Am I Eligible for Bariatric Surgery?
Determining if surgery is right for you
Whether you are eligible for bariatric surgery depends on many health and personal factors. But in general, you may be a candidate if you have a:
Body Mass Index (BMI) of 40 or higher
OR
BMI of 35 to 40, with a serious weight-related condition such as diabetes or high blood pressure
Talk to a bariatric surgeon to determine if surgery is right for you.
Surgery Eligibility Tool
Bariatric surgery isn’t just about losing weight. It’s also about improving health—and even resolving serious conditions like type 2 diabetes and high blood pressure.
To gauge eligibility for weight-loss surgery, simply answer the tool’s 8 quick questions.
You’ll receive an eligibility rating and also learn how your answers factored into that result. You’ll also get suggestions on appropriate next steps.
Surgery Eligibility Tool
You may not be a candidate for surgery at this time.
You may be a candidate for surgery.
You appear to be a candidate for surgery.
You appear to be a strong candidate for surgery.
Not A Candidate
Strong Candidate
Talk to your doctor about your health and weight concerns.
Each person’s health situation is unique. To find the health-management options best for you, talk with your doctor and explore steps you could take to become healthier.
Not A Candidate
Strong Candidate
Weight-loss surgery may be an option for you.
Weight-loss surgery has the power to transform your life—physically, emotionally, and socially—if it’s the right step for you. Explore the possibility further with your doctor.
Not A Candidate
Strong Candidate
Weight-loss surgery may be a good option for you.
Weight-loss surgery has the potential to transform your life on many levels—physically, emotionally, socially, even professionally. Your answers show you meet some important requirements for surgery.
Not A Candidate
Strong Candidate
Weight-loss surgery could be the right option for you.
Weight-loss surgery has the potential to transform your life on many levels—physically, emotionally, socially, even professionally. Your answers show you meet many important requirements for surgery.
Surgery Eligibility Tool
You may not be a candidate for surgery at this time.
You may be a candidate for surgery.
You appear to be a candidate for surgery.
You appear to be a strong candidate for surgery.
1. Your body mass index (BMI) is 40 and higher
According to the National Institutes of Health, people with a BMI of 40 may qualify for surgery. Having one or more obesity-related conditions (e.g., type 2 diabetes) can also increase one’s eligibility.
1. Your body mass index (BMI) is between 35 and 39
According to the National Institutes of Health, people with a BMI of 35 to 39 may qualify for weight-loss surgery if they also have one or more obesity-related conditions, such as type 2 diabetes.
1. Your body mass index (BMI) is 35 or less
Traditionally, people with a BMI below 35 have not qualified for weight-loss surgery. However, experts are beginning to investigate whether some of these individuals might benefit from surgery as treatment for type 2 diabetes or other serious conditions.
2. You have type 2 diabetes.
Weight-loss surgery actually resolves type 2 diabetes in many individuals, often eliminating their need for diabetes medications or insulin shots. In many cases, the diabetes resolves within a few days of surgery. Having type 2 diabetes increases a person’s eligibility for surgery.
2. You do not have type 2 diabetes.
Weight-loss surgery actually resolves type 2 diabetes in many individuals, often eliminating their need for diabetes medications or insulin shots. Surgery can also stop pre-diabetes and prevent type 2 diabetes from ever developing.
2. You have pre-diabetes (also known as impaired glucose tolerance).
Weight-loss surgery can stop pre-diabetes and prevent type 2 diabetes from ever developing. Having pre-diabetes increases a person’s eligibility for surgery.
3. You have joint pain that makes walking difficult.
Excess body weight can put a lot of extra strain on the knees and other leg joints. Weight-loss surgery can lead to significant weight loss—which can mean much less pressure on the joints and the ability to walk and move more easily. Having joint pain can increase a person’s eligibility for surgery.
3. You do not have joint pain that makes walking difficult.
Excess body weight can put a lot of extra strain on the knees and other leg joints. Weight-loss surgery can lead to significant weight loss—which can mean much less pressure on the joints and the ability to walk and move more easily. Having joint pain can increase a person’s eligibility for surgery.
4. You did not check any of the health problems listed.
Having certain health conditions can increase one’s eligibility for weight-loss surgery. Surgery can actually improve or resolve some of those conditions, including high blood pressure and high cholesterol.
Having this condition can increase one’s eligibility for weight-loss surgery. Surgery can actually:
Having these conditions can increase one’s eligibility for weight-loss surgery. Surgery can actually:
Having these conditions can increase one’s eligibility for weight-loss surgery. Surgery can actually:
- reduce the risk of heart disease by more than 80%
- resolve high blood pressure, eliminating the need to take medication
- bring cholesterol down to a healthy level
- resolve sleep apnea, enabling individuals to reap the health benefits of a good night’s sleep
- reduce the severity and frequency of heartburn
- can significantly improve some urinary problems
- increase the chances of conceiving
5. Your weight interferes with your ability to function at work or home.
People typically feel much more able to move around and perform their daily tasks if body size is not a problem. Not only can weight-loss surgery reduce body size, but it can also increase a person’s energy level.
5. Your weight does not interfere with your ability to function at work or home.
People typically feel much more able to move around and perform their daily tasks if body size is not a problem. Not only can weight-loss surgery reduce body size, but it can also increase a person’s energy level.
