Losing weight can be a difficult and disheartening experience. It’s even more challenging for overweight individuals, as their bodies actively work against them. They become resistant to leptin hormones that alert the body when you’re full and reduce your appetite. Once the body loses sensitivity to leptin, it can’t properly manage hunger cravings. Obesity can also make it impossible for individuals to burn enough calories from exercise to achieve sustainable weight loss.
Bariatric surgery combats these challenges to help people struggling with obesity to lose weight and keep it off. However, not everybody is eligible for bariatric surgery. People considering weight loss surgery have to meet the bariatric surgery requirements, much like any other surgical procedure.
The following are the bariatric surgery requirements that determine who’s a good candidate for a weight loss procedure:
- Have a BMI of 40 or higher
- Have a BMI of 35 or higher with comorbidities or medical conditions related to obesity
- Have a BMI of 30 or higher with comorbidities or medical conditions related to obesity if nonsurgical treatment options fail*
- Have a documented history of previous weight loss attempts that failed to achieve sustainable results
* The American Society for Metabolic and Bariatric Surgery (ASMBS) updated their bariatric surgery requirements in 2018 to include individuals with a BMI of 30 or greater, as they fall under class I obesity and can still experience health problems related to their weight.
ASMBS noted that gastric bypass and gastric sleeve procedures offer the greatest health benefits to people with a BMI of at least 30 who also have type 2 diabetes. However, they also noted that the final procedure decision remains between the surgeon and the patient, as everyone has a unique health profile to take into consideration.
However, the National Institutes of Health (NIH) only recommends weight loss surgery for individuals with a BMI between 30-34.9 if they have type 2 diabetes that they can’t control through medical treatments and lifestyle changes. Most insurance companies use NIH statements as guidelines for approving procedures, and they may not cover bariatric surgery for individuals whose BMI falls between 30-34.9 without type 2 diabetes specifically.
Contact us to schedule a consultation to learn more about the bariatric surgery requirements. We are also happy to help answer questions about your insurance to determine if you’re eligible for coverage.