Bariatric Surgery in Bali

Bariatric surgery is a group of weight-loss surgeries that involves making changes to the digestive system, some of which are non-reversible. The idea behind these types of surgeries is to help patients lose weight by either limiting the amount of food they can consume/digest at any one time or reducing their body’s ability to absorb nutrients. Some procedures do both. 

Bariatric surgeries should only ever be the final option when diet and exercise have proved inadequate and there are now serious health concerns caused by a person's weight. In general, these surgeries can only be an option for patients whose body mass index (BMI) is 40 or higher (extreme obesity). In certain cases, patients whose BMI is 30 to 39.9 may qualify for certain types of bariatric surgery if they have serious weight-related problems, such as type 2 diabetes.

The three most common types of Bariatric Surgeries are as follows:

1. Gastric Sleeve – The most common surgery, in which about 80% of the stomach is irreversibly removed, resulting in a sleeve or tube-like structure. This smaller stomach will not be able to hold as much food and produces less of the hormone that regulates appetite (ghrelin), which can lessen the patient’s desire to eat. 
2. Gastric Bypass – A more complicated procedure in which the stomach is divided into two parts; a small upper pouch and a large lower ‘remnant’ pouch. The small intestine is rearranged to bypass the large pouch. As a result, the volume of the stomach is significantly reduced. This causes food to go into the small upper pouch of the stomach and then directly into the small intestine. The small upper pouch can only hold around an ounce of food. Gastric Bypass is typically not reversible. 
3. Gastric Band – Involves an inflatable silicone device that is fitted around the top portion of the stomach to create a smaller stomach pouch. This procedure causes the patient to feel fuller with less food but still allows the body to digest food as usual, without malabsorption. The device can be removed when the patient reaches their desired weight.

The bariatric surgeries mentioned above are typically performed laparoscopically, in which the surgeon creates around one to five small incisions in the abdomen to insert a laparoscope (a long narrow tube with a camera) and surgical tools. The patients are usually given a general anesthetic, so they will not feel anything throughout the surgery.

How Long Should I Stay in Bali?

After bariatric surgery, an overnight stay in the hospital is usually required. In some cases, you may need to stay longer (around 3 to 5 days). However, it is not advisable to leave Bali as soon as you are discharged from the hospital. Stay at least 10 to 14 days following your surgery for initial recovery and follow-up checkups. During the follow-up checkups, your surgeon will remove your stitches and check your overall condition.

What's the Expected Recovery Time?

The recovery time may take around 3 to 6 weeks until you are allowed to go back to your normal activities, including work, with some restrictions. You must avoid heavy work and strenuous activities, such as lifting, pushing, or carrying heavy loads for at least the first three months after surgery. You should also avoid sitting and standing without moving for long periods to avoid blood clots forming in your legs.

What Aftercare is Required?

You will be given a special diet plan immediately after your surgery, as well as detailed post-operative instructions. Make sure to follow the diet plan and instructions to avoid complications and speed up your recovery. In order to maximize and maintain weight loss, it is important that you commit to healthy eating and regular exercise. There may be restrictions on how much food you can consume. You may also need to change your eating habits, such as eating 6 small meals instead of 3 large meals each day. You should take vitamins and mineral supplements to ensure proper nutrition. 

What's the Success Rate?

The success rates vary for each of the different types of bariatric surgery. In general, within the first six months following the surgery, most patients lose around 30% to 55% of their excess weight. Then, as early as 12 months after surgery, most patients lose over 70% of their excess weight. Patients could also maintain a 50% to 60% loss of excess weight for 10 to 14 years after their bariatric surgery. Although the success rates are high, there are risks associated with bariatric surgery, such as bleeding, deep vein thrombosis, infections, spleen injury, stenosis, and infections.

Are there Alternatives?

There is a non-surgical Bariatric procedure, known as the Gastric Balloon. This involves an inflatable device that is temporarily inserted into the stomach via endoscopic placement. A sizable area of the stomach is obstructed by the balloon or balloons, thus reducing the amount of food it can contain at any one time, leading to eventual weight loss. The balloons are usually removed after 6 or 12 months. 

If you cannot or do not want to undergo any surgery or medical procedure, you may be able to work with a doctor who is experienced in treating extreme obesity and a dietician as the alternative. They may recommend you to change your diet, adding physical activity, and prescribe medications.

Bariatric Surgery in and around Bali

About Bali

Bali is an Indonesian province located on the west side of the Lesser Sunda Islands. It is the country’s main tourist hotspot that attracts millions of tourists each year. The beaches are tranquil and perfect for any sun-seeker, the marine life is one of the most diverse in the world, the culture is beautiful, and the mountains are covered in lush jungles and great for hiking. In addition to the natural and cultural beauty, there are myriad of things that tourists can do here, from yoga, partying, surfing, to horseback riding.

