Are you a candidate for weight loss surgery?
First things first. Not everyone is a candidate.
Start by consulting with the medical professional that knows you best, usually your internist or primary care physician. Discuss your weight, general health, personal concerns, and diet and exercise history. If your doctor agrees that you are morbidly obese and have been so for some time, ask him or her for a referral to our bariatric center for an evaluation of your qualification for gastric bypass surgery.
As a pre-condition for surgery, most bariatric surgeons and insurers will want detailed information that documents that you have been unsuccessful at achieving sustained weight loss using other methods. You may need to compile your medical records, a list of all medications you are taking or have taken, your diet history, and the letter referring you for surgical evaluation.
It's critical that your risk of serious co-morbidities, and their accompanying complications, be great enough to outweigh the potential complications of the procedure you choose. In considering the appropriateness of surgery, the bariatric surgeon should follow the standards and guidelines set by the National Institutes of Health (NIH).
The NIH says a candidate should:
- be at least 100 pounds over ideal body weight
- have a Body Mass Index (BMI) of 40 kg/m2 or greater
- or have a BMI over 35 kg/m2 along with significant co-morbidities such as:
- diabetes
- sleep apnea
- hypertension
- cardiovascular disease
- or have a BMI over 35 kg/m2 along with significant obesity-induced physical problems which severely interfere with the ability to do things such as:
- walking
- working
- caring for your family
- have no significant contraindications to surgery
Some insurers also require a psychological evaluation. This investigates whether a prospective patient has a clear understanding of the risks and benefits of surgery and a realistic assessment of the personal outcomes, as well as the motivation and discipline necessary to follow the necessary post-operative routine. If you are not willing to learn new dietary habits, for example, you may jeopardize your success in losing weight and incur considerable discomfort.
... more on deciding if surgery is right for you
Copyright 2005
Professor Rudolf Weiner, MD
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