Getting approved for bariatric surgery is not an overnight process. It takes time to meet the qualifications and work on lifestyle changes to prepare for surgery. If you are thinking about pursuing bariatric surgery, it’s important that you follow the guidelines below to not only make sure that you qualify but also ensure that you get approved through your program and insurance company.
Criteria for weight loss surgery
In order to quality for bariatric surgery, you must have:
- A body mass index (BMI) > 35 with significant comorbidities, such as high blood pressure, high cholesterol, type 2 diabetes, sleep apnea, etc.
- BMI > 40
- BMI < 60*
Other qualifications
In addition to the above criteria, all patients wishing to have bariatric surgery must:
- Attend an initial seminar that explains the program and the bariatric surgeries available.
- Make sure your insurance covers bariatric surgery. PPG – Weight Management & Bariatric Surgery has an insurance coordinator available to assist patients.
- Individuals must have tried and failed other weight loss attempts.
- Age – <18 years or >65-70 years
- 18 years or older. Age limitations are based on current state of health and comorbidities; however, your insurance policy may have an age limit.
- Cannot be an active substance abuser (alcohol, drugs).
- Must be smoke-free for three months. Many insurance companies require a patient to be smoke-free for 3-6 months.
- Clinically significant mental health concerns will need to be controlled.
- Be cleared for surgery based on other medical conditions that might make surgery too risky. These will be assessed on a case-by-case basis.
Patients must also be compliant during the pre-operative evaluation process and cannot gain weight on the pre-operative program.
Required consultations
Before bariatric surgery, the following consultations are required by PPG – Weight Management & Bariatric Surgery program and/or insurance:
- Initial and follow-up consultation with the surgeon
- 3-6 months medically supervised weight loss
- Psychological evaluation
- Nutritional evaluation
- Fitness evaluation
- Upper Endoscopy (EGD)
Other consultations and clearances may be required by the surgeon to make certain that your surgery is safe, such as:
- Cardiac evaluation and clearance
- Pulmonary and/or sleep evaluation and clearance
*Not a standard at all programs.
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