Bali is not only full of fascinating beaches, but this tropical paradise also boasts many high-quality medical facilities offering various types of treatments. The island continues to upgrade its infrastructure and develop its medical centers to compete with neighboring countries, such as Singapore and Thailand. Medical tourists are able to avail of a wide range of treatments including cosmetic surgery and at affordable rates. The medical centers have modern equipment, and there is little to no waiting time for almost every procedure. Additionally, the island is also equipped with exclusive yoga centers, Bali-traditional spas, and Jamu traditional medicinal herbs.

Popular Areas in Bali

• Seminyak is known to be the most luxurious area in Bali. Tourists will find many fashionable boutiques, upscale restaurants, and exclusive clubs. In the afternoon, tourists can soak up the sun while sipping a cocktail in one of its famous beach clubs or take a beginner surfing lesson at one of its beaches. The main beach is Petitenget Beach where tourists can enjoy magical sunsets or swim in its warm waters. The area is also home to Bali’s best cafés, which makes café hopping a must-do event.  
• The Nusa Islands is located around 20 kilometers offshore from the main island and can only be accessed by boat. It consists of three islands: Lembongan, Ceningan, and Penida. The most popular and the closest to the main island of Bali is Nusa Lembongan. The biggest is Nusa Penida and the smallest is Nusa Ceningan. The three islands offer tranquil and almost-empty beaches, which is perfect for anyone who wishes to stay away from crowds.  
• Ubud is the island’s jungle paradise that still retains numerous aspects of traditional Balinese. It is the place for tourists who wants to immerse in Bali’s culture and nature. There are various beautiful temples, dance shows, and historical sites within the area. The most popular place is Ubud Monkey Forest or the Sacred Monkey Forest Sanctuary, which is a sacred temple, an evocative jungle, and natural habitat of monkeys.
• Sanur is Bali’s earliest beach resort and is located on the eastern side of the island; it contains some of the island’s first hotels. The area is known to be family-friendly as well as one of the best places to enjoy Bali’s magnificent sunrises. Sanur is very quiet which makes it the perfect place for relaxation. Wander around for a day and you will find many major cultural landmarks hidden in plain sight.
• Canggu is famous for its green rice fields, dark sandy beaches, and healthy food. This up-and-coming area is also filled with cool cafes and vegan restaurants. It is also a prime spot for surfing since the beaches have massive shore breaks. One of the most famous places in the area is the Pura Tanah Lot Temple as it is a famous seaside religious site located on top of a rock formation, which offers a picturesque view.

Weather and Climate in Bali

Bali enjoys warm and comfortable weather all year round. The tropical island experiences two seasons: dry and wet. The dry season starts in April and ends in October. The average temperatures during this season are between 23 °C to 31 °C. June to August are the driest months, making them the best months to visit the island. The wet season is from November to March. Expect to find many rainy days during the wet season. The temperatures are generally similar to the dry season, but the humidity will increase significantly. 

Getting Around in Bali

I Gusti Ngurah Rai International Airport is the main gateway to Bali and it is located 13 kilometers south of Denpasar and is the second busiest airport in Indonesia. The airport has international connections with major cities around the globe, including Bangkok, Melbourne, Moscow, and Guangzhou. It also serves domestic flights to many regions within Indonesia. The most affordable way to travel to and from Bali is by flying with budget airlines, such as AirAsia, Citilink, and Lion Air. 

There are several ways to get around Bali. Most of the transportation options are very affordable. Hiring a motorcycle is the fastest option, but if you do not like the idea of driving by yourself, you can try the motorcycle taxis known as ‘ojek,’ which can be hailed directly from the streets or by using apps such as Grab and Go-Jek (similar to Uber). The apps also provide private cars and food delivery. Taxis are widely available and run on a meter. The most reliable taxi companies are Blue Bird and Express.

Tourist Visas in Bali

Indonesia is known to be a visa-friendly country since most developed countries can enter without a visa. The country allows a citizen of 170 countries to enter and stay for up to 30 days. Citizens of Japan, the United Kingdom, the United States, and 65 other countries can apply for a visa on arrival. It is best to check at the nearest Indonesia Embassy or Consulate to find out if you need a visa or not. All visitors are required to have a visa valid for at least 6 months. 

Additional Information

1. Local Currency: Indonesian Rupiah (Rp) is the official currency, and $1 converts to Rp14.000.
2. Money & Payments: Tourists will find ATMs that accept international cards almost everywhere (mostly Visa and MasterCard). Credit and debit cards are accepted in many shops, restaurants, and hotels. Tipping is not expected but will be greatly appreciated. 
3. Local Language: The official language is Bahasa Indonesia, and most people will also speak Balinese. English is widely spoken, especially in tourist areas.
4. Local Culture and Religion: Most people in Bali follows Hinduism, and almost every aspect on the island is submerged with the Hindu faith. There is also a large group of Muslims as well as small group groups of Christian and Buddhists. 
5. Public Holidays: Bali celebrates major religious holidays, including Nyepi (Silent Day), Eid Mubarak, Christmas, and Vesak.