Mexico

 You need to research getting weight loss surgery in Mexico.  There are some good surgeons there.  There are some surgeons whose results were mixed.

I also agree about the need for long term care.  

I'm amazed that no one has mentioned Dr. Aceves in Mexicali yet - so I will!  Do a search on here (search box in upper right corner) on Dr. Aceves, you'll see a lot of posts about how great the experience is.

One thing that I liked is that you're in an actual hospital when you go with Dr. Aceves - not a surgical center.  He uses Almater Hospital, very very clean and well-run from what I could see.  This is a question you may want to ask - what kind of facility is used for surgery and recuperation?  Are people moved to a hotel for post-op care?  I wanted to be in a hospital, where they would have IMMEDIATE access to emergency services, in the (unlikely) event I needed them.  As it turned out, my surgery and recovery were completely uneventful.

Good luck on your research!