Bariatric Surgery in Taiwan

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 Taiwan?

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 Taiwan 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 Taiwan

About Taiwan

Whilst still a part of the Republic of China, the small island of Taiwan maintains a wealth of ancient Chinese culture and traditions mixed with modern-day Western inspirations. With its food-loving locals and award-winning whiskeys, Taiwan is a land of surprises. With 14 JCI accredited facilities in Taiwan, Taipei, the capital, is home to most, many of which are part of the University Hospitals and offer a range of specialist tertiary care. The country welcomes an ever-increasing number of medical tourists each year, many of which travel for Bariatric Surgery procedures. Medical Tourists mostly travel from the mainland or from within the region.

Popular parts of Taiwan

Taiwan is one of the most densely populated countries in the world with 23.5 million inhabitants. The country has amazed tourists with its dynamic cities, vibrant culture, interesting history, and incredible natural scenery.

• Taipei is the capital of Taiwan. It is the financial, political, and cultural center of the country. The city is influenced by Chinese culture as well as Japanese, Southeast Asian, and American. There are many things to enjoy in this city, such as delicious food in Rahoe Night Market, enjoy a bird’s eye view of Taipei from Taipei 101 Observatory, visit the incredible Chiang Kai-shek Memorial Hall, and be inspired by the city’s many museums.
• Kaohsiung is Taiwan’s largest port. It’s an urban city that embraces its cultural venues. The most popular tourist destination is the Lotus Pond, a beautiful artificial lake filled with lotus plants and surrounded by temples. Tourists can also visit Pier-2 Art Center, see the Dome of Light, explore Cijin Island, or visit the Fo Guang Shan Monastery.
• Tainan, as the oldest city in Taiwan, has a fascinating culture and history. For historical sights, tourists can visit the Anping Fort, Anping Tree House, or learn Taiwanese embroidery. The city is now filled with quaint cafes tucked within the alleys.
• Hualien has breathtaking natural beauty. It’s the perfect place for tourists who want to get away from busy cosmopolitan cities. Visit the Eternal Spring Shrine, check out the popular Taroko Gorge, fall in love with Qingshui Cliffs, hike the Shakadang trail, and eat the amazing food.
• Taichung is a lively city located in the west-central part of the island. Taichung offers many unique things to see and do. National Taichung Theater will leave tourists in awe by its beautiful architecture. National Taiwan Museum of Fine Arts, Rainbow Village, Gomei Wetlands, Miyahara, and Fengjia Night Market are among the most popular tourist attractions.

Weather and Climate in Taiwan

• Spring starts in March and lasts until May. The average temperature is between 18°C and 24°C. Early rain showers and thunderstorms begin in this season. Heavy rainfall hit the island around mid-May.
• Summer can get extremely hot and humid with an average temperature of 27°C to 30°C. The season starts from June to August. Summer is also the wet season and typhoons are a real possibility especially in July and August. This is the peak season for tourism.
• Autumn has pleasant weather conditions. The rains decrease and the heat will drop. The season starts from September to November with an average temperature of 21°C to 27°C.
• Wintertime is from December to February and it is the coolest and driest season of the country. The average temperature drops to 16°C - 18°C.  

Getting Around in Taiwan

Taiwan Taoyuan International Airport is the main airport in the country, located about 40km west of Taipei in the Dayuan District, Taoyuan. It is the hub for 6 airlines including two of Taiwan’s major airlines, China Airlines, and EVA Air. It has international connections with almost every country in the world. The airport serves major airlines as well as budget airlines such as Air Asia, Eastar Jet, Air Busan, and Tiger air Taiwan. There are other airports that serve international and domestic flights such as Taichung Airport, Tainan Airport, Siaogang Airport, and Taipei Songshan Airport.

Tourists arriving at Taiwan Taoyuan International Airport have a variety of transport options such as buses, taxis, car rentals, and Taoyuan Airport MRT. Buses are the cheapest option to get to the city center. Tourists who head towards the Taipei 101 area should take Bus no. 1960, while bus no. 1819 and 1961 will take tourists near Taipei Main Train Station.

Taxis are available in Terminal 1 and Terminal 2’ arrivals lobby. The fare is based on a meter and will usually cost around 1,200 TWD (40.50 USD). A journey to the city center takes about 50 minutes and taxis operate for 24 hours.

Taoyuan Airport MRT is the fastest way to reach Taipei’s city center. It will take tourists to Taipei Main Station in 35 minutes and costs 160 TWD (5.40 USD). The MRT operates from 6.05 am to 11.35 pm.

Tourists can travel around Taiwan by normal train (TRA). It is an affordable option; a train ride from Taipei to Kaohsiung costs around 845 TWD. Tourists who need a quicker travel time can opt for Taiwan High-Speed Train (HSR). The train travels from Taipei to Kaohsiung in just 90 minutes.

The cheapest way to travel around Taiwan is by bus. Buses are readily available and will reach small villages and mountain resorts. The country provides Taiwan Tourist Shuttle bus system that offers 42 routes to more than 100 tourist destinations.

Taxis and MRT is the best way to travel around big cities. In Kaohsiung, getting around in a bicycle is the best way to explore as it is one of the most bicycle-friendly cities in Taiwan.

Tourist Visas in Taiwan

Citizens of 65 countries do not require a visa to visit Taiwan and can stay for up to 90 days. Nationals of Turkey can obtain a visa on arrival valid for 30 days. It is best to check to the nearest embassy or consulate for visa requirements. Since January 2016, Taiwan offers an eVisa program for 18 countries including Saudi Arabia, Peru, Oman, and United Arab Emirates.

Additional Information

1. Local Currency: The local currency is the New Taiwanese Dollar (TWD). 1 USD converts to 31.98 TWD.
2. Money & Payments: ATMs are widely available except in villages. They’re usually located in convenience stores and banks. Credit cards are accepted in hotels and top-end restaurants. Always carry cash because small stalls and night market joints only accept cash. Tipping is not mandatory but is still appreciated.
3. Local Language: The national language is Hakka, Mandarin, Taiwanese Hokkien, Matsu, Formosan languages, and sign language. English is common, especially in the tourism area. English is spoken more in Taipei.
4. Local Culture and Religion: Taiwan has diverse religious beliefs. Buddhism and Taoism are two of the biggest religion in the country followed by Christianity, Yiguandao, Tiandism, Miledadao, Zailiism, and Xuanyuanism.
5. Public Holidays: Taiwan celebrates Chinese New Year for a week in February. The country hosts several festivals such as Lantern Festival in February, Dragon Boat Festival in June, and Mid-Autumn Festival in September.