Am I a Candidate for Weight Loss Surgery?

We offer a free, online bariatric surgery profiler to help determine if you are a candidate for weight loss surgery or a non-surgical procedure.

Take the Weight Loss Quiz

Your body mass index (BMI) and other factors will determine if you will qualify for specific surgeries or non-surgical procedures.

BMI > 35

If your BMI is 35 or greater and you have an obesity-related condition (such as diabetes or high blood pressure), or your BMI is 40 or greater, you may be a candidate for one of the following procedures:

  • Revision surgical procedures
  • Roux-en-y gastric bypass
  • Vertical sleeve gastrectomy

BMI 30-39

If your BMI is between 30 and 39, you may be a candidate for one of the following procedures:

  • Gastric balloon
  • Laparoscopic adjustable gastric band

Surgery Options

Our bariatric surgeons at Menorah Medical Center are dedicated to providing the latest treatment options available for your weight loss journey.

Laparoscopic Adjustable Gastric Banding (LAP-BAND®) is a purely restrictive procedure in which a band is placed around the uppermost part of the stomach. Patients then receive adjustments (fills) to customize the degree of restriction to the individual. Food travels through the normal digestive process, and patients feel full and satisfied with small meals.

The duodenal switch (DS) procedure, also known as biliopancreatic diversion with duodenal switch (BPD-DS) or gastric reduction duodenal switch (GRDS), is a weight loss surgery procedure that is composed of a restrictive and a malabsorptive aspect. This procedure is typically reserved for patients with a BMI greater than 50, severe diabetics, or those who have failed another weight loss surgical procedure.

How it Works

illustration showing how part of the intesine is removed during surgery

The restrictive portion of the surgery involves removing approximately 70% of the stomach (along the greater curvature) and most of the duodenum.

The malabsorptive portion of the surgery reroutes a lengthy portion of the small intestine, creating two separate pathways and one common channel. The shorter of the two pathways, the digestive loop, takes food from the stomach to the common channel. The much longer pathway, the biliopancreatic loop, carries bile from the liver to the common channel.

The common channel is the portion of small intestine, usually 75-150 centimeters long, in which the contents of the digestive path mix with the bile from the biliopancreatic loop before emptying into the large intestine. The objective of this arrangement is to reduce the amount of time the body has to capture calories from food in the small intestine and to selectively limit the absorption of fat. As a result, following surgery, these patients absorb only approximately 20% of the fat they intake.


The primary advantage of duodenal switch (DS) surgery is that its combination of moderate intake restriction with substantial calorie malabsorption results in a higher percentage of excess weight loss versus a purely restrictive gastric bypass for all individuals. Patients see a loss of 80-90% of excess body weight in the first year.


The malabsorptive element of the DS requires that those who undergo the procedure take vitamin and mineral supplements above and beyond that of the normal population, as do patients having the RNY surgery. Commonly prescribed supplements include a daily multivitamin, calcium citrate, and the fat-soluble vitamins A, D, E and K.


All surgical procedures involve a degree of risk however this must be balanced against the significant risks associated with severe obesity.

Some of the surgical risks or complications for this procedure are: perforation involving small bowel, duodenum, or stomach causing a leak, infection, abscess, deep vein thrombosis (blood clot), and pulmonary emboli (blood clot traveling to the lungs).

Longer-term risks include the possibility of vitamin and mineral deficiency, hernia and bowel obstruction.

If you have undergone a bariatric surgery in the past that was unsuccessful for some reason, you may be a candidate for a bariatric revision. Revision procedures can vary greatly based several factors, including:

  • What type of bariatric operation you had originally
  • How long ago your operation was performed
  • The degree of weight loss you achieved
  • Your current nutrition and physical condition

Revision procedures are certainly not one-size-fits-all, and not everyone is a candidate. The information below will give you general information on your options, based on your original bariatric procedure.

Gastric Sleeve Revisions

With a gastric sleeve procedure, a revision surgery may be needed due to mechanical failure of the original procedure, resulting in:

  • The development of severe acid reflux
  • Prolonged nausea and vomiting
  • A sleeve that is too large

Sometimes after a sleeve procedure, you may not lose as much weight as you would like to lose. The first step in understanding why you may not be losing as much weight as you had hoped or have regained weight. We make sure you were properly educated on how to use the sleeve as a weight loss tool.

Can you answer “yes” to each of the following statements?

  • I eat 60-80 grams of lean protein daily while keeping my overall calorie intake at 800 calories or less.
  • I drink 80-100 ounces of zero calorie liquids daily and avoid all liquid calories (i.e., milk, juice, smoothies, sweet tea, soda, coffee creamer/drinks).
  • I do not drink with my meals and wait a minimum of 30 minutes after eating to resume drinking.
  • I complete a minimum of 45 minutes of exercise 3-5 times per week.

