What is the criteria for having gastric bypass?

The criteria for having gastric bypass can be different depending on where you are having it done and what your insurance requires.

Following is the criteria I have to meet for the Samaritan Bariatric Program.
This also happens to be pretty much the same as my insurance requirements.
I am very fortunate in that I work for the state, and have Samaritan Select health insurance. It is very good insurance, and it will pay for the bariatric program. The costs to me will be, Co-pays for labs and doctors visits (usually $10.00), a total of $750.00 for the bariatric program fees (this is not covered by the insurance) and for the surgery itself I pay only $100.00 per day for the hospital stay, which is usually only about 2 days if all goes well and the surgery is done laparoscopic.

taken from handout from Samaritan Bariatric Program in Corvallis, Oregon:

Mandatory patient selection criteria

1) Body Mass Index (BMI) exceeding 40; (greater than 100 lbs over ideal body wieght); or

2) BMI greater than 35 in conjunction with the severe co-morbidities that are likely to reduce life expectancy.
1. Coronary Heart Disease
2. Type 2 Diabetes Mellitus
3. Obstructive Sleep Apnea
4. Hypertension
5. Hyperlipidemia
6. Hypercholesterolemia
7. Osteoarthritis
8. Gallstones
9. Stress Incontinence

3) Patient must demonstrate a 5% wieght loss after entering our program.

4) Commitment to Samaritan Bariatric Program:
1. Attend two informational classes prior to an office consult with the doctor,
2. Lab work every two months after surgery for the first year.
3. Support groups monthly.
4. Monthly wieght checks for the first year.

5) Health status at level to tolerate surgical procedure.

6) Age 18 - 65 (consenting adult)

7) Not pregnant

8) History of trial medical/dietary therapies:
Provide documentation that you have failed less invasive methods of wieght loss. Less invasive therapies include low-calorie dieting, increased physical activity, behavioral therapy, and pharmacotherapy.

9) Behavioral or psychiatric assessment.


*My insurance also states that this is to be a six month process before the surgery.
I MAY be able to have it before the six months are up, if I have completed all the other requirements. This is strictly up to the person at the insurance company that reviews my request for the surgery.