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BMI for Weight Loss Surgery: Will I Qualify?

What is BMI (Body Mass Index) and What Does it Mean

Are you considering plastic surgery and unsure whether your BMI qualifies you for the procedure? Or, perhaps you want to know more about BMI for weight loss surgery. 

In either case, it’s important to understand what BMI for weight loss surgery is and why it is critical to have a BMI within the qualifying range for your weight loss surgery. These are the things we will be explaining in this article.

But first, what does BMI stand for?

What Does BMI Stand For?

BMI stands for body mass index.

Everyone has a body mass index. It is a number that is calculated based on your height and weight. It is a measure of obesity. 

How Do I Find My BMI?

There are dozens of BMI calculators that you can easily find on the Internet. When you plug in your height and weight, you get a number that characterizes your degree of obesity related health conditions.

BMIs fall into range categories, as follows:

Less than 18.5 = underweight

18.5 – 24.9 = normal

25 – 29.9 = overweight

30 – 34.9 = obese

Over 35 = extremely obese

Why Is BMI Important?

Many people (and their doctors) want to know their BMI for basic health reasons. A normal-range BMI is healthy. But if your height and weight put your BMI in the underweight, overweight, obese, or extremely obese categories, you may be at higher risk for health issues. Lifestyle changes can help you alter your weight and achieve a normal BMI.

BMI for weight loss surgeryBMI for Surgery

You will also need to know your BMI for weight loss surgery, plastic surgery, or any other type of surgery you plan on getting. What’s important to note here is that the BMI range which will qualify you for surgery will depend upon the procedure.

In other words, some procedures may require a high BMI (weight loss surgery), and others may require a normal-range BMI (most plastic surgeries).

For example, it would be impossible to qualify for weight loss surgery for BMI numbers lower than 30. In fact, in many cases, surgeons will not perform weight loss surgery for BMI numbers lower than 40 either. This is simply because most surgeons and doctors will not deem weight loss surgery “medically necessary” if your BMI is not in the “obese” or “extremely obese” categories.

On the other hand, elective procedures require a low BMI. For example, if you’re interested in surgery after weight loss (a tummy tuck, for example), you’ll generally need to have a normal-range BMI.

This is because a person’s level of obesity related health conditions will be related to their unique risk for surgical complications with these procedures. When it comes to plastic surgeries like breast augmentations or tummy tucks, the data show that people with a BMI above 30 are at increased risk for having a complication during or after weight loss surgery.

What Risks Are Associated With High BMI Surgery Patients?

High BMI-related complications from surgery may include a negative reaction to anesthesia, high blood pressure, breathing problems, heart disease, heart attack, stroke, or blood clots. These risks can be serious and even fatal. 

Additionally, we know that people with a BMI over 30 are at increased risk for healing problems. This means that incisions may be slower to heal, there may be infections, and an overall poorer cosmetic outcome may result. This is extremely important with procedures requiring long incisions such as tummy tucks and breast reductions.

Based on this data, board-certified plastic surgeons are likely to decline to perform surgery on you if your body mass index is above 30. We certainly would never want to put you at risk, especially for an elective cosmetic procedure. 

Of course, if you need life-saving surgery, the surgeon will perform the procedure no matter what your BMI is. But plastic surgery is different and we try to keep all the risks at the lowest level possible.

What Does BMI Stand for in Terms of a Reflection of Someone’s Health?

A common criticism of BMI calculations is that it is imprecise and doesn’t always accurately reflect someone’s obesity or surgical risk level. 

This is definitely true. 

A simple calculation using a person’s height and weight does not take everything into consideration. BMI does not consider things like bone mass, muscle mass, or body fat distribution.

In addition, men tend to have a higher BMI overall, and this doesn’t necessarily mean that they are far from their healthy weight. A muscular man may have minimal body fat but a very high BMI. For example, NBA superstar Shaquille O’Neal stands 7’1” tall and 324 pounds. This makes his BMI 31.5 and in the obese range. But no one would consider this elite athlete to be too obese for surgery. 

What if Excess Skin Is Adding to a Person’s Weight?

Another issue with BMI calculations is that patients who have lost a lot of weight will usually still carry significant excess skin. 

A person who has successfully lost 100 pounds and has no body fat left on their body, for example, may be carrying 20+ pounds of extra skin. However, using a simple BMI calculator may give them a BMI over 30 only because of the extra skin they are carrying around. The good news is there is not one board-certified plastic surgeon who would deny skin removal surgery in a case like this.

Does Fat Location Matter?

Also, the location of someone’s excess fat is very important, and this is not considered in BMI calculations. 

Excess fat in the extremities (thighs and legs) carries less surgical risk than excess weight in the abdomen. This is because central obesity (fat in the abdomen) is more dangerous than peripheral obesity (fat is the arms and legs).  In other words, an apple shape is more dangerous than a pear shape. 

Questions and Answers

Can I get gastric bypass with BMI of 31?

The American Society for Metabolic and Bariatric Surgery recommends Gastric Bypass and Sleeve Gastrectomy for BMI 30-35 patients. A 5-year study strongly supports Sleeve Gastrectomy for lower BMI individuals, yielding outstanding outcomes.

What BMI will insurance cover weight-loss surgery?

Most insurance providers typically mandate a minimum BMI of 40 (or 35 with accompanying health issues) to qualify for coverage of bariatric surgery.

Does Dr. Schulman Use BMI for Weight Loss Surgery Procedures?

Here’s what Dr. Schulman has to say about his use of BMI calculations in his practice:

“In my practice, I absolutely use body mass index to help me decide if I am going to operate on a patient. When someone calls to schedule a consultation, we always ask for a current height and weight, allowing us to calculate their BMI.

I will allow people to be seen in consultation if their BMI is below 32. I will then evaluate them in person and decide if it is safe to perform elective cosmetic surgery the way they are. In some cases, I may tell the person they need to lose a few more pounds in order to get their BMI below 30 before I will agree to operate on them.

To find out what your BMI is, check out a BMI calculator and plug in your numbers. This will help you be prepared for your consultation, and it will give you an idea of whether or not you will be required to lose weight prior to your surgery. Your goal should be to have your BMI below 30 and as close to normal healthy weight as you can.”


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