If you answered “no” to any of the above questions, please call us to discuss your situation or attend our quarterly support group. If you answered “yes” to all of the questions above and have failed to lose adequate weight or have regained weight, you may be a candidate for conversion to gastric bypass or duodenal switch procedure.

Gastric Bypass Revisions

In reality, most patients don’t need a gastric bypass revision. The most common complaint we see with patients who have gained weight back after gastric bypass surgery is, “My pouch has stretched out.” While that may be true to an extent for some patients, most patients have reverted back to poor eating habits. When asked how much chicken and veggies they can eat at one time, patients are often no longer aware of the quantity of food they are eating.

It’s important to remember that these surgeries are tools to help you deal with your body’s slow metabolism and poor eating habits. Their main function is to help control appetite and portion sizes. We know portion sizes will increase some over time, but it’s not usually due to major stretching of the pouch.

Another potential cause of weight gain after gastric bypass surgery is stretching of the opening between the pouch and small bowel connection (termed “anastomosis”) over time. This can lead to faster emptying of the pouch which allows you to eat more or be less full with a meal. Revision surgery is not usually effective in maintaining that small opening over time.

In a Roux-en-Y gastric bypass procedure, a small part of the stomach is used to create a new stomach pouch (roughly the size of an egg), which bypasses part of the small intestine. Due to this, you’ll feel fuller more quickly and you won’t be able to eat as much food at one time. You may be a candidate for this procedure if:

  • You are more than 100 lbs. over your ideal weight and you have been unable to lose weight through diet and exercise.
  • You have a Body Mass Index (BMI) of 40 or higher.
  • You have a BMI of 35 or higher and have a condition such as heart disease, sleep apnea, high blood pressure or diabetes that is related to being overweight.

How it Works

Once you and your weight loss team have determined that this procedure is the best option for you and your needs, your Roux-en-Y gastric bypass will be scheduled. Here’s how you will prepare for the surgery:

  • Your doctor will order tests that will check for nutritional deficiencies, to prescribe any supplements you may need prior to the procedure.
  • You will likely have other pre-operative tests to ensure you are healthy enough for surgery. You may meet with other providers before your surgery, such as a dietitian or a psychologist.
  • If you smoke, your doctor will provide resources and support to help you quit smoking prior to surgery. Smoking slows recovery and increases surgery-related risks, so it’s important that you quit before your procedure.
  • You should give your doctor a complete list of all prescription medicines, supplements and over-the-counter medicines that you take. In the week prior to your surgery, your doctor may ask you to stop taking blood-thinning medicines such as aspirin, ibuprofen or warfarin.

Your surgeon performs the Roux-en-Y gastric bypass procedure via laparoscopy (through small incisions using a tiny camera). This procedure involves three basic steps:

  1. Your surgeon divides the stomach (about the size of a deflated regulation football) into two separate sections, creating a small pouch approximately the size of a man’s thumb, separated from the rest of your stomach.
  2. Your surgeon bypasses a portion of the small intestine.
  3. Your surgeon then attaches the bypassed intestine (Roux Limb) to your stomach pouch.

The laparoscopic Roux-en-Y gastric bypass usually takes two hours or less. You will likely stay in the hospital for two to three days after your operation and should be ready to return to full activity within two weeks.

The advantages of Roux-en-Y gastric bypass include:

  • The procedure is particularly effective for people with a high BMI because it has more predictable outcomes than some other types of weight loss surgery.
  • One year after surgery, weight loss averages 77% of excess body weight.
  • Studies show that after 10 to 14 years, some patients have maintained 50-60% of excess body weight loss.
  • This procedure has a positive impact on many weight-related conditions, including diabetes, high blood pressure and high cholesterol.
  • You won’t have to come into the office for ongoing adjustments, like you would for procedures like the gastric band. You will, however, need to come in for regular follow-up care and to ensure your weight loss and nutritional needs are on track.

Considerations for this procedure:

Patients who have undergone a Roux-en-Y gastric bypass must limit their intake of sugary and starchy foods. Otherwise, you may experience something referred to as “dumping syndrome.” Ten -15 minutes after eating a sugary or starchy food, you may experience many of the following symptoms:

  • Abdominal pain
  • Dizziness
  • Flushing skin
  • Rapid heart rate
  • Sweating
  • Diarrhea
  • Fainting
  • Low blood pressure
  • Shakiness
  • Vomiting

Dumping symptoms typically lasts 30-45 minutes. For many people who have had a gastric bypass, dumping or the fear of dumping serves as a motivation to make better food choices and stay away from foods that have tempted them in the past.

