Expert: Jacqueline Jacques, ND - 2/10/2008

Question
hi im 19 years old do i qualify for a bariatric surgery

Answer
Hi Madelyn,

Since you are considered by medicine to be an adult, age is not technically a concern for you in qualifying for surgery.  

Qualifying may mean more than one thing - it can mean "do you meet the medical criteria for surgery so that a doctor will operate on you" or it can mean "will your insurance company pay for you to have surgery."

Let's talk about the first one first.

Medically, to qualify for surgery:

1) You generally need to have a Body Mass Index (BMI) of 40 or higher or
2) A BMI of 35 or higher with another serious medical condition such as diabetes, sleep apnea, high  blood pressure, etc.
3) Most surgeons will also want to know that you are mentally prepared to handle the challenge of surgery and that you are not suffering from a serious medical condition that might make surgery dangerous.

When it comes to insurance, the criteria is similar, but will likely also include:

1) A requirement to prove that you have failed other solutions for weight loss.  This is generally not just telling your doctor that you have dieted or going to Weight Watchers, but documented medically managed weight loss - usually for 6 months.
2) In addition, they may require documentation form your doctor that you have been struggling with weight long term (often greater than 5 years)
3) Depending on your medical insurance and the state you live in, there may be other criteria - they may only cover certain procedures for example.

If you are seriously considering surgery as an option for yourself, here are some things I would suggest:

1) Read as much as you can.  I suggest starting with the websites for the American Society of Metabolic and Bariatric Surgery  (www.asbs.org/ ) and the Obesity Action Coalition (www.obesityaction.org/)
2) Locate local surgical programs in your area (the asbs.org site has listings of the Centers of Excellence, which tend to be the most experienced programs).  Virtually every bariatric surgery program in the country has free informational sessions.  Go to several different programs if you can.  Also find out if you can attend a patient support group - this will give you a chance to listen to people who have had surgery talk about how they feel.  Bring a friend or a family member if you can so you have someone to discuss it with later.
3) If you know anyone personally who has had surgery, talk to them about their experience.  Ask what their experience has been - what's been good, what's been hard, what would they have done differently?
4) Call your insurance company and find out about coverage.  If they say you don't have coverage, don't let that immediately discourage you.  Most surgery programs have people who can help you with insurance issues - but it's good to know where you are starting from.

I hope this helps.  Please let me know if you need more information.

In Health,

Dr. Jacques