Who Qualifies for Bariatric Surgery?

When considering bariatric surgery, one may wonder if they meet the requirements. There are several different things to consider when it comes to undergoing a bariatric procedure. And remember, having surgery isn’t the "easy way out." While having a bariatric procedure is the most helpful tool to lose weight, it is still just a tool. Every successful patient still puts in the effort to eat right, exercise, follow up with their surgeon, take their vitamins, and attend support groups to maintain weight loss.

Clinical guidelines are updated every few years to keep clinicians up to date on the best bariatric practices. Included is an explanation regarding who is a candidate for bariatric surgery. If an insurance has bariatric coverage, they develop their own criteria on what must be met to receive coverage. Your physician's office will most likely be able to give you details on your personal insurance, but it is always helpful to call and get the criteria yourself.

That said, patients who should be considered for bariatric surgery should:

• Have a BMI at or greater than 40 with or without a co-morbid condition
• Have a BMI at or greater than 35 with at least one co-morbid condition
• Co-morbid conditions include type II diabetes, high risk for type II diabetes, poorly controlled hypertension, obstructive sleep apnea, nonalcoholic fatty liver disease/ nonalcoholic steatohepatitis, hip and/or knee osteoarthritis, and urinary stress incontinence.
• Have a BMI of 30-34.9 and type II diabetes with poor glycemic control despite medications and lifestyle changes.

Using these guidelines, you should know if you meet criteria for surgery, but choosing the correct bariatric procedure can still be a challenge. Before you visit your surgeon's office, do your research on each procedure, and know with what you are and are not comfortable. The more educated you are going into that initial consult, the more questions you'll be able to ask, and the more confident you'll be looking forward to surgery. Some general guidelines to consider are:

• Individual goals
• Available expertise
• Patient preference
• Procedure able to be preformed laparoscopically

Choosing to have bariatric surgery is a big step in your weight loss journey. If you are not fully confident and comfortable with doing it, it's not the right time. There are several FDA-approved, non-surgical weight loss options you can consider.

Before making any decisions, take your time, do your research, and come up with the best plan for you!

References:

1. Bariatric surgery. National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/weight-management/bariatric-surgery. Accessed November 30, 2020.
2. Mechanick, Jeffrey I. “AACE/TOS/ASMBS/OMA/ASA 2019 Guidelines.” Endocrine Practice, vol. 25, no. 12, 2019, doi:10.4158/GL-2019-0406.GL.