Do I Qualify for Gastric Sleeve or Bypass Surgery?

People who struggle with obesity and related co-morbidities have benefited significantly from bariatric surgeries. Weight loss surgeries like gastric sleeve surgery and gastric bypass surgery alter the stomach size and impact the ability to absorb calories from food to help you lose weight. The surgery is also termed “metabolic” because it affects the metabolic hormones that manage satiety and hunger for some time after the operation.

A gastric bypass can cause more issues when it comes to the malabsorption of nutrients than a gastric sleeve, but it can result in a higher level of weight loss. For this reason, it is often used for those who need to lose a more significant amount of weight. A gastric bypass is also an excellent option for reflux sufferers before surgery. If reflux becomes an issue post gastric sleeve surgery, it can be converted to a gastric bypass as a remedy.

In Australia, the guidelines for determining bariatric surgery eligibility were quite limited. Generally, you needed to meet various conditions to qualify for this type of surgery, the foremost being that you needed a bariatric surgery BMI (Body Mass Index) criteria of 40 or more, or a BMI of 35 with at least one obesity-related condition. 

In late 2022, after 30 years without a proper scientific review, new guidelines were released by the ASMBS and IFSO. These updated guidelines recommend a BMI for a gastric sleeve of 35 or more to qualify, regardless of comorbid/obesity-related disease, or a BMI of 30-34.9 if there is a concurrent metabolic disease. This will make the surgery more accessible, as it is as safe as gallbladder removal and has unparalleled weight loss outcomes that other weight loss tools have not yet replicated.

• BMI of 35 or above, with or without obesity-related conditions such as diabetes, sleep apnea, joint conditions, and chronic reflux.
• Failure to succeed with supervised dieting programmes and nutritional instruction.

It is important to note that guidelines are not hard and fast rules, and decisions regarding eligibility are ultimately made on a case-by-case basis by experienced medical professionals. You should, therefore, not automatically assume you will or won’t qualify before receiving official advice from an accredited health practitioner or specialist in this field.

Although BMI does not explicitly illustrate an individual's body fat percentage, it is a helpful tool for categorising overall body weight according to accepted standards.

Sleeve gastrectomy BMI requirements are essential when considering weight loss surgery because it gives healthcare professionals and patients information about the severity of the patient's obesity.

BMI measures body fat calculated by considering an individual's height and weight. It can assess whether someone is overweight, obese, or underweight.

Sleep apnea

Cardiovascular disease

Kidney disease

Liver disease

Diabetes

Your long-term weight loss surgery results depend on your ability to adjust your diet, take bariatric multivitamins and maintain healthy lifestyle habits. Being in strong mental health is also vital for the demands of adhering to your treatment plan.

In many cases, you must attend counselling sessions before your procedure to ensure you understand the implications of having such major surgery performed. During these sessions, psychiatrists or psychologists can assess psychological aspects such as moods, coping strategies, and other factors that can influence how successful you may be post-surgery.

Your medical team will discuss the following topics with you:

• Motivation - Do you want to make lifestyle changes, create goals, and learn more about healthy nutrition? Your team will monitor your ability to implement recommended dietary and activity adjustments.
• Previous attempts at weight loss - What weight-loss diets and exercise regimens have you tried? Have you lost or gained weight? Weight loss and gain patterns might assist your team in identifying your issues and proposing tactics for post-surgical goals.
• Eating habits - Obesity may be aggravated by irregular or disordered eating habits. Examples of this include binge eating, stress eating or emotional eating, eating at night, and constant snacking between meals. Some mental health issues such as ADHD and Bipolar disorder are linked with disordered eating conditions. It's good to have a full screen of your mental health, so that any conditions can be well managed to ensure your WLS success is attained. 
• Mental Health - Obesity often co-exists with other conditions such as depression, ADHD, anxiety, and bipolar disorder, making managing your weight challenging. Furthermore, persons with untreated co-morbidities like these frequently struggle to maintain new diets and exercise routines following surgery.
• The use of alcohol and drugs - Poor weight loss and ongoing substance use difficulties following surgery are linked to problems with alcohol or drug use and smoking. Untreated or uncontrolled habits or addictions are likely to inhibit the choice of weight loss surgery.

As of a November 1, 2018 update, some of the Medicare Benefits Schemes changed. Weight loss surgery is not entirely covered under Medicare, and you may have to pay some out-of-pocket expenses. Most weight loss surgeries in Australia are performed under private health insurance, or patients are self-funded. You may draw down an advance from your superannuation fund if you meet certain criteria. This withdrawal is relatively easy to access once you have met the requirements and filled in the relevant paperwork.