Whether you are considering Lap-Band, gastric bypass, or another form of bariatric procedure, the criteria for the surgery are generally the same. If you need to lose a small amount of weight, such as 20 or even 50 pounds, bariatric surgery will not be an option for you. Bariatric surgery is for individuals who are morbidly obese, meaning that their weight is life-threatening. Different insurance companies may have varying criteria for bariatric surgery; patients who are paying for the procedure out of pocket may be subject to more lenient requirements.
Body Mass Index
To qualify for bariatric surgery, a person must have a body mass index (BMI) of at least 40. Body mass index is a measurement used to compare a person's height and weight. BMI is calculated by dividing your body weight by the square of your height. A BMI over 40 is considered morbidly obese, while a BMI between 35 and 40 is Class I obesity. Individuals who qualify are usually at least 100 pounds overweight and/or twice their ideal body weight.
Co-Morbidities
A person with a BMI between 35 and 40 may qualify for bariatric surgery if one or more co-morbidities are present. Co-morbidities are conditions or illnesses experienced in conjunction with a primary condition or illness. In the case of obesity, many patients experience co-morbidities such as high blood pressure, diabetes, high cholesterol, sleep apnea, heart disease or even cancer. In many patients, treating the obesity will also improve or eliminate the co-morbidities.
Medical History
A patient must be over the age of 18 to quality for weight loss surgery. Usually, the patient must have a proven record of failing to lose weight by other means. Requirements for failed attempts at weight loss may vary depending on the insurance company, if insurance is being used to pay for the procedure. Some procedures may require that the patient has been obese for at least two and a half years, and that the patient's weight has been stable for at least one year prior to the surgery.
Exclusion Criteria
Some patients may have other conditions that could disqualify them from weight loss surgery, such as a hormonal or genetic condition that is responsible for the obesity. Other conditions such as congestive heart failure, advanced rheumatoid arthritis or severe reflux disease may make a patient ineligible for the procedure. Women who are currently pregnant or nursing do not qualify for bariatric surgery.
Psychological Evaluation
In some cases, patients may be required to undergo a psychological evaluation to be approved for bariatric surgery. Patients who have underlying psychological issues that have contributed to weight gain often experience what is known as addiction transference, in which the behaviors are manifested in other ways following surgery. Common behaviors following bariatric surgery are alcohol abuse, gambling, and compulsive shopping. In order to avoid the development of new compulsive behaviors, psychological counseling is recommended to first address the underlying issues.
