If you have struggled with obesity for many years and have never been able to lose weight, you may be asking yourself, “Should I have weight loss surgery?” If you have a BMI of over 35, your metabolism, hormones, genetics, medical conditions, or medication may be making it impossible to lose weight with just diet and exercise alone.
Undergoing bariatric surgery may be the best solution to help you achieve a healthy weight, but it is important that you understand that there are weight loss surgery requirements that you must meet and a lifelong commitment involved to maintain your results.
You may have run across a “Do I qualify for bariatric surgery quiz” as you searched online for information, but this article will give you the information you need to determine if you will likely be a good candidate and the reasons why some people are disqualified.
Am I a Candidate for Weight Loss Surgery?
Being approved for weight loss surgery is a process, and normally, you cannot just decide to have gastric sleeve or gastric bypass surgery and then set it up for next week. Usually, there is a process that must be followed, and certain requirements must be met before a surgeon will perform a gastric sleeve, gastric bypass, or other form of bariatric surgery.
If your medical insurance is expected to pay for your bariatric surgery, you may need to fulfill different requirements than if you are a self-pay patient. Bariatric surgery normally comes with several layers of requirements that include the universally expected qualifications, the qualifications required by the surgeon, as well as requirements you will need to meet that are outlined by your medical insurance company.
How to Qualify for Weight Loss Surgery
Universal Bariatric Surgery Requirements
The basic requirements for all bariatric surgery include:
- Your BMI (body mass index) is at least 40 or above, or you are at least 100 pounds overweight, or
- You have a body mass index of at least 35 and suffer from a weight-related comorbidity like high blood pressure, sleep apnea, or type 2 diabetes, etc.
- You have put forth great effort to lose weight using different strategies, but have been unsuccessful.
Surgeon Bariatric Requirements
Surgeons are normally more focused on your safety and your long-term success in maintaining a healthy weight. Many of their requirements may overlap with those outlined by your medical insurance company, such as nutritional counseling and mental health clearance, but they may also have additional criteria, such as stricter smoking rules, extra lab work, or requirements for a pre-surgery diet and for you to meet certain weight loss goals before surgery, to ensure you are committed to making the necessary lifestyle changes.
Medical Insurance Bariatric Requirements
If you are relying on your medical insurance to pay for some or all of the costs for bariatric surgery, you will be required to meet certain criteria in addition to the basic requirements and the criteria set forth by your chosen surgeon. A typical list of bariatric surgery requirements that your insurance company may require includes:
- You must be at least 18 years of age.
- You must meet all the universal criteria for bariatric surgery.
- You must present documented proof that you have attempted weight loss through a structured program (like Weight Watchers or Jenny Craig) within the last two years for at least 6 months or two consecutive programs that were each 3 months in duration and done independently.
- You must be willing to submit to a psychological exam and demonstrate your willingness and dedication to making the necessary lifestyle changes needed to reach a healthy weight and maintain it.
Who Is Not Eligible for Weight Loss Surgery?
There are many things that doctors consider before approving someone for bariatric surgery, and not everyone is a good candidate. Some of the reasons that could disqualify someone from being able to undergo bariatric surgery include:
- Individuals with an active alcohol or drug abuse problem because there is a significantly increased risk for complications.
- Individuals with serious, untreated mental health conditions like severe depression, active psychosis, or eating disorders such as bulimia may be disqualified by their insurance company or their surgeon. The medical team needs to make sure the person can handle the emotional and psychological challenges that come with bariatric surgery recovery and the major life changes that must be followed long-term.
- Medical conditions, like heart or lung disease, advanced liver problems, or other serious illnesses that make anesthesia too risky, may disqualify you from being a candidate for weight loss surgery.
- Doctors also look at whether you can commit to the lifelong dietary and lifestyle changes that must be followed after bariatric surgery. If you do not have the ability or level of dedication to follow the strict nutrition rules or attend your regular follow-up appointments, bariatric surgery will not be successful for you and may lead to nutritional deficiencies.
