Am I a candidate?

The decision about whether bariatric (weight loss) surgery is right for you or a loved one can be daunting and we are here to help. Please attend one of our seminars or webinars for more information about how to make sense of the different procedures that are available, and how to maximize the effectiveness of a given procedure by tailoring it to you as an individual. That’s right! We focus on providing maximum effectiveness and durability of results by focusing on your personal needs. But before we can do that, let us discuss whether or not to embark on this journey in the first place.

To begin with, check with your medical insurance to ensure that you have coverage for bariatric procedures as not all plans will cover these particular surgeries. If you do have coverage, chances are that the criteria for receiving pre-authorization will be based on eligibility requirements for bariatric surgery established by the National Institutes of Health (NIH). Individuals with no comorbidities must have a body mass index (BMI) of 40 or greater. If an individual has a BMI of 35-39, the presence of additional health risks—or co-morbidities—may qualify that person for weight loss surgery as well. These procedures are meant to be performed when diet and exercise have not worked, or when you have serious health problems because of your weight.

Unfortunately, these “traditional” criteria for the eligibility for bariatric surgery are now more than 2 decades old since their original implementation. It is safe to say that a lot has changed in the past 20+ years. Without delving too deeply on the subject, in the intervening years our ability to perform these surgeries using progressively less invasive approaches continues to evolve and improve, and operative outcomes and safety have also improved over the past several decades. Furthermore, our scientific understanding of the metabolic and hormonal effects of these surgeries continues to expand. Several now well accepted procedures, such as the sleeve gastrectomy (which Dr. Elariny had a significant hand in creating), and Duodenal Switch did not even exist in their current form two decades ago.

What this evolution of the bariatric surgical field means to the patient is that perhaps there is a role for expanded eligibility criteria. In fact, this very topic is a matter of intense discussion in the medical community. It is well known that multiple medical societies have seen the benefit of bariatric surgery for patients that have failed medical weight loss attempts. Some societies have even issued position statements for expanded eligibility criteria. For example, the International Diabetes Federation position statement in 2011 considered bariatric surgery appropriate in patients with BMI 30-35 and complementary to type II diabetic medical therapies. The bottom line is, if you are interested in weight loss surgery, but do not meet the NIH criteria for eligibility, you may still be an appropriate candidate under the right conditions so please do not hesitate to discuss this with your healthcare provider.

A special note about patients who have undergone previous bariatric surgery and are seeking consultation for revision: Welcome! Dr. Elariny has extensive experience in revisional bariatric surgery and will be happy to meet with you to discuss feasibility and options on a case-by-case basis.

It is important to remember that all forms of bariatric surgery are major procedures that can pose serious risks and side effects. We will do our best to educate you to the best of our ability every step of the way. Also, you must make permanent healthy changes to your diet and how you experience food to ensure the long-term success of your surgery. Needless to say, we will be there for every part of this important, life-altering, and ultimately positive experience in your life.