The National Institute for Health consensus conference in 1991 established widely accepted guidelines and indications for the surgical management of severe obesity and endorsed the gastric bypass with Roux-en-Y as the most effective means for treating the obese patient. Weight loss surgery is designed for individuals with a BMI of 40 or greater and whose weight severely impairs their quality of life. Individuals with a BMI between 35-40 who have known co-morbidities may also be considered for surgery.
There are many factors that determine whether a person would make a good candidate for bariatric surgery. A reasonable attempt at losing weight with a non-surgical method must be demonstrated. This may include a physician assisted program. Some insurance companies will require one to have attempted such a program as criteria for coverage of a weight loss surgery. Another factor in determining if someone is a candidate for surgery is their understanding and commitment to the life-long changes that will be required to make this a success. It is important that an individual make an informed decision and have the knowledge to do this. The benefits, risks and complications will all be explained in depth to enable one to decide whether they are able to make this commitment.
Good results after the surgical procedure require continued dieting and an exercise plan (see diet and exercise). It is essential that one understand this concept pre-operatively, and not have the expectation that the operation will remove personal responsibility and dedication from the weight loss equation.