Candidates for weight loss surgery

Body mass index (BMI) is a measure of body fat based on height and weight that applies to adult men and women.

You may be a good candidate for bariatric surgery if:

• You are 75 or more pounds heavier than your healthy body weight
• You have a BMI of 35-39 or greater and have serious health problems, such as diabetes or heart disease, caused by excess weight
• You have a BMI of 40 or greater
• You have tried other medically managed weight-loss programs without success
• You are motivated and committed to the lifelong post-operative care and lifestyle changes that bariatric surgery involves

You may not be a good candidate for bariatric surgery if:

• You have ongoing substance abuse, drug or alcohol addiction issues
• You have an uncontrolled mental illness
• You have a significant eating disorder
• You are unwilling or otherwise unable to comply with the necessary guidelines following bariatric surgery

Check your BMI

Mental health issues and bariatric surgery candidacy

Having depression or any other behavioral health illness does not disqualify you from having weight loss surgery. But having any untreated mental illness or other untreated addictions can cause you to be unsuccessful in your weight loss goals after weight loss surgery. By identifying these early on and getting treatment you will be able to add these resources to your support system.

Once you know your BMI, the options below can help you plan the next step in your weight loss journey.

BMI between 25-29

• Attend a non-surgical weight loss information class
• Participate in a community weight loss class
• Schedule an appointment for personalized health and diet coaching with a registered dietitian
• Schedule an appointment for a health evaluation with a primary care physician who specializes in weight management and who can help determine if you are a good candidate for weight loss medications

BMI between 30-34

Take the above steps and:

• Attend a seminar or talk to a bariatric surgeon to learn more about gastric band surgery, which is an option for those who have a BMI greater than 30 if you have certain other medical conditions
• Talk with your provider about medical weight loss programs to help you satisfy your insurance requirements prior to surgery, if applicable

BMI between 35-39

Take the above steps and:

• Learn about all types of weight loss surgery, especially if you have another medical condition, such as diabetes, sleep apnea or high blood pressure

BMI greater than 40

Take the above steps and talk to your doctor about the combination of nonsurgical and surgical options that may be right for you.

To determine if you are a candidate for weight loss surgery, you will need to undergo a psychological and nutritional evaluation. Although these are designed to determine if you qualify for the surgery, they are also intended to give you the information you need to make an informed decision as well. This includes helping you understand what to expect after surgery.

Psychological evaluation

The main goal of a psychological evaluation is to pinpoint the most difficult times for you and to give you strategies to deal with these situations when they occur in the future. It is not the goal of the evaluator to deny or "fail" a patient. They simply want to see you succeed in your weight loss goals. Additionally, most insurance companies require an evaluation and recognize its importance in your success.

Factors of the psychological evaluation

Your social worker or psychologist will be evaluating:

• Your understanding about realities and risks of surgery, to ensure you can make informed decisions about surgery
• Behaviors that may keep you from losing weight or may lead to regaining weight
• Personalized strategies that can help you overcome potential obstacles

They can provide a written report for insurance and/or the surgeon, as needed.

What to expect during the psychological evaluation

You can expect the evaluation to last approximately two hours. There are usually three or more psychological tests to complete on the computer or in writing. You can also expect to have a more conversational clinical interview. We understand people can be nervous during these interviews. We consider it our job to put you at ease and help you feel comfortable during your assessment.

Nutrition evaluation

The goal of the nutrition evaluation is to provide you with information about weight loss surgery and what to expect after surgery. Weight loss surgery is a tool, but you will need to commit to lifestyle changes to find long-term weight loss success.

Factors of the nutrition evaluation

Our dietitians will help you learn:

• How your diet will change after surgery
• How to meet new protein and fluid requirements
• Which vitamin and mineral supplements you will need to take
• How to change your eating behaviors
• What other behaviors will help you find long-term weight loss success

What to expect during the nutrition evaluation

During nutrition screening, you will complete a weight and diet history questionnaire. This will give us information regarding your previous attempts at weight loss. Such attempts may include a supervised weight loss and exercise program and/or the use of popular diets.

Here is what the dietitian is looking for:

• Your medical history and lifestyle
• Your weight loss/gain history and current eating habits
• Your exercise habits
• Your understanding of the surgery
• Your understanding of, and willingness to be compliant with, the lifestyle changes needed post-surgery

The nutrition evaluation is often required by your insurance company to help you get through the preapproval process for weight loss surgery. The dietitian can also assist with any supervised diets that may be required by your insurance company.

Weight loss surgery is not necessary—or an option—for every person who wants to lose weight. Depending on how much weight you need to lose to achieve better health, we may first use a variety of nonsurgical options, such as:

• Body composition testing
• Free community classes
• Individual appointments, group visits and classes that help you develop healthy weight-related behaviors
• Medical evaluations with a provider specialized in weight loss
• Metabolic testing
• Nutrition classes

Whatever your weight loss needs may be, we are here to help develop a customized plan for improving your health.