What Can Disqualify You from Bariatric Surgery: Key Factors

Bariatric surgery

When looking into bariatric surgery as an option for weight loss and medical conditions associated with obesity, it is essential to understand what could make you ineligible. This comprehensive guide will provide an in-depth look at the factors that may impact your eligibility for this life-changing procedure.

Age and BMI are essential factors to consider when assessing eligibility for bariatric surgery. Furthermore, we delve into specific medical conditions that could disqualify patients from receiving bariatric procedures like gastric bypass or sleeve gastrectomy.

Mental health factors are also critical when evaluating candidacy for obesity surgery; hence, we discuss the importance of psychological evaluations and how mood disorders might affect post-surgery adherence. Additionally, we emphasize the commitment to lifestyle changes pre-and post-surgery – including healthy eating plans, regular physical activity, and participation in support group meetings.

Lastly, understanding insurance company criteria for bariatric surgery approval is essential to navigating the financial aspect of this journey. We also offer alternative non-surgical weight loss options like Orbera gastric balloon procedure and Suture Sculpt ESG treatment as viable solutions for those who may not qualify or prefer less invasive methods.

This detailed analysis aims to equip you with valuable information on what can disqualify you from bariatric surgery while offering guidance on alternative paths to achieve your desired weight loss goals safely and effectively.

Table of Contents:

Universal Criteria for Bariatric Surgery

Bariatric surgery is a life-changing procedure that can help individuals with severe obesity achieve significant weight loss and improve their overall health. However, not everyone qualifies for this type of surgery. Patients must meet specific criteria to ensure the safety and success of bariatric procedures such as gastric bypass or sleeve gastrectomy.

Obesity Surgery & Insurance - Weight Loss Surgery Cost

Age requirement of at least 18 years old

First, you must be an adult to get this surgery. So, the age requirement is at least 18 years old. This ensures that the patient has reached physical maturity and can make informed decisions about their healthcare choices.

Body Mass Index (BMI) qualifications

Now, let’s talk about the weight. To qualify for bariatric surgery, you should have a Body Mass Index (BMI) of 40 or higher, which indicates severe obesity. If your BMI is between 35-39.9, you may still qualify if you have one or more obesity-related medical conditions like type 2 diabetes, sleep apnea, hypertension, or heart disease.

  • BMI over 40: You’re eligible without any additional comorbidities required.
  • BMI between 35-39.9: You need at least one severe obesity-related medical condition to qualify.

You can use an online BMI calculator or consult a healthcare professional to calculate your BMI accurately.

Meeting these universal criteria is the first step in determining eligibility for bariatric surgery. A comprehensive evaluation by a qualified bariatric surgeon will also consider other factors, such as medical history, mental health status, and commitment to lifestyle changes. A complete evaluation by a qualified bariatric surgeon is necessary to make sure that individuals considering weight loss surgery are adequately prepared and have the highest likelihood of achieving sustained health benefits.“Want to qualify for bariatric surgery? Meet the universal criteria of age 18+ and BMI ≥40 (or ≥35 with comorbidities). Consult a surgeon for evaluation. #bariatricsurgery #weightlossjourney”Click to Tweet

Medical Conditions That May Disqualify You from Bariatric Surgery

Bariatric surgery can be a potential solution for those suffering from serious medical issues associated with obesity. But only some are eligible for this type of weight loss surgery. Certain medical conditions can pose additional risks during the operation and recovery process. Some common medical issues could disqualify you from getting bariatric surgery.

Stomach Infections and Ulcers

Active stomach infections or ulcers can increase the risk of complications during and after the procedure. If you have any active stomach infections or ulcers, bariatric surgery may not be appropriate. It’s essential to treat any existing infection before considering weight loss surgery.

Liver Diseases

Liver disease, particularly advanced cirrhosis, may also disqualify you from undergoing bariatric procedures like gastric bypass or sleeve gastrectomy. The liver is crucial in processing nutrients and medications following weight loss surgery. Therefore, impaired liver function could lead to serious post-operative complications.

Cancer

If you have been diagnosed with cancer or are currently undergoing treatment, your bariatric surgeon might advise against pursuing obesity surgery. Cancer treatments such as chemotherapy and radiation therapy can weaken your immune system and make it more challenging to recover from major surgical interventions like gastric bypass or sleeve gastrectomy.

Other Factors

Severe obesity-related medical conditions like type 2 diabetes or heart disease may require additional evaluation and management before you can be considered a suitable candidate for bariatric surgery. It is essential to collaborate with medical professionals and adhere to their advice for the most beneficial results from any weight-reduction plan.“Medical conditions like stomach infections, liver disease, and cancer can disqualify you from bariatric surgery. Consult with your healthcare provider for the best weight loss options. #bariatricsurgery #healthylifestyle”Click to Tweet

Mental Health and Bariatric Surgery: What You Need to Know

Obesity and psychological well-being can be intertwined. That’s why patients considering bariatric surgery undergo psychological evaluations to determine if they have any underlying mental health issues that could interfere with their ability to adhere to post-operative guidelines.

