Bariatric Surgery in Metro Manila

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 Metro Manila?

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 Metro Manila 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 Metro Manila

About Manila

Manila is the capital of the Philippines and is divided into 16 districts; it is one of the densest and populated cities of the world. Each district has its own history and cultural legacy. The city was under the rule of Spanish conquerors for almost three centuries. You can see the remains of that era in the ruins of the historical buildings. Today, the City is very modern with tall skyscrapers and modern architecture.

The Philippines is developing into one of the top countries in the world for medical tourism. Approximately 15 million people globally travel to other countries in search of quality medical care at affordable prices. Manila is a favorite destination due to the following reasons:

• It provides state-of-the-art procedures at affordable prices.
• With excellent infrastructure, the City can handle the large numbers of foreigners who visit Manila.
• The Hospital and clinic staff are very competent, friendly, and educated and have a good knowledge of English to communicate with their patients.  
• The doctors are very well-qualified and hold international certifications.
• The city has a reputation in providing excellent post-surgical care by the nurses and physiotherapists.
• The Medical Industry provides many alternative therapies at some of the best spa resorts. You can combine a surgical procedure with alternative healing therapies at the same time.

Popular Areas in Manila

Manila Bay has many tourist spots and you will find many monuments that depict the Spanish occupation of the country. There are many Baroque Colonial Churches that will enable you to appreciate the artistic designs.

The National Museum of the Philippines, Bahay Chinoy, the National Art Gallery, and the Metropolitan Museum of Manila are some of the popular museums that you must visit in Manila. Rizal Park also known as Luneta is a historical urban park that is worth visiting.

There are also many organized tours that can help you get the best out of your sightseeing, for example, the Intramuros Tour, Rizal Park Tour, or the Skyscraper Gazing Tour and more.

Manila is a very modern contemporary city as the historical buildings have been replaced by modern architecture with better planning and layout and the buildings are earthquake resistant.

The city has many cultural and religious festivals throughout the year. There are plenty of shops, both big and small where you can buy branded goods at affordable prices.

Weather and Climate in Manila

The Philippines is a tropical country and in Manila, you will not experience too much temperature variations. January is the coolest month while May is the warmest month. The average temperature remains between 14°C and 38°C. The rainy season is between May and November. The rest of the months are dry. Manila is a humid city and bad weather such as Typhoons may occur during the months of June and September.

Getting around in Manila

People traveling from nearby countries such as Malaysia and Indonesia can use the City’s sea entry points. For all other passengers, the best option is to take the air route.

The Ninoy Aquino International Airport is the City’s major international airport. It has four different terminals that connect via bus transfers. If you are taking a connecting flight, remember to keep some time as a buffer, as transfers may force you to travel through the busy streets of Manila. Terminal 1 caters to International flights and Philippine Airlines uses T2 and domestic carriers and international carriers use T3 with budget carriers largely using T4.

You can take a bus from the airport to the city. Taxis have meters and you can hail a cab outside the airport. Buses and small vans or jeepneys are popular modes of transport within the city.

Manila has three light rail systems and one heavy train line. The light rail systems are the LRT-1, LRT-2, and MRT-3. You can also use the pedicabs and tricycles for shorter distances. In some areas, you can even find horse-driven carriages called calesa.

Tourist Visas in Manila

The visa process is not a very complex system as the Philippines has a visa waiver program for certain countries. All European nations, South American countries, and many others form part of this program. Citizens from these countries can stay in Manila for up to 30 days, whereas nationals from Brazil and Israel may stay in Manila for 59 days. Hong Kong, Macau, and Portugal residents can stay for 14 days without a visa. Tourists belonging to other countries need to apply for a visa to enter the Philippines, in the consulate in their respective countries.

You must also have a valid return ticket. Passport must also be valid for at least six months and beyond to stay in the country. Visa-exempt people may extend their stay by one or two months after which they will have to apply for a visa.

Additional Information

• The currency of the Philippines is Peso (symbol: ₱). It is strong in the world market and the usual exchange rate is 1 Dollar equals 50 Pesos. Dollars are easy to exchange compared to other currencies.
• Credit cards are acceptable in almost every place. The city also has many ATMs from where you can withdraw money without difficulty. However, ATMs will charge you a minimal exchange fee on foreign cards.
• Bargaining and negotiating are acceptable in most places and it can get you better deals.
• Restaurants may add a service charge of up to 10%. You can pay a cash tip of 5 to 10 %. People often round off the taxi fare.
• Manila is a city full of people who speak English proficiently. Filipino and English are the two official languages. Filipino is a variety of Tagalog, Austronesian languages.
• Hindu, Muslim, Buddhism, and Christian religions have left their mark on the Philippines at different periods. Today, a majority of the population is Roman Catholic.
• There are many public holidays in Manila. Some of the important ones are Christmas Eve, Christmas, Eid al-Fitr (Ramadan), Labor Day, New Year, and Good Friday, etc. The Independence Day falls on June 12th and Manila Day on 24th June.