Qualifying for Surgery

woman jogging as part of post-surgery weight loss

Steps for qualifying

  • Participate in an online information session as the first step.
Join an online session
  • Complete a pre-operative evaluation with the surgeon, a nurse specializing in cardiovascular risk reduction, a nutritionist and a psychologist.
  • Receive prior approval from your insurance company
  • Commit to our post-operative program and to long-term lifestyle changes.

Medical criteria

  • According to the National Institutes of Health (NIH)  criteria, patients with a body mass index (BMI) between 35 and 40 are eligible for surgery if they have weight related co-morbidities, such as sleep apnea and diabetes.
  • Also according to the NIH, Patients with a BMI over 40 are candidates, even if they do not have weight related co-morbidities.
  • Your obesity must have persisted for at least two years.
  • You have tried multiple medical weight loss attempts in the past five years.
  • Your age is between 18 and 64 years (Over age 65 is evaluated on a case-by-case basis).
  • You should not have untreated metabolic cause for obesity, such as thyroid or adrenal disorders.
  • You should not have psychological or medical problems that would limit surgical success. Candidates with inpatient psychiatric admission within the past two years will be reviewed individually.
  • You should not be drug, alcohol or tobacco dependent.
  • If you are a current smoker, you must agree to quit and be smoke-free for a minimum of three months before surgery.
  • If you have a history of substance abuse, you must be substance free for a minimum of two years.
  • You cannot be pregnant and must be willing to postpone pregnancy for one to two years after surgery.

Insurance coverage

  • Some health insurance companies consider bariatric procedures elective. For this reason you must obtain insurance approval for the surgery.
  • For patients not covered by insurance, there are self-pay options.
  • While many of the costs incurred during the evaluation process will be covered by insurance, some charges may become the responsibility of the patient.