Expert: Cathy Wilson, ACC-ICF, CLC - 9/3/2008

Question
Hi, I am 5'9 and weigh 226 pounds. The BMI calculators tell me I'm obese, 31.5 BMI. I've just been rejected from a free seminar about bariatric surgery. Is it impossible to even be evaluated for surgery unless your BMI is 35-40? I have been trying to lose weight/eat healty/exercise for quite a while to no avail.

Answer
Hi Selena,

To determine if you are a good candidate for weight loss surgery, your bmi is a factor for consideration.  As far as for BMIs, yours is low.  However, that isn't to say you wouldn't qualify for weight loss surgery.

Do you have any co-morbidities?  Co-morbidities are conditions that are obesity-related.  If you are a Type 2 diabetic, if you have sleep apnea, if you have arthritic conditions of your joints and spine, blood pressure or other similar health conditions, those would be a big consideration for weight loss surgery.

Did you try to register for the new patient information lecture from a bariatric program?  Sometimes the best place to start is with your own primary care physician.  You could talk to your physician about your concerns regarding your obesity and any other health conditions you may have.  Also, you could have lab tests taken to see if you have diabetes or pre-diabetes, or any other indications of a medical issue.

Bariatric programs vary as far as bmi requirements.  For some bariatric programs, for the lapband procedure, their bmi criteria is lower than for a more malabsorptive procedure.  Depending on the area you live, check into other bariatric programs.  If you are willing to travel, contact bariatric programs that aren't close in your area.  

The first step I would suggest is to start with your primary care physician.  If your primary care physician can recommend you for weight loss surgery, that can carry more to a bariatric surgeon.  Also, if you have a co-morbidity, that also adds to your bmi.  If you also have a pre co-morbid condition, that is also a contributory consideration.

Okay, you've had one door shut but that doesn't mean your options are gone.  Take it further by starting with your primary doctor and obtain a complete lab work-up in getting tested.  Go from there and see what your health condition and issues are.  From there, check into other programs.  Protocols vary from surgeon to surgeon and bariatric programs.  

I would also encourage you to keep a diet log.  If you are like most weight loss surgery patients, you have an extensive diet career in trying various diets throughout the years.  As much as you can, record the dates and names of the programs you used to lose weight.  It is important to be able to show your numerous efforts to lose weight and not be successful for a long period of time.  That is also a helpful record to have for insurance and a bariatric surgeon program.  

If this is something you want, exhaust all of your options that I outlined above.  I commend you for not taking your first "no" and letting it go.  Be persistent in checking out your options.  You can also use the Internet and check into the many bariatric programs throughout the country.  

All the best of luck to you.  

In health,
Cathy, CLC
Certified Life Coach, Weight Loss Surgery Coach