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Surgery
Candidates
Qualifying
for
Bariatric
Surgery
In order to be considered a candidate for bariatric surgery, a person generally has to be eligible by National Institute of Health guidelines established in 1991. The consensus statement requires a patient to have a Body Mass Index (BMI) of greater than 40, or greater than 35 with documented diagnosis of obesity related illnesses such as type 2 diabetes, hypertension, sleep apnea syndrome, or coronary artery disease. Most insurance companies will enforce the same standard, but may have additional criteria which may include a lengthy history of failed conservative weight management. They might also require psychiatric evaluation, extensive physical examination and testing, and assessment by a registered dietitian. Check with your benefit manual for specific coverage criteria and feel free to call us and ask us any questions you may have. You may also see our Insurance Coverage page for some of the specific details required by some of the area’s major insurance carriers.
Most bariatric surgeons will agree that surgery is needed on anyone who has a BMI greater than 30 with the presence of several obesity related conditions. While this would seldom be covered by insurance, most surgeons will accept a self-pay candidate under these conditions.

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