Published on March 18, 2019

Evaluation for bariatric surgery

Man with family in backgroundBariatric surgery is an option for some people who are obese and have not been able to lose weight with other methods, such as diet and exercise.

Healthcare providers most often recommend bariatric surgery to people with a body mass index (BMI) of 40 or greater. BMI is a method of screening for a weight category using a person’s height and weight for calculation. A BMI of 25 to 29.9 is considered overweight. A BMI higher than 30 is considered obese. Your healthcare provider might also suggest bariatric surgery if your BMI is between 35 and 40 and you have a medical problem that may get better with weight loss, such as diabetes, sleep apnea, high blood pressure or osteoarthritis.

Who evaluates me for bariatric surgery?

Your medical team will only perform surgery if they know it will provide health benefits. For the surgery to be a success, you will need to make lifelong changes to your diet and lifestyle. Your medical team will want to know that you are ready for the life changes that go with surgery.

You will need to go through an in-depth screening process to be approved for bariatric surgery. As part of your evaluation, you will need to give some details about your weight and diet history.

To be approved for the surgery, you will need to meet with healthcare providers such as:

  • Your surgeon, who must confirm that you are a good candidate for surgery
  • A mental health professional, to assess your psychological health and readiness for the surgery
  • A registered dietitian, who will look at your diet and eating habits and help you begin to make the needed changes
  • Your primary care provider who can assess your general health and readiness for surgery
  • A cardiologist, who can make sure your heart is healthy for surgery
  • A pulmonologist, who can make sure your lungs are healthy for surgery

You may need to work with these healthcare providers for several months before you can get approval. They need to make sure you are in good mental and physical shape for the surgery. You might need to work with other healthcare professionals if you have other medical or social problems. All of these healthcare providers must agree that the surgery is safe for you.

Checking your mental readiness is a vital part of the approval process. Bariatric surgery is a big personal commitment. The surgery will permanently change your eating habits. To get approved for the surgery, you will need to show that you fully understand the risks and benefits. Support from your partner, family and friends can also be important for your mental readiness for the surgery.

What tests do I need for bariatric surgery approval?

As part of the approval process, you will need physical exams and testing. This is to make sure you are healthy enough for the surgery and recovery. You may need tests to evaluate your heart, lungs, stomach, liver and gallbladder, including:

  • Blood tests
  • Chest X-ray
  • Echocardiogram
  • Electrocardiogram
  • Pulmonary function test
  • Sleep study
  • Upper GI or endoscopy
  • Upper abdominal ultrasound

Your healthcare providers may also ask you to lose weight before surgery. If you smoke, your surgeon will likely require you to stop smoking to go ahead with surgery. These lifestyle changes help to make the surgery and recovery safer for you.

Realistic weight loss goals

It is important to have realistic weight loss goals going into the surgery. Most people don’t lose all of their excess weight after surgery. Depending on the type of surgery you have, you may lose one-half to two-thirds of your excess body weight. Your healthcare provider can give you a more exact idea of what you can expect. 

Losing this amount of weight may help any health conditions you have, even if you still carry some excess weight. You may be able to reduce or stop some of the medicines that you take. You may also have more energy and a more positive self-image. Having a realistic weight loss goal can help keep you motivated. It can help keep you on track with your good eating habits.