Bariatric surgery is often recommended for people who are unable to lose a substantial amount of weight using diet and exercise alone. While it’s an option for many people, weight-loss surgery isn’t appropriate for every person.
Certain circumstances may contraindicate weight-loss surgery. This means that despite the potential for weight loss and other health benefits, surgery and surgery-related complications could present a danger, particularly in the presence of certain preexisting conditions.
Wondering whether you are a candidate for weight-loss surgery? While we can’t speak to the specifics of your case, we provide some general information about bariatric surgery below.
Who benefits from weight-loss surgery
According to the National Institute of Diabetes and Digestive and Kidney Diseases, weight-loss surgery may be appropriate for:
- Those who have a body mass index (BMI) of 40 or higher
- Those who have a BMI of 35 or higher along with a serious health issue such as Type 2 diabetes, sleep apnea or heart disease
- Those who have a BMI of 30 or higher along with Type 2 diabetes or other health conditions that can’t be controlled with other treatment options
While that may sound like a significant amount of weight, the threshold may not be as high as you think. For example, a woman who is 5’1” and weighs 185 pounds would have a BMI of approximately 35, which qualifies her for weight-loss surgery, especially if she also has diabetes or other related conditions. Now, compare that to someone who weighs the same but is taller—let’s say 5’10”—who would have a BMI of around 26, which falls within the ‘normal’ to ‘overweight’ range and wouldn’t qualify for surgery. This highlights how height significantly influences BMI and eligibility for surgery.
When determining whether someone is a good candidate for weight-loss surgery, other factors will also be considered. This includes whether the person has tried other methods of losing weight and whether the person understands the changes that will be necessary after surgery. When certain preexisting conditions such as diabetes, hypertension or sleep apnea are present, patients may still qualify for surgery even at a lower BMI threshold. However, extensive preoperative evaluations are conducted to optimize the patient’s health status, helping to minimize risks and improve their candidacy for the procedure.
Why you might not be a candidate for weight-loss surgery
Every person is unique, and your individual circumstances will be considered when you talk with a bariatric surgeon about whether surgery is right for you. With that said, though, surgery may not be recommended if there’s a potential for harm.
In some cases, the surgical procedure itself or complications following bariatric surgery may pose a danger, making careful patient selection and preparation essential to reduce potential risks. Weight-loss surgery may not be recommended if:
- You are currently pregnant.
- You can’t or won’t commit to the lifestyle changes necessary post-surgery.
- You have a heart disease, lung disease or another medical condition that makes any kind of surgery dangerous.
- You have an autoimmune connective tissue disease or a family history of one.
- You have an infection that could be spread during a surgical procedure.
- You have an uncontrolled inflammatory disease of the gastrointestinal system.
- You have certain anatomical abnormalities of the esophagus, stomach or intestines.
- You have certain bleeding disorders.
- You have had a gastric injury during a past surgery or through other circumstances.
- You have active cancer.
Other disqualifying factors—at least on a temporary basis—may include an untreated or uncontrolled mental health issue, attempted suicide in the recent past, or drug or alcohol abuse. You may also be considered a poor candidate for weight-loss surgery if you have not tried other methods of losing weight first. The presence of some of these conditions is not always a complete contraindication for bariatric surgery. Your bariatric surgeon will be able to discuss these factors with you and carefully assess your individual candidacy. In many cases, some of these issues can and should be addressed prior to surgery to improve your overall health and reduce potential risks, optimizing your chances for a successful outcome.
Other options for losing weight
If you are not considered a candidate for weight-loss surgery, you still have options. The Bariatric Weight Loss Center at Northeast Georgia Medical Center has achieved MBSAQIP Obesity Medicine Accreditation, which recognizes our commitment to offering nonsurgical weight-loss options for patients who do not qualify for bariatric surgery.
Our team of providers can review your health history and lifestyle and create a personalized treatment plan based on your needs. In most cases, this includes our medical weight-loss program, which uses nutritional guidance, behavioral modifications, physical activity and sometimes medications to stimulate weight loss.
During the program, you’ll work closely with weight-loss experts, including an obesity medicine specialist who can suggest changes to your program when needed. When FDA-approved anti-obesity medications are recommended, you’ll be carefully monitored for any potential complications and to determine whether dosage changes are necessary.
In cases where bariatric surgery has been determined to be contraindicated, patients can opt for endoscopic procedures. One such option is the Orbera™ intragastric balloon, which may be suggested as an alternative for those who aren’t eligible for weight-loss surgery. During this procedure, a deflated Orbera™ gastric balloon is inserted through the mouth and expanded in the stomach, reducing stomach capacity and providing built-in portion control. The balloon remains in the stomach for up to six months to assist with weight loss. However, because the balloon is removed using an endoscopic procedure after six months, this option may not be suitable for patients with conditions that increase operative risks.
The bottom line? If you aren’t a candidate for weight-loss surgery, you have hope! We will work with you to find a solution that meets your needs in a safe way.
Next steps
The Bariatric Weight Loss Center at Northeast Georgia Medical Center offers comprehensive weight-loss services, including both surgical and nonsurgical treatment options. Call 770-525-6613 or watch our patient education video to learn more.