When considering bariatric surgery, you may wonder whether you meet the requirements. There are several things to consider before having a bariatric procedure. And remember, surgery is not the "easy way out". While 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 their weight loss.
Key takeaways
- Guideline criteria: BMI ≥ 40, BMI ≥ 35 with at least one co-morbid condition, or BMI 30–34.9 with poorly controlled type 2 diabetes.
- Insurers or health systems may set their own criteria – check yours.
- Research each procedure before your first consultation.
Clinical guidelines and coverage
Clinical guidelines are updated every few years to keep clinicians up to date on the best bariatric practices, including who is a candidate for bariatric surgery. Insurers that cover bariatric surgery develop their own criteria that must be met to receive coverage. Your physician's office will most likely be able to give you details about your insurance, but it is always helpful to contact your insurer and get the criteria yourself.
Who should be considered for bariatric surgery?
Patients who should be considered for bariatric surgery:
- have a BMI of 40 or more, with or without a co-morbid condition;
- have a BMI of 35 or more with at least one co-morbid condition;
- have a BMI of 30–34.9 and type 2 diabetes with poor glycaemic control despite medication and lifestyle changes.
Co-morbid conditions include type 2 diabetes, high risk of type 2 diabetes, poorly controlled hypertension, obstructive sleep apnoea, non-alcoholic fatty liver disease/non-alcoholic steatohepatitis, hip and/or knee osteoarthritis and urinary stress incontinence.
Choosing the right procedure
Using these guidelines, you should know whether you meet the criteria for surgery, but choosing the right bariatric procedure can still be a challenge. Before you visit your surgeon, research each procedure and know what you are and are not comfortable with. The more informed you are at your initial consultation, the more questions you can ask and the more confident you will feel about surgery. General factors to consider:
- Individual goals
- Available expertise
- Patient preference
- Whether the procedure can be performed laparoscopically
Choosing bariatric surgery is a big step in your weight loss journey. If you are not fully confident and comfortable with it, it is not the right time. There are several 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 together with your doctor.
Sources
- Bariatric surgery. National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/weight-management/bariatric-surgery. Accessed 30 November 2020.
- Mechanick JI. AACE/TOS/ASMBS/OMA/ASA 2019 Guidelines. Endocrine Practice. 2019;25(12). doi:10.4158/GL-2019-0406.GL
This article is for general information only and does not replace personal medical advice. Always discuss your situation, blood test results and supplementation with your bariatric team or healthcare provider.