Everything You Need to Know
Living with obesity is not simply a matter of willpower or lifestyle choices – it is a complex, multi-faceted medical condition that affects every system in your body, from your heart and joints, to your hormones and mental health. For many people, diet and exercise alone are not enough to achieve sustainable, healthy weight loss. That is where bariatric surgery comes in.
At the Hilton Bariatric Unit, situated at Life Hilton Hospital in Pietermaritzburg, KwaZulu-Natal, our multidisciplinary team leads the way in bariatric practice across South Africa. In this guide, we answer the most common questions patients ask – so you can make an informed, confident decision about your health.
What Is Bariatric Surgery?
Bariatric surgery is a collective term for surgical procedures designed to help people with severe obesity lose weight by making changes to the digestive system. At the Hilton Bariatric Unit, the procedure we perform is the Roux-en-Y Gastric Bypass (RYGBP) – widely regarded as the gold standard for long-term, durable weight loss.
During a Roux-en-Y Gastric Bypass, the surgeon creates a very small stomach pouch by stapling across the upper portion of the stomach, and then reconnects the digestive tract to bypass a portion of the small intestine. This limits how much food you can eat, reduces hunger-related hormones, and produces powerful metabolic changes – including significant improvements in insulin resistance and blood sugar regulation.
The procedure is performed laparoscopically (keyhole surgery), meaning smaller incisions, less pain, and a faster recovery compared to open surgery. This technique has been the standard of care since the mid-1990s.
- A note on other procedures: Some bariatric centres offer gastric sleeve or gastric banding procedures. At the Hilton Bariatric Unit, we seldom perform sleeve operations and never perform gastric banding. Our focus is on delivering the best long-term outcomes for our patients, and the Roux-en-Y Gastric Bypass consistently achieves this. Learn more on our Surgery page.
Who Qualifies for Bariatric Surgery?
Internationally accepted guidelines generally recommend bariatric surgery for adults with:
- A Body Mass Index (BMI) of 40 or above, or
- A BMI of 35 or above with one or more obesity-related conditions such as Type 2 diabetes, high blood pressure, sleep apnoea, or joint disease.
- A history of not achieving lasting results through diet, exercise, or medical management.
Every candidate at the Hilton Bariatric Unit undergoes a thorough, individualised assessment by our full multidisciplinary team before any approval for surgery is given. There is no one-size-fits-all approach – your health, history, and goals all matter.
Is Bariatric Surgery Safe?
This is one of the most important questions we receive – and the answer is: yes, when performed by an accredited, experienced team, bariatric surgery is safe.
Laparoscopic Roux-en-Y Gastric Bypass is a complex procedure, but it is performed routinely by specialist surgeons with the right training, equipment, and clinical environment. The Hilton Bariatric Unit, under Dr Henry van Niekerk as Principal Surgeon, holds full accreditation through SASSO (the South African Society for Surgery of Obesity) and operates within Life Hilton Hospital’s world-class infrastructure. View our Accreditations.
Like all surgical procedures, bariatric surgery carries risks – including bleeding, infection, and anaesthetic complications. This is precisely why our patient selection process, pre-operative preparation, and post-operative care are so thorough and why our team includes a dedicated anaesthetist, endocrinologist, dietitian, and psychologist.
Does Weight Loss Surgery Actually Work?
The evidence is clear: bariatric surgery is the most effective long-term treatment for severe obesity. Patients can generally expect:
- Significant weight loss of 5–7 kg per month for the first 6 months post-surgery, tapering thereafter as the body finds its new equilibrium.
- Marked metabolic improvements, including remission or significant improvement of Type 2 diabetes, often before major weight loss even occurs.
- Improvements in blood pressure, sleep apnoea, joint pain, fertility, energy levels, and overall quality of life.
You may have heard stories of people regaining weight after a few years. It is important to look at the full picture: sustained results depend on ongoing nutritional support, regular follow-up, and psychological engagement. This is why lifelong support is built into the Hilton Bariatric Unit’s patient journey – because surgery is a powerful tool, but it works best as part of a comprehensive, supported programme.
What Is the Patient Journey at the Hilton Bariatric Unit?
Our programme is designed to support you before, during, and long after your surgery. There are four key phases:
- Consult
You will be seen by all principal members of the bariatric team – Dr Andrew van der Walt (Endocrinologist), Dr Henry van Niekerk (Bariatric Surgeon), Delia Miranda (Clinical Psychologist), and Fran Steart (Clinical Dietitian). Comprehensive evaluations, blood tests, an ECG, and a sleep study are conducted. The team then meets to discuss your case and determine approval. - Preparation
Once approved, a surgery date is scheduled – typically around three months later to allow time for dietary preparation and medical optimisation. An appointment with the anaesthetist is made 2–3 weeks before surgery. For those with medical aid, a motivation is submitted at this stage. - Hospitalisation
Surgery takes place during a 2–3 day hospital stay at Life Hilton Hospital. After the procedure, you are encouraged to mobilise early and, when ready, you are discharged home. - Recovery and Long-Term Support
After approximately 6 weeks, patients progress to normal, healthy small meals eaten 6 times per day. Long-term nutritional monitoring, vitamin and micronutrient supplementation, and psychological support continue for life – because the improvement in quality of life from durable, long-term weight loss is the reason patients choose this journey.
