When patients struggle with obesity and traditional methods including exercise and diet are not successful, weight loss surgery is often an option. There are different types of weight loss surgery, which are generally known as bariatric surgery, but the purpose of all weight loss procedures is always to help patients lose weight and improve their overall health. To do so, surgeons limit the size of the stomach and the amount of food that can be ingested, while in some cases the digestive system itself is also altered.
Despite the fact that having surgery to facilitate the process of losing weight may seem appealing, it is not for everyone. It is a surgical procedure and therefore has risks and contraindications associated with it. As a result, there are bariatric surgery eligibility criteria that need to be met for patients to be submitted to bariatric surgery, while there are also recommendations that should be followed to decrease risks and increase the success of the procedure.
Bariatric Surgery Eligibility Criteria
In order to qualify for bariatric surgery, patients need to have a Body Mass Index (BMI) higher than 40, or more than 100 pounds overweight. In the case of at least two obesity-related co-morbidities such as type II diabetes (T2DM), hypertension, sleep apnea and other respiratory disorders, non-alcoholic fatty liver disease, osteoarthritis, lipid abnormalities, gastrointestinal disorders, or heart disease, the BMI required is 35 or higher. In addition, patients also need to demonstrate an inability to achieve a healthy weight loss sustained for a period of time with previous traditional attempts to lose weight.
Another criteria is to be older than 18 years, since the studies focused on bariatric surgery in children have yet to prove its safety and efficacy. These guidelines are defined by the American Society for Metabolic and Bariatric Surgery (ASMBS) and are eligibility criteria used in all types of bariatric surgery. However, since there are different types of procedures, physicians evaluate which one is more appropriate according to the patients’ characteristics and medical state. In addition,physicians will analyze not only the guidelines, but also other aspect of the patient to recommend a bariatric surgery and evaluate the most effective one.
Evaluation of Eligibility for Bariatric Surgery
Each case is specific and a medical team, often including a doctor, dietitian, psychologist and surgeon, will analyze not only the requirements, but also other features to declare a patient’s eligibility for bariatric surgery. If a patient hasn’t tried other non-surgical methods to lose weight, it is often recommended as a first option. The medical team will evaluate the patient’s nutrition and weight history to understand weight trends, efforts to lose weight, exercise regimen, levels of stress, timing and other criteria.
The patient’s medical history is also analyzed to seek comorbidities associated with obesity and other medical conditions that may increase the risks of having a surgery. Since the psychological status may contribute for obesity and influence the success of the surgery, the physicians may postpone the procedure in case of instability. Motivation is also determinant to the achievement of the surgery’s goals and the team will also evaluate the patient’s willingness and ability to follow the recommendations prior and following the procedure. In specific cases, the medical team may recommend bariatric surgery to patients with a BMI between 30 and 34 and severe medical conditions, as well as to underage patients.