Apr
2014

Q&A: How overweight do I have to be to consider the gastric banding or the gastric bypass surgery?

Ask A Doctor Question: 

I am just wondering how overweight do I have to be to consider the gastric banding or the gastric bypass surgery and how much will the insurance company will pay of this?

- Cheryl

Answer: 

Keith Norton Marshall, DO - LocateADoc.com

Cheryl,
 
In order to qualify for Bariatric surgery, you have to have a BMI over 35 with at least one co- morbidity, like Diabetes, or hypertension. Or, a BMI  over 40 without. 
 
BMI  is Basal Metabolic Index, a calculation of weight divided by height, squared. Normal BMI is 18-25. There are charts available to find your BMI. It is about 75-100 lbs over ideal body weight. 
 
You also have to be a good candidate for surgery and have a good understanding of how it works. Patients get a lot of education so they know what they need to. 
 
Insurance covers the surgery if it is a benefit of the plan. Same as any surgery. There are also cash prices if patients do not have insurance. 

--Keith Norton Marshall, DO
Warren, MI

Answer: 

Laura L. Machado, M.D., F.A.C.S. - LocateADoc.com

Hello Cheryl,
 
Bariatric surgery criteria are based upon standards of height versus weight, or what we calculated called a body mass index or BMI.  BMI ranges above 35 generally will qualify for surgery under most health plans.  The amount of coverage will vary based on your particular policy. 

--Laura L. Machado, M.D., F.A.C.S.
Sacramento, CA

LocateADoc.com does not evaluate or guarantee the accuracy of any Ask A Doctor Q&A content. Read full conditions of use here.