism company.
Instead, she found a doctor online, and asked for his certification, complication rate, and post-op care routine.
She said she was surprised at the strong opinions in a social media support group and cautioned against relying on them.
“Seventy or 80% on this big Facebook group page were using one surgeon. I looked into that clinic and there’s no way I would have gone there.
“The surgeon I ended up going with, he does one or two procedures a day. He’s got a maximum of six patients that he has in his hospital.
“Whereas this other one that I looked into they can do sort of up to eight surgeries a day. It’s great to get other people’s feedback but it’s really important to do your research.”
Before the surgery in 2023 the woman was 102kg – now she is 66kg.
However, she paid for post-op care in New Zealand which picked up a vitamin B1 deficiency, and she has been able to manage reflux.
She also paid for counselling which she credited with helping her keep the weight.
Doctor says he meets two patients a week with complications
French – a bariatric surgeon working in public and private – said on average he saw two patients a week who had developed complications such as food intolerance after returning home.
He recently admitted one patient to Waikato Hospital with an abscess from a leak, and said he was worried about the impact of complications – that he believed were increasing – on New Zealand’s overloaded public health system.
“The problem is with the volume of patients having surgery with no proper vetting or preparation is leading to large volumes of requests for help, many of which we don’t have capacity to see.”
“The biggest issue I foresee is the load that’s going to come on the public system ... and also the fact that I think people are being put at substantial risk and they are under-informed and misinformed at the same time.”
A large volume of patients having bariatric surgery are doing it overseas without proper preparation, leading to complications that are clogging up the public health system in NZ, says a surgeon.
French said he was also concerned that patients were not getting the appropriate type of surgery for their needs, and that most were getting a gastric sleeve because they were cheaper and quicker to perform.
However, they were not necessarily safer or more successful, he said.
“Essentially I think people are being sold a product that this will in most cases give you lifelong weight loss, you’ll go away, you’ll have a holiday, you’ll have this operation, the weight will come off and stay off and you’re unlikely to have any problems afterwards.
“We see many, many cases where the opposite is true.”
He said without post-op care patients could end up putting the weight back on and he called for medical tourism companies to be regulated.
‘They’ll just burden the health system here'
Andrea Schroeder of Tailor Clinics in Hamilton – which offered private surgery packages including post-op care – said patients with complications that were not life-threatening were being referred back to their GP.
“If they’ve got an emergency or some sort of acute problem, they will get seen. They’ll just burden the health system here.”
Schroeder said some patients were having to get revision surgery to deal with the complications.
But Trim Up founder Kirsten Leonard pointed out a person paying for the surgery here was likely to end up in the public health system if anything went seriously wrong.
“I know of a person last week who had surgery in New Zealand that ended up in hospital with collapsed lungs.”
Leonard set up her medical tourism company in 2018 after having bariatric surgery in Mexico and said she had taken 260 clients overseas for the surgery.
“I’d be keen to have a breakdown on what complications the after-care helps prevent. For example a leak is a surgical error and nothing to do with any after-care.”
She said all her clients were expected to have blood work prior to surgery to identify any deficiencies and afterward the patients had access to a nutritionist in Mexico for a year and to the surgeon if advice or information was needed.
“You also have access to the many Trim Up clients who have been there, done that and are happy to help anytime.”
Her packages, which start at $14,500 for a gastric sleeve, include aftercare with The Wellness Centre in Christchurch.
She recommended her clients sought psychological care themselves after three months so they could choose their own counsellor.
Leonard also said many nurses she had taken overseas for the surgery were impressed with the care and cleanliness at the Mexican hospital.
She was concerned about other, new medical tourism companies which seemed to be “money-focused, not people -focused” but she did not know how medical tourism could be regulated.
A line on her website about gastric sleeve surgery that read: “It can be easily revised in the off-chance of it not being as successful as planned”, would be removed in a website update soon, she said.