- If you are pregnant, you are not a candidate for weight loss surgery, and if you are planning to become pregnant in the near future, it is recommended that you wait until at least 12 to 18 months after your surgery to try to conceive. It is critical that women who become pregnant after weight loss surgery work with their doctors and be under ongoing observation to ensure that both mother and baby get the nutrition they need.
There may also be instances where you do qualify for bariatric surgery and are initially approved for the procedure, but it may be cancelled or delayed if you do not follow the pre-surgery guidelines provided by your surgeon.
What If I Don’t Meet the Qualifications for Bariatric Surgery?
If you do not qualify for bariatric surgery, you may be a good candidate for a non-surgical procedure like a gastric balloon or prescription weight loss medication. When used together with changes to your lifestyle, like switching to a low-calorie diet, getting enough exercise, and nutritional coaching, both of these options can offer substantial results.
The knowledgeable bariatric surgeons at LESI can help determine the best weight loss solution for you and can create a custom plan that will help you achieve sustainable weight loss.
Most people are eligible for solutions that do not involve surgery, and they offer minimal downtime. If you are tired of trying to navigate weight loss on your own, set up a consultation with the Laparoscopic & Endoscopic Surgery Institute (LESI) and learn about the options we provide that can help you gain control over your weight and reach your goals. The expert weight loss team at LESI is ready to provide you with the strategies, tools, and support to improve your health.
Frequently Asked Questions
How Do I Know if I Qualify for Weight Loss Surgery?
If your body mass index is over 39 or you have a BMI of at least 35 along with chronic weight-related health issues like type 2 diabetes, high blood pressure, or sleep apnea, you will meet the most basic requirements for weight loss surgery. Some insurance plans will now approve bariatric surgery for people with a BMI of 30 or higher if they have chronic weight-related health conditions.
The best way to find out if you qualify for bariatric surgery is to speak with one of the skilled bariatric surgeons at LESI, who can evaluate your health and discuss your weight loss history and whether you are prepared to commit to permanent diet and lifestyle changes after surgery.
Is It Hard to Get Approved for Weight Loss Surgery?
Gaining the approvals needed to go forward with weight loss surgery is a process and can take time and require meeting several different requirements. You are often required to complete several months of supervised weight loss attempts, attend nutrition counseling sessions, undergo psychological evaluations, and complete medical testing before surgery.
Insurance carriers often also have strict requirements that you must meet before you can undergo surgery, which can make getting approved for bariatric surgery long and frustrating.
If you meet the medical guidelines and complete all the required steps, you have a good chance of being approved.
Can I Get Gastric Bypass if I Weigh 200 Pounds?
A knowledgeable bariatric surgeon will be able to determine if gastric bypass surgery is right for you. Everyone is different, and your eligibility for undergoing gastric bypass surgery will depend on your BMI, height, and the condition of your health in addition to your weight.
Someone who is 5 feet tall and weighs 200 pounds has a much higher BMI than someone who is 6 feet tall at the same weight. Your doctor will calculate your BMI, discuss your current health situation, and go through a number of evaluation steps to determine your eligibility for gastric bypass surgery.
What Is the Minimum Weight for Weight Loss Surgery?
There is no single minimum weight requirement for weight loss surgery because two people can weigh the same but have varying degrees of health, depending on how tall they are. Doctors use body mass index (BMI) as a more accurate benchmark to determine eligibility for weight loss surgery.
Usually, if your BMI is over 35 and you have other weight-related health conditions, you would meet the basic qualifications for weight loss surgery. Some non-surgical weight loss solutions may be an option for people with lower BMIs, and working with an expert weight loss doctor like those at LESI can help you find your best strategy.
Is 70 too Old for Weight Loss Surgery?
There is no maximum age limit for weight loss surgery, but the surgeon would carefully evaluate an older patient to ensure they were in good enough health to safely handle the surgery and be put under anesthesia.