6. You have been frustrated by your attempts to lose weight in the past.
Weight-loss surgery can succeed where diet, exercise, and other nonsurgical methods have failed. In fact, a National Institutes of Health expert panel concluded that surgery is the only effective treatment for long-term weight loss in severely obese individuals.
6. You have not been frustrated by your attempts to lose weight in the past.
Most individuals considering surgery have tried in earnest to lose weight—usually numerous times. For many people, surgery gives them weight-loss and health benefits that they’ve never been able to achieve through diet and exercise alone.
6. You have not made serious attempts to lose weight.
Most individuals considering surgery have tried in earnest to lose weight—usually numerous times. For many people, surgery gives them weight-loss and health benefits that they’ve never been able to achieve through diet and exercise alone.
7. You have private or employer-provided health insurance.
Health insurance plans often do cover weight-loss surgery fully or partially. To help patients complete the authorization process for coverage, many weight-loss surgery programs have an on-staff insurance specialist who can provide guidance.
7. You participate in the Medicare program.
Medicare coverage for weight-loss surgery was expanded in 2006.
Having an obesity-related health problem (e.g., type 2 diabetes) helps Medicare subscribers qualify for coverage.
7. You participate in the Medicaid program.
Weight-loss surgery is covered by Medicaid in many states. Having an obesity-related health problem (e.g., type 2 diabetes) helps Medicaid patients qualify for coverage.
7. You have some type of health insurance.
People are often surprised to learn that many health insurance plans provide coverage for weight-loss surgery. Some plans cover costs completely, some cover costs partially, and others cover specific services (eg, lab tests, surgeon’s fees).
7. You do not have health insurance.
Many individuals without health insurance use financing programs that enable them to pay for their weight-loss surgery over time. The cost of surgery can often be less than the ongoing costs of medications for obesity-related health problems, such as type 2 diabetes or heart disease
7. You are not sure if you have health insurance.
Covering the costs of weight-loss surgery is easier than many people may think. Many insurance plans, including Medicare and Medicaid, do offer full or partial coverage. For those without insurance, financing programs can offer affordable monthly payment plans.
8. You feel that a healthy weight would enable you to enjoy activities that you are unable to do now.
Many individuals find that the many physical benefits of surgery—healthier weight, improved health, increased energy—lead to tremendous personal rewards. Many find satisfaction in accomplishments that they never thought possible. Read personal success stories of people who’ve had weight-loss surgery.
Surgery Eligibility Tool
You may not be a candidate for surgery at this time.
You may be a candidate for surgery.
You appear to be a candidate for surgery.
You appear to be a strong candidate for surgery.
- 1. Ask for your doctor’s help with goal setting. Talk with your doctor and decide on your health and weight-loss priorities.
- 2. Stay active. Try to walk or do other exercise most days.* Physical activity has countless health benefits. It can also boost your energy level and your mood.
- 3. Make one healthier food choice. Don’t put pressure on yourself to overhaul your eating habits overnight. Start small. For one high-calorie or high-fat snack or side dish, substitute a fruit, vegetable, or other healthy choice.
*Check with your doctor before starting an exercise program.
- 1. Schedule a doctor visit. Let your doctor know if you’re starting to think about weight-loss surgery. Print out your results from this tool and take them to your visit.
- 2. Sign up for more information. Learn about what’s involved in weight-loss surgery, from the decision-making stage through post-surgery weight management. Sign up now.
- (see insurance items below)
- Consult with your doctor. Make sure your primary care doctor knows you are considering weight-loss surgery. He or she can explore your eligibility in more depth. Print the results of this tool and take them to your visit.
- Find out about weight-loss surgeons in your area. To locate specialists near you, many of whom offer free informational seminars, use the convenient Find a Surgeon tool.
- (see insurance items below)
- Sign up for important information. You’ll learn what to expect at all stages of the weight-loss surgery process and how to choose a surgeon. Sign up now!
- Meet with wight-loss surgeons and their program coordinators. Ask for information on surgery benefits and risks. Find out what support services they offer before and after surgery. To locate programs in your area, use the convenient online tool to find a weight-loss surgeon.
- Learn more about the weight-loss surgery process. Sign up for a helpful program that explains what to expect at all phases of the process—from making the decision to maintaining your surgery results over the long term. Sign up now!
- (see insurance items below)
Check your insurance policy.
To learn what your health plan covers for weight-loss surgery, review your policy or ask your employer’s benefits manager or insurance company.
Find out about your insurance coverage.
Medicare coverage for weight-loss surgery was expanded in 2006.
Call Medicare services to find out about their coverage. In recent years, coverage for weight-loss surgery has been expanded.
Find out about insurance coverage in your state.
Call your local Medicaid services to find out about your state’s coverage for weight-loss surgery.
Check your insurance policy.
To learn what your health plan covers for weight-loss surgery, review your policy or ask your employer’s benefits manager or insurance company.
Find out about affordable payment options.
Many people without insurance cover surgery costs in ways that they can afford, such as monthly payment plans. Ask the weight-loss surgery programs for information on financing options.
Find out if you have insurance coverage.
Even if you do not, cost doesn’t have to be a barrier to weight-loss surgery. Many patients cover costs with convenient, affordable payment plans.
This tool is based primarily on eligibility guidelines from the National Institutes of Health. This information does not constitute medical advice. Consult a medical professional before pursuing surgery.
