Bariatric Surgery in Japan

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 Japan?

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 Japan 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 Japan

About Japan

Japan is special in its own way; the culture, food, people, as well as technology are envied by the world over. With old Japan, comes the ancient tradition in the form of a geisha performance, onsen (hot spring) visit in the mountains, tea ceremony, or shrine visit. In contrast, there is modern Japan, full of smart systems and electronics, colorful advertisements and displays, and ultra-modern architecture. In recent years, Japan has become one of the top destinations in the world for oncology treatments and sees many tens of thousands of medical tourists each year. Many of these travel from within the region, including China and Korea, but they are unable to compete with the SE Asian nations with prices. Private hospitals are located across the country, with a particular focus in major cities like Tokyo, Kyoto, and Osaka. 25 of these facilities are JCI-accredited, with many offering Bariatric Surgery procedures.

Popular Parts of Japan

Located in the Pacific Ocean, Japan is a stratovolcano archipelago. The four largest islands are Honshu, Hokkaido, Kyushu, and Shikoku. With a population of 127 million, 98% are ethnic Japanese. The country perfectly balances traditional with modern technology. Tourists will first see its exceptionally modern face, but after traveling around, they will find many opportunities to connect with the beautiful traditional culture.

• Tokyo is Japan’s capital, one of the 47 prefectures of Japan. It’s a huge metropolis that offers traditional arts and culture, futuristic infrastructures, and good restaurants. The cherry blossoms that bloom in Spring is one of the most popular sights. The soft pink petals are an icon of the country. There is an unlimited choice of shopping, many museums that cover every era of Japanese art history, and even a robot restaurant.
• Kyoto is made of religious architecture, with around 2000 temples and shrines. It moves at a slower pace than any other city in Japan. Filled with samurais, geishas, Zen gardens, and the torii gate, Kyoto is the spiritual center of Japan. The city is also known for its food, head to the Nishiki Market, a four-hundred-year-old local food market that offers a range of national cuisine to modern food from all over the world.
• Osaka, the second largest metropolitan area after Tokyo is known to be the most delicious city. The city is nicknamed “the nation’s kitchen.” Visit Dotonburi to experience the food culture of Osaka. Besides the food, there are numerous attractions that tourists should visit such as Universal Studios Japan, Cup Noodles Museum, Aquarium Kaiyukan, Osaka Castle, and Umeda Sky Building.
• Fukuoka has a welcoming feel with sunny weather and so much to do. It’s made up of two towns, the port city of Hakata and the former castle town of Fukuoka. Visit the impressive Fukuoka Castle, explore the Sumiyoshi-Jinja Shrine, learn history in Kyūshū National Museum, experience the ancient art of calligraphy and origami in Hakata Machiya Folk Museum, and enjoy a calming bath in one of the Onsen hot springs.
• Nagoya is the industrial center of Japan. It’s the birthplace of Toyota and a popular pinball-style game Pachinko. Although many of the historic buildings were destroyed in the air raids of 1945, tourists can still indulge in its culture and tradition. Visit the Nagoya Castle that was reconstructed in 1959, walk around the Atsuta Shrine, or see the history of the automobile in the Toyota Automobile Museum.

Weather and Climate in Japan

Japan has four distinct seasons.

1. Summer starts in June and lasts until August. The temperature can get very hot, up to 40 °C in some places, with high humidity. June is the rainy season where the farmers plant their rice. The rainy season is over in August but the typhoon season starts to peak.
2. Autumn starts in September and ends in November. September has the greatest risk of typhoons. The weather is generally mild. October is pleasantly warm with less humidity than in summer, making it a food time for traveling the country.
3. The temperature will drop in Winter. It lasts from December to February and is usually dry, pleasant, and sunny. The average temperature is around 2°C to 12°C, it rarely drops below 0°C. The northern island of Hokkaido, the Japan Alps, and the Japan Sea coast get a lot of snow while Tokyo gets very little snow.
4. Spring is said to be the best time to visit Japan because of its mild weather and cherry blossoms. The season starts in March and ends in May. The temperature will gradually increase during spring with little rainfall and clear sky.

Getting Around in Japan

The main airport for international tourists is the Narita International Airport. It is located around 60km east of central Tokyo. It serves both domestic and international flights to almost every major city around the globe. There are several budget airlines that operate flights from this airport, namely Jetstar Japan, Eastar Jet, and Peach. There are other international airports such as Kansai International Airport, New Chitose International Airport, and Kyushu Saga International Airport.

To get to Tokyo from Narita Airport, tourists can use the rail, bus, taxi, or car rental. The most affordable train line is the Keisei Line that connects with the Toei Asakusa Subway Line and the Yamanote Line, it costs around ¥1,190 to ¥1,230 ($10 to $11.3). There’s also the Sky Access Express train that offers better access to Tokyo, a trip to Asakusa will cost around ¥1,290 ($11.9) and take about 58 minutes. The quickest way to get to Tokyo will be by the Skyliner train, it takes just 36 minutes to Nippori and will cost around ¥2,470 ($22.7). The airport introduced N’EX Tokyo Round-Trip ticket for foreign passport holders that provides round-trip travel from Narita to Tokyo and back for ¥4,000 ($37) for adults and ¥2,000 ($18.4) for children.

A regular taxi from Narita to Tokyo is very expensive, usually over ¥20,000 ($184). The best option is the shared minibus that starts with ¥6,180 ($57) per person. Buses are usually more affordable, the Limousine Bus costs ¥2,880 ($26.5) and the Tokyo Shuttle costs around ¥900 ($8) to ¥1,000 ($9).

Getting around Japan is fairly easy because the country has excellent public transportation. It is recommended to get a Japan Rail Pass. Japan’s bullet train is fast but expensive. There are cheaper train options. Buses are less expensive but will take more time than trains.

Tourist Visas in Japan

Citizens of 68 countries and territories can enter and stay in Japan for up to 90 days without a visa. Citizens of Indonesia, Brunei, and Thailand are granted a 15-day visa-free trip to Japan. Citizens of the United Arab Emirates are allowed to stay for 30 days without a visa. It is advisable to contact the nearest Consular Section of the Embassy or Consulate General of Japan for more information.

Additional Information

1. Local Currency: Yen (¥) is the local currency. $1 will get you ¥11 ¥1,000 is worth approximately $9.
2. Money & Payments: ATMs are usually located in post offices and convenient stores. There are only a few branches of major Japanese banks that accept foreign-issued cards. Credit cards are accepted in major cities, but the rural area doesn’t. It’s best to always bring cash and bring a coin purse because everything below ¥500 is coins. Tipping is not mandatory, high-end hotels and restaurants usually add a 10% service fee to the bill.
3. Local Language: The official language is Japanese. English is common in major cities with many tourists such as Tokyo, Osaka, and Tokyo. Some restaurants write their menu in English and Japanese.
4. Local Culture and Religion: The dominant religion in Japan is Shinto and Buddhism. There’s a small group of Christians as well.
5. Public Holidays: Japan has sixteen national holidays each year, including Children’s Day, Constitution Memorial Day, and Marine Day. The country hosts numerous annual festivals such as Gion Matsuri in Kyoto, Awa Odori in Tokushima, and Yuki Matsuri Snow Festival in Sapporo.