Whether weight loss surgery is right for you depends on more than one number. Your BMI matters, but so do your health conditions, your weight loss history and how ready you are for lifelong changes. Here is how candidates are usually evaluated, and what your options are at each BMI.
The short answer
- Self-pay gastric sleeve: available from a BMI of 30, for patients 16 and older.
- Surgery with insurance: most plans require a BMI of 40 or more, or 35 or more with a weight-related condition.
- Gastric balloon: a non-surgical option often used at a BMI of 30 to 40.
- Medical weight loss: usually a BMI of 30 or more, or 27 or more with a weight-related condition.
Not sure of your BMI? Our BMI calculator takes under a minute and shows which options may fit.
What BMI looks like at your height
BMI compares your weight with your height. This table shows roughly what weight equals a BMI of 30, 35 and 40 at three common heights:
| Height | BMI 30 | BMI 35 | BMI 40 |
|---|---|---|---|
| 5′4″ | 175 lb | 204 lb | 233 lb |
| 5′7″ | 192 lb | 223 lb | 255 lb |
| 5′10″ | 209 lb | 244 lb | 279 lb |
BMI is a screening number, not a diagnosis. It does not tell muscle from fat, and the 2022 surgical guidelines note that people of Asian descent face weight-related health risks at a lower BMI, so surgery can be considered from a BMI of 27.5.
What medical guidelines say
The 2022 guidelines from the American Society for Metabolic and Bariatric Surgery (ASMBS) recommend surgery for people with a BMI of 35 or more, whether or not they have related health problems, and say it should be considered from a BMI of 30 for people with metabolic disease such as type 2 diabetes. Many insurance plans still follow older criteria from 1991: a BMI of 40 or more, or 35 or more with a serious weight-related condition.
Weight-related conditions that often count
- Type 2 diabetes or prediabetes
- High blood pressure
- Sleep apnea
- High cholesterol
- Fatty liver disease
- Acid reflux (GERD)
- Joint pain or arthritis
Which conditions count, and what records are needed, depends on your insurance plan. We check this for you for free.
More than a number
- You have tried to lose weight in other ways, such as diet, exercise or medication, without lasting results.
- You are ready for lifelong changes: smaller, protein-first meals, daily vitamins and regular activity.
- You can keep your follow-up visits, usually at 1 week, 1 month, 3, 6 and 12 months after surgery.
- You do not smoke, or you are willing to quit before surgery.
- You are not pregnant and are willing to wait 12 to 18 months after surgery before becoming pregnant.
When surgery may need to wait
Some situations can make surgery unsafe until they are treated: a heart or lung condition that makes anesthesia risky, active alcohol or drug misuse, or a mental health condition that would make recovery hard. Some patients need a psychological evaluation, decided case by case, and many insurance plans require one. These situations do not always rule surgery out. Often the right care first makes surgery possible later.
If you don't qualify yet
You still have options. The non-surgical gastric balloon and our physician-supervised medical weight loss program, which can include GLP-1 medication, work at lower BMIs. Read how GLP-1 medication compares with surgery.
The next step
The surest way to know is a consultation, and your first one with Dr. Wadiwala is free. We check your insurance for free, and if you pay for surgery yourself, it can be scheduled within 1–2 weeks of your consultation. Call 281-653-6544 or request a consultation.
Related reading
- Gastric Sleeve vs. Gastric Bypass
- GLP-1 Medication vs. Weight Loss Surgery
- GLP-1 Medication vs. Surgery: Which Costs Less?
- Does Insurance Cover Weight Loss Surgery in Texas?
- Weight Loss Surgery and Type 2 Diabetes
- How to Prepare for Weight Loss Surgery
- Life After Bariatric Surgery: The First 12 Months
- Diet After Bariatric Surgery: What You Need to Know
Sources
- Eisenberg D, et al. 2022 American Society for Metabolic and Bariatric Surgery (ASMBS) and International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO): Indications for Metabolic and Bariatric Surgery. Surg Obes Relat Dis. 2022;18(12):1345-1356.
- National Institutes of Health. Gastrointestinal Surgery for Severe Obesity: Consensus Development Conference Statement, 1991. Am J Clin Nutr. 1992;55(2 Suppl):615S-619S.
- Centers for Medicare & Medicaid Services, National Coverage Determination 100.1: Bariatric Surgery for Treatment of Co-Morbid Conditions Related to Morbid Obesity.
- Houston Surgical Weight Loss BMI calculator, Self-Pay, Gastric Balloon and After Surgery pages.
This article is general information, not medical advice. Talk with your doctor about what is right for you.