Bariatric surgery has been considered a last-hope procedure for extremely overweight people who have been unable to lose weight through diet and exercise or who have other severe health problems, such as diabetes.
Over the past year, the guidelines to qualify for the surgery have been changed by a panel of doctors and surgeons representing various medical associations that set rules for bariatric surgeries. Before the change, only people with a body mass index (BMI) of 35 or higher were eligible. But now, some people with a BMI as low as 30 may qualify. More than 25 percent of adults 65 and older have a BMI of 30 or higher.
BMI is used by most health care professionals to determine if a person is underweight, normal weight, overweight or obese. It has supplanted the traditional height-to-weight tables used for decades. For a BMI calculator, go to nwsdy.li/bariatric.
To put the BMI numbers in perspective, a 5-foot, 6-inch woman would have to weigh at least 217 pounds to be eligible for bariatric surgery under the old guidelines. New guidelines indicate she might be eligible if she weighs 186 pounds, as long as she meets other criteria. (Her "normal" weight range using BMI is 115-154 pounds.) BMI is not gender specific, so the numbers are the same for a man of the same height.
There are three types of bariatric surgeries: lap band, laparoscopic sleeve and gastric bypass. The cost is about $10,000 to $35,000, depending on the procedure, but for many, the results are life-altering and lifesaving. "You're going to lose about 70 percent of your excess weight in 18 to 24 months," says Dr. Nick Nicholson, a Dallas-based surgeon and author of "Weight Loss Surgery: The Real Skinny."
But be aware, Medicare and most private health insurers haven't adjusted to the new guidelines and still will not consider paying for the surgery unless a person has a BMI of 35 or higher.
Under the old guidelines, a person would have to be morbidly obese -- often 100 to 200 pounds overweight -- before qualifying for the surgery. Even assuming they lost 70 percent of their excess weight, they would still be considerably overweight. But for someone with a BMI of 30, the surgery could leave them within striking distance of their ideal weight.
"If you start at 60 [pounds overweight] and you lose 70 percent, that's 42 pounds," Nicholson says. "Now you're 18 pounds away from perfect, and that's a whole lot more achievable."
Covidien, a company that provides equipment for weight-loss surgery, has a guide for prospective bariatric patients at nwsdy.li/bariatric.