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What Makes a Good Candidate for Weight-Loss Surgery?

BMI, medical and weight history and other factors considered

An overweight African American woman with a positive attitude is a potential candidate for bariatric surgery.

BMI, medical and weight history and other factors considered

For people who are struggling with obesity and obesity-related conditions, weight-loss surgery may be an option that could significantly improve their lives.


So, what makes a good candidate for weight-loss surgery, also known as bariatric surgery?


Several factors are involved. Weight-loss surgery is often considered when efforts to lose weight through lifestyle changes and medications are unsuccessful. The surgery may also help with obesity-related conditions.


Your physician can discuss the risks and benefits of the procedure and whether it is right for you.

Who qualifies for weight-loss surgery?

Body Mass Index (BMI) uses weight and height to estimate body fat. A BMI above 30 is considered obese. A BMI between 35-50 marks morbid obesity. A BMI above 50 is extreme obesity.


Weight-loss surgery may be an option for someone who:


  • Has a BMI of 40, or is more than 100 pounds overweight
  • Has a BMI of 35 or more with one or more obesity-related conditions, such as diabetes, hypertension, sleep apnea, heart disease or fatty liver disease
  • Has tried non-surgical weight loss methods without success
  • Is willing to make lifestyle changes for long-term success


“Many people who are overweight or obese spend years trying to take off the weight through diet and exercise but have no success. In those cases, weight-loss surgery can be life-extending,” says William Fuller, MD, a bariatric surgeon at Scripps Clinic Center for Weight Management and Bariatric Surgery in Del Mar.


Your physician will recommend a weight-loss procedure based on several factors, such as medical conditions, prior operations and weight history. It’s important to check with your insurance company and ask if your policy covers weight-loss surgery.


If approved for a procedure, a pre-surgical plan will be developed that will include evaluations, classes and meetings.

What are the risks and benefits of weight-loss surgery?

There are different types of weight-loss surgeries. The most common procedures limit how much you can eat by reducing the size of your stomach. Some procedures dampen the hormonal signaling that encourages eating.


Gastric sleeve is the most common weight-loss procedure. It involves the removal of a large portion of the stomach to create a sleeve-shaped tube. It is usually done as a minimally invasive procedure, which generally results in less pain, less time in the hospital and shorter recovery compared to open surgery.


Weight-loss surgery is very safe, but there are still risks.


“It’s worth repeating that weight-loss surgery is a serious decision that is usually considered only when other efforts have failed,” Dr. Fuller says.


“Generally, the patient has severe obesity, putting them at risk for cardiovascular disease, diabetes or another serious condition. In those cases, the risks posed by the surgery are greatly outweighed by the risks of being obese.”

Life after weight-loss surgery

Your physician will go over what to expect after the procedure, including side effects, diet and exercise. It’s largely up to the patient to maintain their weight loss through long-term healthy living.


“The whole point of weight-loss surgery is to help patients change their eating habits. It’s critically important that they have the motivation to do this,” Dr. Fuller says.


Getting the surgery but continuing with the same old diet and lifestyle habits could have negative health consequences.


“Weight-loss surgery is not the easy way out. It requires a deep commitment to the process before, during and after the procedure,” Dr. Fuller says. “For people who make that commitment, weight loss surgery can go a long way toward restoring good health.”