Bariatric surgery requirements and eligibility
Partners in your weight loss journey
Being successful with bariatric surgery and weight management requires a lifelong commitment. The expert team at Penn Medicine is your partner from the very beginning. We start by making sure you’re healthy enough for surgery and ready to make the lifestyle changes that support your weight loss goals.
Do you qualify for weight loss surgery at Penn Medicine?
Bariatric surgery can be life-changing, but it may not be appropriate for everyone. Our bariatric medicine team ensures you meet the requirements for optimal results. Your success is our priority.
Candidates for bariatric surgery have to meet established criteria based on standards set by the National Institute of Health (NIH). Most insurance providers base their approvals on these criteria.
The standards include:
Body mass index (BMI)
A BMI greater than 40, or greater than 35 with medical complications related to obesity including:
- Gallbladder disease
- High blood pressure
- Sleep apnea
- Type 2 diabetes
Check your BMI with this BMI calculator from the Centers for Disease Control and Prevention.
Drug use, alcohol use, and psychiatric conditions
People with active alcohol use disorder, drug addictions, or major psychiatric disorders may not qualify for weight loss surgery. Some insurance providers require negative nicotine, alcohol, and drug tests to approve surgery.
Bariatric surgery may not be appropriate for people with certain health conditions, including:
- Advanced lung disease
- Cancer requiring active treatment
- Heart failure
You also need to be healthy enough to have general anesthesia during surgery. Our team will help determine the best solution for you based on your current state of health.
Bariatric surgery screenings and pre-operative eligibility tests
If you meet the criteria for weight loss surgery, you’ll begin a series of evaluations and tests with our bariatric medicine team. These help us determine whether surgery is an appropriate treatment for you.
We run a series of tests to be sure you’re healthy enough for bariatric surgery. The tests check for obesity-related diseases (like diabetes, heart disease, hypertension, pulmonary disease, sleep apnea, vascular disease, or depression) and how they affect your health.
Screening tests may include:
- Abdominal ultrasound
- Blood studies including a complete blood count (CBC), blood urea nitrogen (BUN), cortisol, creatinine, electrolytes, prolactin, and thyroid-stimulating hormone (TSH)
- Cardiac clearance
- Chest x-ray
- Echocardiogram (ECG)
- Electrocardiogram (EKG)
- Liver function tests
- Medical clearance
- Pulmonary function tests
- Sleep study
- Upper gastrointestinal (GI) evaluation
Our dietitians evaluate your weight loss history and current eating behaviors using a weight and diet history questionnaire. They’ll also provide counseling and guidance to prepare you for life after surgery. We work with you to develop a post-surgery nutrition plan that may include vitamin and mineral supplements.
Bariatric surgery changes your relationship with food. Our psychological evaluation ensures you’re ready for the changes surgery will bring. Our mental health professional will assess your:
- Current psychological function
- Eating behaviors
- Level of physical activity
- Psychiatric history
- Weight and dieting history
You’ll learn about behavioral changes required for the best post-operative results and psychological changes you may experience after surgery.
We will verify your insurance coverage before your first appointment. We send all necessary documentation to your insurance provider for preauthorization, and help you meet all insurance requirements throughout the process. Penn Medicine is accredited by the American College of Surgeons Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP). Many insurance carriers require patients to have bariatric surgery at a MBSAQIP accredited center.
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