Weight loss surgery requirements: Here’s what you need to know

A healthy living blog from Marshfield Clinic Health System

Weight loss surgery requirements: Here’s what you need to know

Jun 17, 2024

Weight loss surgery can be a life-changing option for those who qualify. There are a handful of weight loss surgery requirements you must first meet.

Weight loss surgery requirements: Woman with glucose monitor on her arm tightens her pony tail, like she's getting ready to exercise — Many programs and insurance providers require weight loss surgery participants to lose or maintain weight before surgery.

It commonly takes six months to a year to complete prerequisites for metabolic and bariatric surgery and is surely not the easy way out. Preparation and lifelong commitment are required for long-term success.

Before weight loss surgery

In general, weight loss surgery requirements include you to have a BMI greater than or equal to 40 or BMI greater than or equal to 35 with a co- morbidity to qualify for weight loss surgery. Most programs and insurance providers also require the following:

1. Counseling and lifestyle changes

Weight loss counseling before surgery typically includes working with a dietitian and participating in a medically supervised weight-loss program. During this time, you must complete multiple visits while making lifestyle changes. Additionally, other health conditions must be at their best state possible.

“Unlike other surgeries, weight loss surgery is only a tool. Results do not depend on just the surgery, but also whether the patient keeps on track with the diet and plan beforehand,” said Dr. Vijaya Nirujogi, surgeon and director of bariatric and metabolic surgery for Marshfield Clinic Health System. “Most bad experiences around weight loss surgery are because of a lack of follow-up or understanding of the new lifestyle needed after surgery to succeed.”

2. Losing or maintaining weight

Many programs and insurance providers require participants to lose or maintain weight before moving forward with surgery.

Nirujogi recommends treating obesity type II (body mass index greater than 35) with significant health issues such as poorly controlled diabetes mellitus type 2 or morbid obesity (body mass index greater than 40) with or without comorbid health conditions sooner rather than later. Resolution of medical problems is higher in those who have had the problem for a shorter amount of time.

“As with any treatment, multiple factors are taken into consideration to determine candidacy both medically and behaviorally,” Nirujogi said.

After weight loss surgery

1. Time away from work

If the procedure is laparoscopic, you can return to work in a couple of weeks. If you have a manual or physical job, your surgeon may require you to wait 4-6 weeks. Most patients stop using pain medication within a week.

2. Full liquid diet

For the first two weeks after surgery, you are assigned a full liquid diet. Then, you advance to pureed foods, soft foods, and, finally, regular food. You should eat according to the plan provided by your care team, which should be high in protein to help you keep muscle mass.

“Most patients don’t feel hungry because of metabolic changes caused by surgery and the fact that the stomach pouch is pretty much the size of an egg,” Nirujogi said.

After about a month, your body adjusts to the changes in the intestines and reduced calorie count.

After a year

Expect extensive follow-up for the first year and then annual check-ups.

“Follow-up is really important because your surgeon is best able to catch issues stemming from your surgery. A regular follow up with the bariatric team also helps keep patients on track and decrease risk of regaining weight and long-term nutritional deficiencies,” Nirujogi said.

With weight loss, many patients experience excess skin. Nirujogi recommends waiting to surgically remove excess skin until maximum weight loss is achieved, and you have maintained that weight for at least three months or more. Most excess skin removal surgeries are not covered by insurance unless it is medically necessary.

Marshfield Medical Center in Marshfield is the only accredited Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program Center of Excellence in north central Wisconsin and provides follow-up care for the life of a patient. To learn more, go here.