Learn more about our Patient Journey.
How Much Does Bariatric Surgery Cost in South Africa?
A full schedule of costs is available on request from Dr Van Niekerk’s rooms — please email denise@hiltonsurgeon.co.za to request it.
Does Medical Aid Cover Bariatric Surgery?
Only a limited number of medical aids in South Africa provide cover for bariatric surgery. When they do, this typically covers a portion of the total costs, meaning a co-payment may still apply. Our team can advise you on how to motivate your case to your medical aid provider — and importantly, medical aids will only consider funding surgery performed at an accredited unit, which the Hilton Bariatric Unit is.
What If I Need Private Funding?
Our trusted funding partner, Medifin, offers flexible financing options for patients who require assistance with the costs of surgery. Visit medifin.co.za or contact our rooms for more information on what may be available to you.
Explore Funding Options.
What Are the Long-Term Results?
At the Hilton Bariatric Unit, our patients’ stories speak for themselves:
- Bianca reduced from a size 26/24 to a size 14 in just one year post-surgery.
- Howard and Megan Nicol described the surgery as giving them “a second chance.”
- Vigeshree attended her two-year annual check-up feeling stronger, healthier, and full of hope.
Long-term success is built on three pillars: the right surgical technique, lifelong nutritional support, and ongoing psychological care. Our team is committed to all three.
Why Choose the Hilton Bariatric Unit?
At the Hilton Bariatric Unit, our patients’ stories speak for themselves:
- Specialist multidisciplinary team – surgeon, endocrinologist, psychologist, dietitian, and anaesthetist working together
- SASSO-accredited at Life Hilton Hospital, Pietermaritzburg
- Gold-standard procedure – Roux-en-Y Gastric Bypass performed laparoscopically
- Holistic, whole-patient approach – addressing obesity as the complex, chronic disease it is
- Real patient outcomes backed by case studies and testimonials
- Flexible private funding available through Medifin
- Lifelong post-operative support to help you sustain results for life.
This article is for informational purposes only and does not constitute medical advice. Please consult with a qualified healthcare professional to discuss your individual circumstances.
Frequently Asked Questions About Bariatric Surgery
What procedure does the Hilton Bariatric Unit perform?
The Hilton Bariatric Unit primarily performs the Roux-en-Y Gastric Bypass (RYGBP), which is considered the gold-standard bariatric procedure for sustainable, long-term weight loss and metabolic improvement. Sleeve gastrectomy is seldom performed, and gastric banding is not offered.
How long is recovery after bariatric surgery?
Most patients are discharged from hospital within 2–3 days after laparoscopic surgery. After approximately 6 weeks, patients are able to eat normal, healthy small meals and resume most daily activities. Your surgeon and dietitian will provide a recovery plan tailored to your specific circumstances.
Will I need to follow a special diet after surgery?
Yes, and it is a critical part of your long-term success. You will follow a staged eating plan under the guidance of our Clinical Dietitian, Fran Steart — progressing from liquids to soft foods to small solid meals eaten regularly throughout the day. Long-term vitamin and micronutrient supplementation is also required due to changes in nutrient absorption.
Can bariatric surgery improve Type 2 diabetes?
Bariatric surgery — particularly the Roux-en-Y Gastric Bypass – produces powerful metabolic changes that often lead to remission or significant improvement of Type 2 diabetes, sometimes even before substantial weight loss has occurred. Our Endocrinologist, Dr Andrew van der Walt, monitors your metabolic outcomes closely throughout your entire journey.
Do I need psychological support for bariatric surgery?
Yes — psychological readiness is treated as seriously as physical readiness at the Hilton Bariatric Unit. Our Clinical Psychologist, Helen Jones, works with every patient before and after surgery to ensure emotional preparedness, address psychological aspects of eating behaviour, and support long-term mental well-being through what is a life-changing process.
How do I take the first step?
Contact our rooms to schedule an initial consultation. Our friendly team will guide you through everything you need to know.
📞 033 329 5764 📧 denise@hiltonsurgeon.co.za 📍 Suite G10, Life Hilton Hospital, 1 Monzali Drive, Hilton 🕐 Mon – Fri: 8am – 5pm
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