Overview of WLS Patient Criteria

Bariatric Patient Criteria
Your doctor can help guide you to the most appropriate type of weight loss surgery based on your health and weight.

Weight loss surgery, also known as bariatric surgery or obesity surgery, has helped many severely obese people lose weight and improve their health. Severe obesity is a very difficult condition to treat. Because substantial and lasting weight loss is not easy to achieve with a healthy diet and exercise alone, weight loss surgery is often the best chance for many severely obese people at losing the excess weight and keeping it off. But is weight loss surgery right for you?

Is weight loss surgery right for you?

The first attempts at weight loss should focus on adopting a healthier diet, increasing physical activity, and participating in a medically supervised weight loss program. If you have made serious attempts, however, to lose weight with non-surgical methods of weight loss but have failed, then weight loss surgery may be an appropriate treatment option for you. It might also be appropriate if you have serious obesity-related health problems.

The decision to have weight loss surgery should not be taken lightly. Weight loss surgery may help you lose weight and improve your health, but it also requires a lifetime commitment to changes in your lifestyle habits and brings with it other risks, side effects, and complications.

Are you ready for weight loss surgery?

The following questions will help you decide if you are ready for weight loss surgery. It is not meant to take the place of a consultation with your primary care doctor, but give you topics to discuss with your doctor concerning your overall health and weight loss options.

If you are trying to decide if weight loss surgery is right for you, consider these points:

  • Are you unlikely to lose weight with further non-surgical methods of weight loss?
  • Are you informed about the surgical procedure and changes to your anatomy?
  • Are you aware of the potential surgical risks, side effects and long-term complications, and occasional failures?
  • Do you understand the lifetime changes you will be required to make to your diet choices, eating habits, exercise level, and lifestyle habits?
  • Are you determined and motivated to lose weight and improve your health?
  • Are you committed to medical follow-up care for the rest of your life?

Do you qualify for weight loss surgery?

Weight loss surgery is major gastrointestinal surgery with certain conditions that must be met in order for patients to be considered for weight loss surgery.

To find out if you qualify for weight loss surgery, consider these patient guidelines:

  • Is your BMI 40 or higher?
  • Is your BMI 35 or higher with any serious obesity-related health problems, such as diabetes, heart disease, severe sleep apnea, or high blood pressure?
  • If you are a woman, are you more than 80 pounds overweight?
  • If you are a man, are you more than 100 pounds overweight?
  • Have you been overweight for 5 years or more?

You may not qualify for weight loss surgery if you have any of these conditions:

  • You have an illness that has caused you to be overweight
  • You drink too much alcohol or have a history of substance abuse
  • You have an inflammatory disease, GI tract disease, or stomach problems
  • You have an eating disorder
  • You are mentally unstable or clinically depressed

Age Considerations

In terms of age, it is generally viewed that bariatric patients should be between the ages of 18 and 60. In some cases, however, weight loss surgery may be approved for older patients in their 60's and for teenagers younger than 18. A person's age does not necessarily preclude them surgery, but a patient's overall health should be evaluated as to the potential risks and benefits of weight loss surgery as well as his or her attitude and motivation.

Although weight loss surgery has been successfully utilized on some teens with obesity, it is usually considered only in the most serious situations. Surgical intervention is a treatment of last resort and considered only for patients who have completely exhausted other weight loss options, thus most teens rarely qualify for weight loss surgery. Not only is the long-term safety and effectiveness of weight loss surgery in teens not known, but many surgeons do not believe that teenagers are able to make a decision involving such a complicated and life-long procedure. At this time, the most effective weight loss approach in obese and overweight teens is considered to be a change of lifestyle focusing on diet choices and physical activity.

Psychological Evaluation

Before patients are approved for weight loss surgery, a patient can expect to undergo a psychological evaluation. The purpose of this evaluation is to determine whether the patient is mentally and emotionally prepared for the surgery, is competent to make the decision, understands the seriousness of the procedure and the required lifestyle changes, does not have any eating disorders or other disqualifying psychiatric or psychological issues, is not clinically depressed, has realistic expectations, and is prepared to deal with the outcome of the weight loss surgery.

Which weight loss procedure is best for you?

You may qualify for one or more of the weight loss procedures, but your doctor can help guide you to the most appropriate method of bariatric surgery based on your health and weight. Although gastric bypass surgery is the most common bariatric procedure, it may not be the best choice for you. For some patients, gastric banding may be the better choice because it is safer and less drastic, including teens or older patients who do not qualify for other weight loss procedures. On the other hand, patients with a BMI over 50 may qualify for the duodenal switch procedure which is a malabsorptive procedure recommended only for the very obese. The newest option is the gastric sleeve procedure, which does not involve rerouting the small intestine or implanting a medical device. Make sure you discuss the options with your doctor, including the concerns and benefits of each weight loss surgery, to determine which procedure is the best fit in your situation.