Gastric Bypass Surgery Requirements In South Africa

Gastric bypass is a surgical weight loss procedure used to treat morbidly obese people. It reduces the capacity of the stomach and, in so doing, limits the intake of food to small amounts at a time.

A patient who undergoes a gastric bypass procedure is fully anaesthetised for up to three hours, and specialised skills are required to complete the surgery. Accordingly, the associated medical costs for the surgery alone can be anywhere in the region from R100 000 to R150 000!

Until quite recently, scheme members undergoing a gastric bypass had to cover the costs themselves. Medical aids in South Africa deemed the procedure an elective surgery, and consequently excluded the treatment altogether.

Requirements to qualify for gastric bypass surgery

Gastric bypass and other weight-loss surgeries are major, life-changing procedures. While weight-loss surgery can help reduce your risk of weight-related health problems — such as type 2 diabetes, high blood pressure, heart disease and sleep apnea — it can also pose major risks and complications. You may need to meet certain medical guidelines to qualify for weight-loss surgery. You likely will have an extensive screening process to see if you qualify.

In general, gastric bypass or another weight-loss surgery could be an option for you if:

  • Efforts to lose weight with diet and exercise have been unsuccessful
  • Your body mass index (BMI) is 40 or higher
  • Your BMI is 35 or more and you have a serious weight-related health problem, such as type 2 diabetes, high blood pressure or severe sleep apnea
  • You’re a teenager who’s gone through puberty, your BMI is 35 or more, and you have serious obesity-related health problems, such as type 2 diabetes or severe sleep apnea

In some cases, you may qualify for certain types of weight-loss surgery if your BMI is 30 to 34 and you have serious weight-related health problems.

What is the criteria for gastric bypass surgery?

You typically qualify for bariatric surgery if you have a BMI of 35-39, with specific significant health problems like Type 2 diabetes, sleep apnea or high blood pressure. A BMI of 40 or higher also is a qualifying factor.

How much does gastric bypass surgery cost without insurance?

If you have health insurance, the one-off up-front fee of $3,500 applies whether you choose to have lap band surgery, gastric sleeve surgery, gastric bypass or provisional surgery from one form to another. Without health insurance, it can cost up to about $20,000.