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Who is not a good candidate for bariatric (weight loss) surgery?

Dr. Khoi H. Du, MD
Bariatric Medicine (Obesity Medicine) Specialist

In order to qualify for bariatric surgery, a patient has to have a body mass index (BMI) of 35 plus comorbidity, or a BMI over 40. Further, a patient who isn’t fully committed to the process would not be a good candidate for bariatric surgery. Patients think that the surgery is going to be a miracle cure for weight loss, but it's not. A good outcome requires commitment and a willingness to make lifestyle changes.

You may not be a good candidate for bariatric (weight loss) surgery if you have:

  • ongoing drug or alcohol addiction
  • uncontrolled mental illness
  • significant eating disorder
  • an unwillingness to comply with the necessary guidelines following bariatric surgery

A person may not be a good candidate for bariatric (weight-loss) surgery for the following reasons:

  • The procedure represents an unacceptable risk to the person.
  • The person doesn’t understand or accept the risks and commitments that accompany such a life-changing procedure.
  • There is active evidence of alcohol and/or drug abuse.
  • The person has an untreated or unmanageable psychiatric disability.
  • The person has not tried potentially effective non-surgical treatments.
  • The person has reversible endocrine disorders that can be the root cause of his or her morbid obesity or metabolic disease.
Dr. Melissa B. Bagloo, MD
Bariatric Medicine (Obesity Medicine) Specialist

This surgery is obviously a very serious step. Patients with psychiatric conditions such as depression, bipolar disease and/or schizophrenia should be under the care of a psychiatrist before they consider surgery. These conditions can become exaggerated by the body changes that are associated with weight loss. There are some medical conditions which make the surgery too dangerous to perform. These occur rarely but must be taken into account. If patients meet the eligibility guidelines that are outlined above, they are obvious candidates for success with this surgery.

Weight-loss surgery is a huge step toward a healthier lifestyle. However, not everyone is a good candidate for bariatric (weight loss) surgery. All patients considering bariatric surgery at Penn must meet specific criteria before being scheduled for a screening evaluation. These criteria are based on universal standards established by the National Institutes of Health. Surgeons at Penn Medicine evaluate other criteria, such as a patient’s age and general health, including cardiovascular health and psychological well-being, to determine if bariatric surgery is appropriate.

Those who are mentally ill or have other risk factors may not be recommended for bariatric surgery.

People who are not good candidates for bariatric (weight loss) surgery include those who:

  • are medically fragile and could not safely undergo surgery
  • have psychiatric issues including eating disorders that are not fully managed
  • refuse to quit smoking
  • do not meet the body mass index (BMI) and co-morbidity criteria
  • do not want to make the commitment to lifelong change

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.