Weight Loss Surgery Requirements

Are You a Candidate for Weight Loss Surgery?

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Your Body Mass Index (BMI) is a calculation that helps determine a healthy body weight based on your height. It is also used by insurance companies to determine if you are eligible for weight loss surgery coverage.

Weight Loss Surgery Eligibility

Insurance companies generally consider you eligible for weight loss surgery coverage if:

Your BMI is 40 or more OR

Your BMI is 35 to 40 AND you have a major health complication such as:

  • Diabetes
  • Cardiovascular disease, including high blood pressure, high cholesterol, or significant heart disease
  • Debilitating joint pain
  • Sleep apnea
  • Uncontrolled GERD or acid reflux
  • Pulmonary hypertension

If your BMI is below 35, your insurance provider may deny coverage for weight loss surgery. We also know that this can change, as your weight varies over time based on where you are in the dieting cycle.

Calculate Your BMI

Types of Weight Loss Surgery

If You Are a Candidate for Bariatric Surgery
Learn what factors your surgeon will review when recommending a type of surgery, the pros and cons of each procedure, and how each works.

If You Had Bariatric Surgery
If you  did not achieve significant weight loss or are experiencing a complication, we can evaluate your concerns and discuss your options, including:

If You Are Not a Candidate for Weight Loss Surgery

If you aren't a candidate for bariatric surgery, you may want to consider other weight loss options we offer, including:

A badge from the American College of Surgeons and American Society for Metabolic and Bariatric Surgery for an Accredited Center Quality Program
Bariatric Center of Excellence

Duke Regional Hospital is accredited by the American Society for Metabolic and Bariatric Surgery for its high standards of care in weight loss surgery. 

This page was medically reviewed on 12/03/2021 by