Are you a candidate?

Whether you are a candidate to undergo a bariatric surgical procedure is a two-part question. The answer to the first part is whether you meet some surprisingly simple medical criteria, and the answer to the second part is whether you are ready to make the type of sustained lifestyl change that will help you get the most out of surgery.

Surgeons and the medical community have agreed that, for the vast majority of patients who meet these simple criteria, bariatric surgery is a medically appropriate intervention. For most people in this category, the risk of surgery is much less than continuing to live with the excess weight.  The medical criteria to "qualify" for bariatric surgery are:

  1) Body Mass Index (BMI) > 40 (try the BMI calculator), OR

  2) BMI > 35, with at least one medical problem exacerbated by weight. Some examples of medical conditions that are understood to be caused or exacerbated by weight include:

  •     Diabetes (Type 2, or insulin resistant)
  •     High Blood pressure (Hypertension)
  •     Obstructive Sleep Apnea
  •     GERD (Reflux Disease)
  •     High cholesterol, High lipids
  •     Degeneration of the knees or other weight-bearing joints

For most people who meet the guidelines above, bariatric surgery makes sense from a medical and statistical standpoint.

BMI Calculator

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Being mentally prepared

The second part of the answer is a bit more complex. You must ask yourself: “Are you ready to make the commitment to lifestyle change that is needed to get the most success from a surgical procedure?” This is a question that can only be answered by each individual person. We believe that, in order to choose surgical treatment for your excess weight, you must have a strong sense of conviction that:

  1. the excess weight is causing medical harm in your case
  2. you have done everything that you reasonably can do without surgery to lose weight
  3. you are ready to change your relationship with food and exercise
  4. you are committed to engage in lifetime follow up

Other medical considerations

In order to be an appropriate candidate for surgery, there must be a good chance that the patient will do the things that he/she needs to do in order to be healthy and successful in the long run. The medical community calls this the ability to comply with medical recommendations, such as diet changes, follow up appointments, taking supplements, exercising regularly, etc. Most surgeons agree it is not proper to do surgery on patients who have an uncontrolled psychiatric problem, who have a profound lack of social support, who are very immature, or who suffer from mental retardation.

Surgery in teenagers is a controversial topic. It makes sense to intervene to reduce weight at a young age before the weight causes permanent physical or psychological damage. On the other hand, there are concerns about whether a young person has the maturity to properly understand and comply with the lifetime changes required by surgery. The surgeons at Acadiana Weight Loss have done surgery for a number of patients from 15-18 years of age; these are considered on a case-by-case basis.

Most surgeons do not do bariatric surgery in people older than about 60 years, because the risk of surgery tends to rise with increasing age. The usual age cutoff for Acadiana Weight Loss is 64 years, but if an involved physician feels that consideration of surgery is appropriate in an older person we are happy to consider this on a case-by-case basis.

Many surgeons, including those of Acadiana Weight Loss, believe that bariatric surgery can be sensible and reasonably safe for some people with a BMI between 30-35. This is a controversial area, in which we consider patients on a case-by-case basis. We are not aware (unfortunately) of any insurance company that supports bariatric surgery in this weight range.

Sometimes, a patient is suffering from medical problems that are so severe that they cannot undergo surgery. This situation is called 'prohibitive risk', and fortunately it is rather uncommon. No patient should decide or be told that they have prohibitive risk for surgery, unless they are given this information by a surgeon experienced in bariatric surgery.

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