If you’re just beginning to research bariatric surgery, the number and variety of the types of procedures may seem a bit confusing. That’s because hospitals and surgical clinics follow strict protocols in terms of which patients qualify for the different types of bariatric procedures, both for the safety of the patient and the prognosis for success.
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To begin with, let’s look at the medical guidelines. To qualify for the gastric sleeve, gastric bypass, or Lap-Band surgeries, you must:
- Be more than 100 pounds over your ideal body weight. To find out what an ideal weight is for your body, check the National Institute of Health’s weight table. Find your height in inches down the left side and then scan across that row – healthy weights for your height will be listed in the “Normal” columns. For example, if you are 5-foot 10-inches, that converts to 70 inches (5 x 12 + 10). The normal weights for 70 inches range from 132-167. A weight between 174-202 is considered overweight; 209-271 is considered obese; and 278-376 is morbidly obese.
- Your body mass index (BMI) must be 40 or higher. To figure out your BMI, enter your height and weight in our online BMI calculator. Those with a BMI of 19-24 are viewed as having a normal weight; a BMI of 25-29 is seen as overweight; a BMI of 30-39 is considered obese, and a BMI of 40-54 is considered extremely obese.
- Or, your BMI is 35 or higher and you have a serious weight-related medical issue. The American Society for Metabolic and Bariatric Surgery considers high blood pressure, type 2 diabetes, non-alcoholic fatty liver disease, osteoarthritis, lipid abnormalities, gastrointestinal disorders and severe sleep apnea among those issues.
- You are an adult between the ages of 18 and 60. Surgery can be done on some older and some younger people, depending on the individual situation. The guidelines exist because younger teenagers may not be disciplined enough to follow through on post-surgical lifestyle changes, and even if they are, weight-loss surgery can lead to malnourishment or bone loss, which could affect a growing teen’s physical development. On the upper end, guidelines exist because those who are older than 60 have higher levels of risk with surgical procedures. If you are older than 60, your doctor will help you determine whether the surgery is riskier for you than continuing to live at your current weight with any obesity-related medical issues.
- Multiple efforts in the past to lose weight through diet and exercise were not successful.
In addition, some patients may qualify for certain bariatric procedures if they have serious weight-related issues and a BMI between 30 and 34.
Please note: The requirements for the gastric balloon are different. Learn more about the gastric balloon procedure.
If you believe you may be a candidate for bariatric surgery, you will undergo an extensive medical and psychological screening before being approved. Your medical team may include a surgeon, nutritionist and a psychologist; their combined efforts are an attempt to determine:
- Your medical history and current physical condition, including any health problem that could be made worse by surgery (such as blood clots or heart irregularities)
- Your current nutritional state, which includes your dietary habits, your exercise habits, the medicines you take, whether you drink alcohol (and how much), and whether you smoke (and how much)
- Their prognosis for how well you will do after surgery
- Whether you have the right mindset to adapt to the tremendous changes in lifestyle that will be required after surgery
- Which type of gastric procedure is best for you to undergo
The psychological aspect is important
Some mental illnesses contribute to obesity or make it difficult to follow through with the maintenance required after weight loss surgery. These may include:
- Binge-eating disorder
- Substance abuse
- Anxiety disorders
- Depression
- Schizophrenia
- Severe bipolar disorder
Having one or more of these conditions doesn’t necessarily mean that you can’t have the surgery, but your doctor may want to postpone a procedure until they are certain you’ve been treated and that your condition is being properly managed.
What about insurance?
Most of the guidelines above are consistent with insurance company requirements. An insurance provider may also want to see a letter from your physician stating that the surgery is medical necessity, and/or proof that you completed a doctor-supervised diet for six months sometime within the last two years without success.
Are you interested in more information?
Dr. Naim and the staff at Soma Weight Loss are committed to your success. Please reach out if you have more questions about bariatric surgery or wish to schedule a consultation — call 855-SOMA-411 (766-2411) or contact us online. We are here for you!
Maiquel Soma
Maiquel has been helping patients understand their weight loss options at Soma Bariatrics for over two years. As the office manager, she is responsible for the paperwork that comes before and after surgery, as well as scheduling procedures and helping patients schedule consultation and follow-up appointments.