Psychological Evaluations: A Crucial Step

A mental health practitioner examines the emotional state, strategies for managing stress, and assistance accessible to the patient. They also assess if any untreated or uncontrolled psychiatric conditions may hinder successful outcomes following surgery.

  • Anxiety: Unmanaged anxiety can lead patients to overeat or struggle with adhering to postoperative dietary restrictions.
  • Depression: Untreated depression may affect motivation levels and adherence to lifestyle changes required after surgery.
  • Bipolar Disorder: This condition can cause extreme fluctuations in mood and energy levels, which might impact one’s ability to maintain consistency in diet and exercise routines.

Impact of Mood Disorders on Post-Surgery Adherence

The presence of mood disorders does not automatically disqualify someone from undergoing bariatric surgery. Nonetheless, before the procedure, these conditions must be managed appropriately for a successful outcome. Proper management ensures better chances of success by improving patients’ abilities to follow through on necessary lifestyle changes.

Patients affected by mood disorders should collaborate with their mental health practitioners, bariatric surgeons, and bariatric support networks to build a thorough plan for controlling their state of affairs before and after the operation. This may include medication adjustments, therapy sessions, or participation in stress-reduction activities like yoga or meditation.

Sometimes, patients might be asked to postpone surgery until they have demonstrated stability in managing their mental health issues. This ensures the best possible outcomes from weight loss procedures such as a gastric sleeve or gastric bypass.

Key Takeaway: 

Before undergoing bariatric surgery, patients must undergo psychological evaluations to determine if they have any underlying mental health issues that could interfere with their ability to adhere to post-operative guidelines. Mood disorders such as anxiety, depression, and bipolar disorder can impact one’s consistency in diet and exercise routines. Proper management of these conditions is crucial for successful outcomes following surgery.

Commitment Towards Lifestyle Changes Pre-and Post-Surgery

The success of weight loss surgeries like gastric bypass or sleeve gastrectomy depends heavily on patients’ ability to adhere to strict guidelines set by their bariatric surgeon.

Healthy Eating Plans Before and After Surgery

Before surgery, patients must follow a specific diet plan designed by their healthcare team. This helps them lose initial weight, reducing surgical risks and improving outcomes. After surgery, it’s crucial to maintain a nutritious eating plan as their doctor or nutritionist recommends. A well-balanced diet promotes weight loss and prevents complications such as nutrient deficiencies or dumping syndrome.

Regular Physical Activity is a Requirement

Incorporating regular exercise into one’s daily routine is essential for successful long-term weight management after bariatric surgery. Patients should work closely with their healthcare providers in developing an appropriate exercise program, gradually increasing intensity levels over time while taking care not to push themselves too hard initially post-surgery.

Role of Support Group Meetings in the Weight Loss Journey

A strong support system is integral to achieving lasting results following bariatric surgery. Weight loss centers often host support group meetings, allowing bariatric surgery patients to share their experiences and successes with those who have undergone similar procedures. Attending these gatherings regularly allows individuals to learn from one another’s triumphs and setbacks while fostering a sense of camaraderie among participants.

To qualify for bariatric surgery, patients must demonstrate a genuine commitment towards making necessary lifestyle changes both pre-and post-surgery. Attending support group meetings regularly can help people struggling with obesity-related medical conditions gain weight control, better their health, and lead a more fulfilling life. Don’t let obesity-related medical conditions keep you from living your best life.

Key Takeaway: 

Bariatric surgery requires a commitment to lifestyle changes pre-and post-surgery, including healthy eating plans, regular physical activity, and attending support group meetings. Patients must adhere to strict guidelines their healthcare team sets for successful weight loss outcomes. A strong support system is essential in achieving lasting results following bariatric surgery.

Insurance Company Criteria for Bariatric Surgery Approval

Insurance companies have their criteria for approving weight loss surgery, and they may require additional documentation or proof that a patient has tried other non-surgical methods to lose weight without success. This plays an important part in deciding who gets approved since many people rely on them to cover costs associated with the procedures, which are often expensive.

Varying Approval Criteria Among Different Insurance Companies

Different insurance companies have varying requirements when it comes to bariatric surgery coverage. Some may need you to provide evidence of your medical history, while others might ask for documented attempts at supervised diet plans and exercise programs. You must research your insurer’s guidelines before proceeding with surgical consultations or appointments.

Importance of Documenting Non-Surgical Weight Loss Attempts

To increase the likelihood of getting approved by your insurance provider, document all previous efforts towards losing weight through non-surgical means such as dieting, exercising, attending support groups like Weight Watchers, or trying medically-supervised programs. Insurance providers typically want evidence that these options were unsuccessful before considering covering obesity surgery expenses.

  • Maintain records of gym memberships and workout routines followed over time.
  • Gather receipts from nutritionists’ visits or meal planning services used in the past.
  • If applicable, obtain physician documentation regarding failed attempts to use prescription medications for weight management.
  • Note down participation details in support group meetings regularly attended throughout one’s journey towards healthier living habits pre-and post-operation.

