The decision to undergo gastric bypass surgery is challenging. Indeed, when you decide to have gastric bypass, you are committing to altering your digestive system for the rest of your life, and you have to be willing to change behaviors that have contributed to obesity. Gastric bypass surgery is a positive transition for many people as it can increase overall health, mobility, and quality of life. Bypass surgery is one of the most effective weight loss procedures for overweight or obese people. If you are interested in surgical weight loss, you must meet the gastric bypass requirements to undergo this procedure.

What is Gastric Bypass Surgery?

Gastric bypass surgery is a bariatric procedure where a surgeon changes the digestive tract to help you lose weight. This surgery is a two-part procedure. Firstly, the surgeon creates a small pouch out of your stomach that can hold only a small amount of food at one time. Secondly, the surgeon modifies the small intestine by cutting the top portion of the small intestine and re-attaching it to the lower end of the small intestine. Frequently called Roux-en-Y (RNY) gastric bypass, this procedure helps people lose weight in three key ways:

1. The amount of food you can eat is restricted.
2. Calorie and nutrient absorption are limited.
3. Gut hormones change, which helps suppress your appetite because you feel full for longer in between meals.

This procedure permanently changes your digestive anatomy. Therefore, it requires a willingness to make permanent changes to your life so that you can succeed. There are specific criteria for gastric bypass surgery that determine if you qualify for this surgery.

What are the requirements for Gastric Bypass Surgery?

Every patient is different, and their needs and desire for gastric bypass surgery vary. Yet, there are specific requirements for gastric bypass surgery that you must meet for a surgeon to consider operating. Gastric bypass BMI requirements are as follows:

• BMI ≥ 40, or if you are more than 100 pounds overweight
• BMI ≥ 35 and you have at least one (or more) obesity-related conditions such as high blood pressure, sleep apnea, and type II diabetes.
• You are unable to reach or sustain a healthy weight despite other weight loss efforts, including dieting and exercising.

All patients must meet these minimum qualifications for gastric bypass surgery. You can calculate your BMI here.

While weight requirements for gastric bypass surgery guide the decision on whether or not you are a candidate for surgery, there are other essential factors that your surgeon may consider. Indeed, many bariatric surgery centers have additional requirements or recommendations for their patients before they are willing to perform this procedure. For example, some surgeons may require that their patients meet a weight loss goal before surgery. Many centers help their patients reach this goal with diet and exercise support. Patients must also follow a liquid diet before surgery to prepare the digestive tract, shrink the liver, and increase safety during the operation. Furthermore, most surgeons will require you to stop smoking before scheduling you for gastric bypass surgery.

When searching for a gastric bypass surgeon, leading bariatric surgery organizations, including the American College of Surgeons and the American Society for Metabolic and Bariatric Surgery, recommend you work with a board-certified bariatric surgeon who practices with a multidisciplinary approach. Therefore, look for a bariatric surgery center that offers nutritionists, personal trainers, mental health therapists, and a support group. Gastric bypass surgery permanently alters your digestive system, so you must meet the physical and behavioral requirements required by your surgeon.

Gastric Bypass Requirements Insurance - Will my plan cover surgery?

The financial cost is a big factor for people deciding to have gastric bypass surgery. Without insurance, bariatric surgery costs range from $14,000 - $33,000. Gastric bypass surgery tends to cost on the upper end of this range. For many people, surgery is not an option if insurance does not cover all or part of bariatric surgery.

Over 40% of adults in the United States are obese. Many sources have considered the obesity rate to be of pandemic proportions in the world. Therefore, bariatric surgery is becoming more common as a means to combat obesity and obesity-related comorbidities. Insurance companies are starting to recognize the benefits that bariatric surgery can have on improving the health and longevity of their insurees.

Coverage is dependent on your ability to follow insurance requirements for gastric bypass surgery. Indeed, patients who can follow gastric bypass surgery criteria are more likely to get part or all of their operation covered. Medicare and Medicaid do cover some bariatric procedures like gastric bypass and gastric banding. Make sure you are familiar with the Medicaid requirements for gastric bypass surgery and the Medicare gastric bypass requirements if you have these federal insurance plans.

Privately-held insurance plans may also cover some or all of gastric bypass surgery. However, many private policies exclude bariatric surgery. For example, even people who meet the United Healthcare gastric bypass requirements or the Blue Cross Blue Shield gastric bypass requirements may not get coverage unless their state-of-residence requires insurance carriers to provide coverage. You will need to follow gastric bypass insurance requirements no matter what company you have health insurance through.

It can feel daunting to pursue insurance coverage for surgery. Most bariatric surgery centers will guide you through the maze of insurance and may even handle all of the communication between you and your carrier. If cost is a factor, look for a bariatric surgeon who offers payment plans or who has staff that can help you navigate your insurance.

What are the qualifications to get gastric bypass surgery in other countries?

Some people seek gastric bypass surgery in a different country because their home country does not meet their specific needs. Indeed, this is a rather common phenomenon called bariatric surgery tourism. For example, some people consider having gastric bypass surgery elsewhere because it is too expensive in their home country, wait times are too long, or the surgeons do not have enough experience performing this procedure.

Requirements for gastric bypass surgery can vary in different countries. For example, the qualifications for gastric bypass surgery in Canada may differ from those in Mexico. Many countries offer clear guidelines such as the gastric bypass NHS requirements in the United Kingdom, whereas others may not be clear. Before searching for gastric bypass surgery centers outside of your home country, look for board-certified bariatric surgeons. They can help address your concerns about having the procedure in your home country.

Gastric Bypass Requirements After Surgery

Just like you must meet the weight requirements for gastric bypass surgery, you also must adhere to your surgeon’s post-gastric bypass surgery criteria. These requirements ensure that you achieve your weight loss goals, keep your post-op body healthy, and keep the weight off for good. Most surgeons will require you follow some, or all, of these guidelines:

• Keep all of your follow up appointments.
• Work with a dietician in the weeks and months following surgery so that you learn to eat the right foods and proportions. For example, patients must meet protein requirements after gastric bypass to have a full recovery and succeed in reaching their weight loss goals.
• Follow your surgeon’s gastric bypass vitamin requirements to prevent nutritional deficiencies.
• Take your medications regularly for other health conditions such as high blood pressure and diabetes. These medications may need to be adjusted in the months and years following surgery as weight loss can improve and even resolve many conditions.
• Establish a physical fitness regimen with an exercise physiologist to help you stay on track and keep the weight off for good.
• Speak with a mental health professional who can help you navigate through habit changes, strained relationships, and struggling to find your new self-identity after being obese.
• Participate in a support group to help you find a community that is going through the same experiences as you. Meeting with people in person is extremely valuable. However, you can also search for a community in online weight loss surgery forums. We offer a community of our own you could leverage.