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BEFORE & AFTER: Garrett Roche from Shanballymore showing how he looked before his weight loss surgery and after. He has lost six stone since having the surgery done in September.

"The best decision of my life" is how Shanballymore man Garrett Roche describes the gastric sleeve surgery he had in Bruges in Belgium in September.

Back at home with his wife Carima and their two young children and six stone lighter already, Garrett, who says he'd been heavy all his life, declared, "I should have done it years ago."

The surgery, in which part of his stomach was removed, was done under anaesthetic in around 40 minutes, Garrett explains. Five 1cm incisions were made. He was discharged from hospital the day after and stayed for a further day in a hospital in Bruges. He had the surgery on a Monday and returned home on the Wednesday. There was some discomfort on the Tuesday, Garrett remembers, but not as much pain as he'd anticipated.

Getting a taxi from Dublin airport, the driver asked Garrett where he'd been on holidays, assuming he'd been relaxing somewhere nice, he looked so well! Instead, Garrett explained the reason for his trip to the amazed taxi man.

At home, Garrett had to adjust to eating much smaller amounts. In the first four days, he says, it'd take him half an hour to eat a pot of yoghurt. Now, he says, half a side plate will fill him.

"I have a sensation of fullness after I eat a small amount. I don't feel hungry at all." In the process of the operation, the amino acid hunger-stimulating peptide and hormone Ghrelin, produced by cells lining the stomach, were removed.  

Garrett says he still got to enjoy some of his favourite foods over Christmas, just not in anything like the quantities he would have eaten previously.

He had intended exercising post-op, to boost his weight loss. He didn't start though. "I was worried that I would lose weight too fast if I did," he explains, saying he was losing at the rate of a quarter stone a week. It's slowing down now though so he does intend embarking on an exercise programme.

Garrett was 22 stone when he had the operation. With six off, he says he'd be happy to lose two more. He'd been told he had a metabolic age of 51. He's 36. Now, for the first time in ten years, he says, he's been taken off the medication he was taking for hypertension and cholesterol and is no longer pre-diabetic. "I'm on no medication for the first time in ten years," he points out.

Garrett says that, with a Body Mass Index (BMI) of 42, he wasn't considered, under Irish regulations, big enough for the surgery. Frustrated at the long waiting lists for public patients to have the surgery in Ireland, and conscious of the cost of having it done privately here, he researched  options and discovered the 1,200 bed  AZ Sint-Jan Hospital in Bruges and Dr Bruno Dillemans, a specialist he says is highly respected among his peers and in the field. Practised in the surgery, using advanced keyhole and laparoscopic surgical techniques, Garrett says Dr. Dillemans "Literally wrote the book on weight loss surgery."

Not only was the surgery much faster in Bruges than the type of surgery carried out in Ireland, Garrett says, it was much cheaper, costing him €7,200 in total, half what it does here, he says.

Garrett's own battle with his weight, led to an interest in weight management generally and he had begun championing the overseas surgery option before he had his own operation, after discovering the obesity surgery expert Dr Dillemans. He set up his own referral service, www.internationalsurgerygroup.co.uk to advise people on overseas weight loss surgery. The group gives advice to people on their options and can refer them to Dr Dillemans, taking a referral fee.

After a time Garrett says he felt it was only right that he would get on with his own weight loss surgery. He wanted it for himself and, he felt, it would add credence to his group to be able to have the benefit of personal experience.

The usual checks are made on people prior to surgery to determine their suitability. Surgery won't be approved for any patient Dr Dillemans doesn't think is a suitable candidate. Patients must also adhere to a quite strict dietary regimen pre-surgery and must be in the right state of mind psychologically.

Up to now, health insurers were unwilling to fund the cost of surgery done overseas, but there was a breakthrough recently, Garrett reports, when Cork-based Laya Healthcare, signed off on 90% of the funding for a patient to have the surgery done. It's a step in the right direction, Garrett believes, and one which he's hoping will be copied by other health insurers.

He wrote to the Minister for Health last year asking him to visit the hospital in Bruges and see the surgery being done there but the Minister declined and also declined to send an envoy. Garrett thinks that's short-sighted, when surgeries that could change people's lives could be done at less cost to the State which would in turn shorten the long waiting lists for the surgery here and help alleviate the health problems obesity brings, not to mention the savings that could be made on medication used to treat them.

There has been one other very positive development though for Garrett's referral service and that's the news that global healthcare products company Covidien is supporting it financially.

He handles referrals for people in the UK and Ireland and, on Monday, when he spoke to The Avondhu, he'd had four, two from Ireland and two from the UK.

While steering his growing business, Garrett is still relishing the benefits of his own recent weight loss. He got a real kick out of being able to run up to the house in Doneraile Park after his children while there recently. It was something the heavier Garrett wouldn't have been able to do. As 2014 begins, the Shanballymore man has a lot to look forward to.

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