By keeping a detailed record of your weight loss journey, you’ll be better prepared to present your case for bariatric surgery coverage. Remember that insurance companies are more likely to approve the procedure if they see that you’ve exhausted all other options and are committed to making lasting lifestyle changes post-surgery.

In some cases, even if an insurer denies initial approval for bariatric surgery, patients may have the option to appeal the decision. Please consult with your bariatric surgeon or healthcare provider about navigating this process should it become necessary in your situation.

Key Takeaway: 

Insurance companies have criteria for approving weight loss surgery, which may require additional documentation or proof of non-surgical attempts to lose weight. Different insurance companies have varying requirements for bariatric surgery coverage, and documenting all previous efforts toward losing weight through non-surgical means can increase the likelihood of getting approved by your insurance provider.

Alternative Non-Surgical Weight Loss Options

If you don’t qualify for bariatric surgery, don’t sweat it. Alternative non-surgical options can still help you lose weight without undergoing invasive surgeries. These procedures include the Orbera gastric balloon and Suture Sculpt ESG.

Orbera Gastric Balloon Procedure

The Orbera gastric balloon is a temporary, non-surgical solution designed to help patients lose weight by reducing their appetite. The procedure involves placing a soft silicone balloon into the stomach through the mouth using an endoscope. When filled with saline solution, a soft silicone balloon, the size of a grapefruit, is inserted into the stomach through an endoscope to help reduce appetite and facilitate weight loss.

This helps patients feel full faster and consume fewer calories throughout the day. After six months, doctors remove the balloon during another outpatient procedure. Alongside this treatment, patients receive comprehensive support from healthcare professionals like dietitians and exercise specialists to maintain healthy habits even after removing their balloons.

  • Pros: No incisions or permanent changes to your digestive system; relatively short recovery time compared to surgical options.
  • Cons: Temporary solution (6 months); may require multiple treatments over time for sustained results; less dramatic weight loss than surgical methods.

ESG Treatment

Endoscopic Sleeve Gastroplasty (ESG) is another minimally invasive option for those who do not qualify for traditional bariatric surgery but still want assistance losing weight. This procedure uses an endoscope inserted through your mouth and specialized sutures to reduce the size of your stomach by approximately 70%.

By limiting the amount of food that can be consumed, patients feel full faster and eat less overall. This treatment is often combined with lifestyle changes like healthy eating plans and regular exercise programs to maximize weight loss results.

  • Pros: Minimally invasive; no incisions or removal of any part of the digestive system; shorter recovery time than surgical options.
  • Cons: May not result in as much weight loss as traditional bariatric surgery; it requires a commitment to long-term lifestyle changes for optimal success.

These non-surgical alternatives require sustained dedication to a healthier lifestyle. They require dedication to long-term lifestyle changes like healthy eating and regular exercise programs to achieve optimal results. Before starting a journey towards better health, consulting with an experienced healthcare professional to decide which option suits your objectives is paramount.

Key Takeaway: 

If you don’t qualify for bariatric surgery, alternative non-surgical options are available such as the Orbera gastric balloon and Suture Sculpt ESG. These procedures can still help you achieve significant weight loss without invasive surgeries but require dedication to long-term lifestyle changes like healthy eating and regular exercise programs for optimal results.

FAQs about What Can Disqualify You From Bariatric Surgery

What disqualifies you from bariatric surgery?

Contraindications for bariatric surgery include active cancer, severe liver disease, stomach infections, and certain mental health conditions.

Can you be denied weight loss surgery?

Patients can be denied weight loss surgery if they do not meet eligibility criteria such as BMI requirements, age restrictions, or have disqualifying medical conditions.

Does anxiety affect bariatric surgery eligibility?

Anxiety alone does not necessarily affect bariatric surgery eligibility, but untreated or uncontrolled anxiety disorders might impact adherence to post-surgery guidelines and should be addressed before the procedure.

How difficult is it to get approved for bariatric surgery?

The approval process varies depending on individual circumstances and insurance company criteria. Still, it requires meeting specific qualifications related to BMI, age, medical history documentation of non-surgical weight loss attempts, and commitment towards lifestyle changes.

For more information on bariatric surgery and eligibility requirements, check out ASMBS.

Conclusion

What can disqualify you from bariatric surgery?

  • You may not be eligible for bariatric surgery if you’re not at least 18 or don’t meet the BMI qualifications.
  • Medical conditions like stomach infections, liver diseases, and cancer can also disqualify patients from undergoing weight loss procedures.
  • Before approval, mental health evaluations are required, and mood disorders can impact post-surgery adherence.
  • Commitment towards lifestyle changes pre-and post-surgery is crucial, including healthy eating plans, regular physical activity, and support group meetings.
  • Insurance company criteria vary, but documenting non-surgical weight loss attempts is important.
  • Alternative non-surgical options like Orbera gastric balloon procedure or Suture Sculpt ESG treatment may be available.

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Healthy Life Bariatrics

Dr. Babak Moeinolmolki
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