Do I qualify for bariatric weight loss surgery?

Qualifying for bariatric weight loss surgery primarily comes down to your BMI and overall health risks. You may be a candidate for bariatric surgery if you meet ONE of these criteria:

  1. Body Mass Index (BMI) 40 or greater
  2. BMI 35-39.9 along with ONE of these diseases: diabetes, high blood pressure, high cholesterol level, heart disease, obstructive sleep apnea, reflux disease and degenerative joint disease.

Learn more about different BMI ranges below.

Determination of the best approach to controlling weight and promoting weight loss is a complex process and should involve a discussion with your primary medical provider. The insurance industry and the federal government have recommended that we use a calculation called the “Body mass index (BMI)” to direct this process. This is a simple mathematic formula: Weight/Ht. x Ht., BUT, it is based on kilograms and meters, not pounds and inches.

BMI 19-25

Congratulations! Your weight indicates that you are maintaining a reasonably healthy lifestyle. There are no known medical issues directly related to weight in this range.

BMI 26-30

Be mindful of your diet and activity level. While there are no known medical issues directly related to weight in this range, you are considered “overweight”, and might benefit from a more careful diet to include protein sources (meats and dairy), vegetables (except potatoes, rice and corn), and fruit, while avoiding processed carbohydrates such as sugar-containing snacks and desserts, breads, pastas, chips and crackers.

BMI 31-35

Patients in this range are considered “obese” by insurance and government standards. You might need to consider a formal weight-control program such as Weight-Watchers or Jenny Craig. You should consider increasing your activity level (this will NOT produce weight loss, but may help prevent further weight gain). 

Federal guidelines will allow patients in this range to have a surgical adjustable gastric band placed, but you may have to pay cash for this. No insurance policies will cover this benefit at this relatively low weight range.

BMI 36-40

Patients in this range are at real risk of developing medical problems related to their weight — high blood pressure, diabetes, high cholesterol, and sleep apnea/sleeping disruption, just to name a few. 

If you haven’t developed any of these medical problems yet, you should consider starting a true weight control program. We can assist you with this at Mosaic Life Care at St. Joseph - Bariatric Care. It is important that you make a serious effort to get your BMI back under 35 at this point.

If, on the other hand, you have already developed high blood pressure, diabetes, or sleep apnea, you should consider surgical approaches to weight control, and promotion of weight loss. These include adjustable gastric band, gastric bypass, and sleeve gastrectomy — all are available at Mosaic Life Care at St. Joseph - Bariatric Care.

BMI 41-50

Patients in this range are considered by federal and insurance standards to have a medical problem called “morbid obesity”. This is NOT meant to be a term of prejudice at all.  It should serve as a “wake up call” that your weight is seriously affecting your health. 

High blood pressure, diabetes, high cholesterol, heart disease, sleep apnea/sleep disruption, arthritis in the neck, back, hips, and knees, liver disease, heartburn, and certain types of cancer, are sure to follow, if nothing is done. And the only effective method for weight control for patients in this category is surgery: adjustable gastric band, gastric bypass and sleeve gastrectomy. The good news, if there is any, is that any of these can be accomplished by “scope surgery”, and all are available at Mosaic Life Care at St. Joseph - Bariatric Care.

BMI 51-60: Patients in this range are sometimes referred to as “super-obese”. If you are in this range, your health status is in serious danger. And your options for treatment are becoming fewer. 

Some of the surgical approaches for patients in this category are not extremely effective. Many patients in this category will struggle to get their BMI under 35 even if they have an adjustable gastric band inserted, or have sleeve gastrectomy — even gastric bypass may not prove effective. 

But that makes it even MORE important that patients in this category seek surgical help as soon as possible. A good response from surgery can make you much healthier, and possibly extend your life by several years.

BMI over 60: Patients in this range are felt to have a terminal illness. Without appropriate surgery for this problem, patients will invariably develop high blood pressure, diabetes, high cholesterol, sleep apnea/sleep disruption, arthritis in the back, hips, and knees, liver disease, and are at significant risk for development of cancer of the breast and uterus (women), prostate (men), as well as cancer of the esophagus, stomach, pancreas, kidneys, and large intestine. 

When the weight is at this level, patients will find that many hospitals will not be willing to consider surgery for weight control. Here at Mosaic Life Care, we recognize the serious nature of your problem, and will cooperate as much as we possibly can to help you reverse your problem with your weight.

A note about BMI in active people: 

The BMI calculation is not a perfect method for demonstrating weight problems. Some very healthy people, who are very physically active, can have remarkably high BMI’s. An example would be a professional athlete or trainer, who can be extremely healthy, but because of muscle development, can show a BMI up to 35-40! In that circumstance, further information can be gained by measuring the waist line (half-way between the rib cage and the hip bones). Men should try to keep this measurement below 36”, and women should try to keep this measurement below 33”. Another easy check is to try to keep your waistline measurement at less than half of your height!

Learn more about Mosaic Life Care at St. Joseph - Bariatric Care.

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