I'm 300 lbs, 5'7", do I qualify for the gastric sleeve?

I just want to qualify for the gastric sleeve procedure. It has been a tough journey. I got close to qualifying a few years ago and then I went on a binge. I had to move and my new apartment was right across the street from a prominent food court. Needless to say, I went on a food bender and gained back the 75 lbs that I lost.


F, 42, Florida

Tags:woman age 35-44 5 ft 4 in to 5 ft 7 in 290-309 lbs weight gain

Bariatric surgery is a life-changing procedure and a major surgery that carries a certain level of risk. When being evaluated as a potential candidate for weight-loss surgery, your surgeon will certainly consider your body mass index or BMI which takes into account both your height and weight. Based on the height and weight you have provided, you have a BMI of 47. Most bariatric procedures, such as gastric sleevectomy, require the patient to have a BMI of 40 or more, or in some cases, a BMI of 35 with comorbidities such as heart disease, type 2 diabetes, sleep apnea, or high blood pressure.

However, while your BMI is a major consideration, there are in fact a range of guidelines that surgeons must follow to establish whether you are a suitable candidate for surgery, and whether the health benefits of surgery outweigh the possible risks and complications. Potential gastric surgery patients are subjected to a rigorous screening process to ensure that they have the highest possible chance of success in the period following surgery. Your bariatric surgeon will first ensure that attempts to lose weight with diet, exercise or weight loss programs have been unsuccessful. A team of health professionals, including a doctor, psychologist, and dietician will meet with you to establish your current state of physical and mental health, and eating habits.

Studies have shown that bariatric surgery can increase the risk of suicidal ideation in people with existing mental health conditions that are not effectively managed. The risk of suicidal ideation is more common among those who have attempted suicide in the past. Other mental health conditions such as schizophrenia, binge eating or substance abuse may make it more difficult for a patient to maintain the benefits of surgery. However, this risk does not necessarily mean that bariatric surgery is not right for those with mental health conditions but, rather, that screening is necessary to identify any potential risk and mitigate it with close monitoring and support.

Your healthcare team will also consider your weight history. Considerable data will be collected about your medical history, current medications, alcohol intake, fluctuations in weight, dieting efforts, eating habits, exercise regime, motivation, and other relevant factors. Patients who suffer from existing health conditions such as blood clots or liver disease are not ideal candidates for weight loss surgery because surgery may worsen these conditions.

One of the most important considerations is your personal motivation. The healthcare team will evaluate your willingness and ability to follow prescribed changes to your diet and exercise routine. These changes are generally implemented at least several months before surgery so that you have time to get used to your new lifestyle. Patients who are able to give up smoking, follow a medically-supervised diet, and gradually increase exercise tend to enjoy better and more sustained postoperative results than those who do not. In addition, most healthcare insurance providers insist on the patient losing some weight prior to the procedure. If you do not make the suggested dietary and exercise changes your surgery may be delayed or canceled.

Even if your surgery is approved, there is the financial hurdle to negotiate. The average cost of a sleeve gastrectomy is approximately $15,000. You will need to talk to your provider to ensure you have insurance coverage to fund the procedure and the necessary finances for any copayments not covered by insurance.

According to my calculations, your BMI is 47 which establishes you as a candidate for bariatric surgery. Gastric sleeve surgery is generally indicated for morbidly obese adults with a BMI of 40 or higher. However, even though your BMI qualifies you for the procedure, there are other criteria that must be fulfilled before a patient is approved for a sleeve gastrectomy.

One important consideration is whether you can handle the rigors of surgery. You didn't mention if you have any medical conditions that may render the surgery risky. Often existing health problems, such as heart disease or high blood pressure, originate from the obesity itself and the health risk can be mitigated by weight loss prior to surgery. In general, surgeons recommend that patients lose some excess weight before a sleeve gastrectomy as it can reduce the length of time in surgery, as well as the risk of complications during the procedure.

Another important consideration for surgeons is your psychological readiness. Gastric sleeve surgery and other weight loss procedures require a series of lifestyle changes which can be stressful or provoke emotional reactions. As part of the evaluation process, you will be assessed by a psychologist who will check your dieting history and other personal factors to verify that you would be a good candidate for the procedure.

Many insurance companies also require that you begin implementing these dietary and lifestyle changes prior to surgery so that you are prepared for the impact weight loss surgery will have on your life and you increase your chances of keeping the weight off in the postoperative stage.

A gastric sleeve procedure is indicated for patients ages 18-65 with a body mass index (BMI) greater than 40.  Based on your height and weight, your BMI is 47.  So you would qualify.