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Global bariatric tourism

Global bariatric tourism driven by price and accessibility

92 surgeons responded to the survey who performed 18,001 procedures in 2017, 64 revealed they operated on foreign patients performing 3,740 operations

Global bariatric tourism accounts for at least 2% of worldwide bariatric procedures and is driven by affordability and long waiting lists, according to researchers from Poland, Mexico, the USA and the UK. Interestingly, Mexico, Lebanon and Romania dominate as destinations for patients mainly from the USA, UK and Germany.

The paper, ‘Current Practice of Global Bariatric Tourism—Survey-Based Study’, published in Obesity Surgery, reported on the experience of bariatric surgeons with medical tourism on a global scale through an online-based survey who were members of the International Bariatric Club (IBC).

The survey examined:

  • surgeon’s country of practice,
  • number and types of bariatric procedures performed
  • number of tourists treated
  • costs of treatment
  • tourists’ countries of origin
  • follow-up provided for patients
  • complications; and
  • reasons for travel

In total, 92 surgeons responded to the survey who performed 18,001 procedures in 2017, 64 revealed they operated on foreign patients performing 3,740 operations.

The majority of the respondents practice in India (n=11.17%), Mexico (n=10.16%) and Turkey (n=6.9%) with the most number of bariatric surgeries for tourists performed in Mexico (2,557 procedures) performed in 2017. The most frequent procedures provided for tourists were laparoscopic sleeve gastrectomy (LSG) provided by 89.1% of the respondents, laparoscopic Roux-en-Y gastric bypass (40.6% of respondents) and one anastomosis gastric bypass (37.5% of respondents).

The reasons for foreign patients choosing bariatric tourism, were cost (54.7%, the high cost of private sector bariatric surgery in the patients’ country of origin), long waiting list in public sector (42.2%), the respondent’s global recognition (35.9%), lack of insurance coverage (37.5%) and lack of bariatric healthcare in the country of origin (31.2%).

Regarding where the patients came from the authors reported that in the Americas, most participants came to Mexico from the US and Canada. In Europe, Turkish responders operated mainly on patients from Germany, Iraq, USA, and Canada. The most frequently mentioned European tourists came from the UK.

The mean estimated cost of surgery was US$7,760 USD (US$4,035±), although the price of surgery was reported as low US$2,300 for a sleeve gastrectomy in Egypt and US$2,500 in Turkey. The authors noted that there was a weak positive correlation between GDP per capita and the estimated cost of the bariatric procedure (p<0.001).

Forty-nine surgeons (77.8%) maintained follow-up of for three months, but only eight (12.7%) maintained it only until stitches/clips were removed, with 45 bariatric specialists (72.6%) recommending follow-up by a bariatric team in the country of origin.

Fourteen (22.2%) surgeons reported complications that included venous thromboembolism (n=5, 7.8%) and gastric/anastomotic leak (n=5, 7.8%), ileus (n=3, 4.7%) and internal bleeding (n=3, 4.7%) (Table 3).

“When we applied our results to the global number of bariatric procedures, we estimated that at least 1.9% of all worldwide obesity surgeries were performed for bariatric surgery tourists. The percentage may be higher, but as we were not able to reach every surgeon providing such services for foreign patients we cannot know for sure,” the authors concluded. “…Further research regarding domestic complications of homecoming bariatric tourists may provide answers to pending questions regarding this topic.”

To access this paper, please click here

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