“Medicare” is actually composed of 14 systems – one delivered by each of the provinces, territories and federal government. Most provide coverage for certain bariatric surgical procedures.
The wait time for bariatric surgery in the public healthcare system can be quite long. Prior to the COVID-19 pandemic wait times were a minimum of 3 years in some provinces from the time your doctor referred you to a bariatric clinic to the time you will have surgery. Since the pandemic, many hospitals have had to postpone elective surgeries to free up hospital beds, thus prolonging the wait times for bariatric surgery. These wait times are unacceptable for many people living with obesity and its comorbidities every day. To learn about the pre-pandemic wait times in your province, see the table below.
|Provinces||Wait Time between Referral and Surgery|
|British Columbia||3 years|
|Alberta||2.5 – 3 years|
|Saskatchewan||3.5 – 4 years|
|Ontario||2.5 – 3 years|
|Quebec||2.5 – 3 years|
|New Brunswick||5 – 8 years|
|Nova Scotia||9 years|
|Newfoundland and Labrador||1.5 years|
*Adapted from Obesity Canada-Obésité Canada. Report Card on Access to Obesity Treatment for Adults in Canada 2019. Edmonton, AB: 2019, April.
If you are ready to self finance your surgery you can have your surgery done in 4-6 weeks, the time required to prepare you for safe surgery. In some cases, the surgeon may ask you to obtain additional tests, such as a sleep study to determine if you have sleep apnea. In some cases this may delay surgery by an extra 1-2 weeks.
The total time in the surgical theatre is about 2 hours. This includes 60-75 minutes of actual surgery time (what surgeon’s call “skin to skin”) and the rest of the time is nursing preparation and anesthesia (going to sleep and waking up) time. An additional 2 hours may be spent in the post anesthesia recovery area before patients return to the ward.
Laparoscopic gastric bypass patients stay in our hospital for 2 days after surgery and vertical sleeve gastrectomy patients stay for 1 day. Rarely, if the surgeon wants to monitor you he may keep you in hospital for an extra day at no additional cost to you.
You will be followed by the surgeon, nurse, and dietitian for the first 3 months after surgery, and the dietitian will continue follow-up with you until 6 months after surgery.
We recommend 4 weeks off of work in order to fully recover from your surgery and to be able to hydrate and eat well enough to sustain yourself throughout the day. However, for some people who work desk jobs, they may be able to return to work within 1-2 weeks from surgery if they choose.
You will be asked to avoid contact sports for 4 weeks. You can do long walks for the first 4 weeks, then you can do any activity as long as it does not hurt. Patients are strongly encourage to do regular physical activities to achieve and to maintain good weight loss.
Walk as much as you can without becoming tired during the first four weeks after surgery. Eventually, you might try to set step count goal for yourself and try to improve on this weekly. All patients are strongly advised to start a regular training program in order to maximize their weight loss, reduce muscle loss, and maintain the weight lost over time.
The weight loss occurs over the course of 1 year after surgery with the most and fastest part of the weight loss occurring in the first 6 months after surgery. The surgeon can provide you with an estimate as to how much weight you may be able to lose based on statistics. Bariatric surgery is a tool, and like all tools, if used incorrectly they may not produce the complete effect that was anticipated. Weight regain is always possible after surgery, however in most cases this occurs when an individual does not maintain the dietary and lifestyle habits that are recommended lifelong. In other less frequent situations, weight regain may occur due to an imbalanced thyroid or due to certain medications. This is why it is important to be followed by a general practitioner lifelong after surgery, even if your health has improved.
Can I expect to live a normal life after this operation without constantly worrying about secondary problems?
Most patients report a remarkable improvement in the quality of life after they lose most of their excess weight. Certain associated medical conditions like type II diabetes, high blood pressure, sleep apnea, and stress incontinence improve or disappear after this weight loss. On the other hand women usually develop chronic anemia due to insufficient iron after this operation. This can be avoided by taking the recommended supplements and post-operative follow-up. In a very small number of people, it’s possible that a hernia may develop at any moment of your life after surgery.
I have already had bariatric surgery but have regained some weight. Do you offer revisional surgeries?
While we do offer revisional surgery, each person must be assessed on a case by case basis to determine if revisional surgery will produce further weight loss. In some cases you may be advised to work with a dietitian specialized in bariatric surgery. You may be asked to have some tests done in order to assess the anatomy and integrity of your surgery before a decision is rendered.