The risks involved with Roux-en-Y gastric bypass are:

  • Your body will not properly absorb nutrients such as iron and calcium because the duodenum (small intestine) is bypassed, which can lead to iron deficiency anemia. This is a particular concern for those who experience chronic blood loss during excessive menstrual flow or bleeding hemorrhoids. Women, already at risk for osteoporosis after menopause, should be aware of the potential for increased loss of bone calcium.
  • Bypassing the duodenum has caused metabolic bone disease in some patients, resulting in bone pain, loss of height, humped back and fractures of the ribs and hip bones. All of these deficiencies can be managed through proper diet and vitamin supplements.
  • A chronic anemia due to Vitamin B12 deficiency may occur. The problem can usually be managed with Vitamin B12 pills or injections.
  • The bypassed portion of the stomach, duodenum and segments of the small intestine cannot be easily seen using X-ray or endoscopy (a small, flexible tube with a camera and light attached to the end) if problems such as ulcers, bleeding or malignancy should occur.

The endoscopic sleeve gastroplasty (ESG) is a new procedure for those who want the benefits of weight loss surgery but from a less invasive, non-surgical procedure. It involves suturing the stomach from the inside to significantly reduce its capacity by up to 80%. After the procedure, the stomach remains intact but has been sutured from top to bottom to leave a smaller banana shaped stomach through which the food you eat passes.

The major benefit of the ESG is that it is performed endoscopically with a stitching device placed into the stomach through the mouth. This means that unlike surgery, there is no cutting or stapling, no scarring and no wounds. The procedure is carried out under general anaesthetic and usually takes about an hour.

It works by reducing stomach capacity and slowing down the speed at which food passes into the bowel. The food you eat goes into a small pocket at the top of the stomach before working its way down through the reduced, banana shaped stomach, and emptying into the bowel.

illustration that shows how part of the stomach is removed during surgery

Vertical sleeve gastrectomy is a surgical procedure for weight loss. With this procedure, the surgeon removes a large portion of your stomach. The new, smaller stomach is about the size of a banana, which limits the amount of food you can eat at once and helps you feel fuller after smaller meals.

Vertical sleeve gastrectomy might be right for you if:

  • You are more than 100 lbs. over your ideal weight and you have been unable to lose weight through diet and exercise.
  • You have a Body Mass Index (BMI) of 40 or higher.
  • You have a BMI of 35 or higher and have a condition such as heart disease, sleep apnea, high blood pressure or diabetes that is related to being overweight.

Vertical sleeve gastrectomy is often performed on patients who are too overweight to safely undergo other types of weight loss surgery.

How it Works

If you and your weight loss team has determined that vertical sleeve gastrectomy is the best weight loss surgery option for you and your needs, your procedure will be scheduled.

Prior to the surgery, you should expect to undergo:

  • A complete physical exam and related testing to ensure you are healthy enough for surgery
  • Blood tests and an ultrasound of your gallbladder
  • Nutritional counseling
  • Psychological counseling to make sure you are emotionally prepared for surgery and the required follow-up care

Typically, vertical sleeve gastrectomy is performed via laparoscopy (using small incisions with a tiny camera). Here’s how vertical sleeve gastrectomy works:

  • Your surgeon will make two to five small cuts (incisions) in your abdomen. The scope and instruments needed to perform the surgery are inserted through those incisions.
  • The camera (now inside your abdomen) is connected to a video monitor, so the surgeon can have a clear view during the procedure.
  • Your surgeon removes approximately three-fourths of your stomach, and joins the remaining portions of your stomach with surgical staples. This process creates a long vertical tube-shaped stomach.
  • Your surgeon removes the scope and other instruments, and the incisions are stitched closed.

The laparoscopic vertical sleeve gastrectomy takes about 60-90 minutes. You can expect to stay in the hospital for about two days after the procedure. You’ll be able to drink clear liquids the day after your procedure, and begin a pureed diet by the time you go home. Your surgeon, nurse or dietitian will recommend a diet for you following surgery. Following your dietary instructions is important for your safety and to achieve maximum weigh loss results.

ORBERA™ non-surgical weight loss procedure can help people lose weight who have not had luck losing weight with other diet programs. Designed by weight loss specialists to be a temporary tool to help you lose weight, ORBERA is a two-part weight loss system that includes placing a soft gastric balloon in the stomach to limit how much you can comfortably eat at one time and a one-year coaching program to help you maintain your new, healthier lifestyle.

How it Works

ORBERA™ is ideal for people who want the positive effects of weight loss surgery without the risks of surgery and associated long-term complications. The placement of the soft gastric balloon only takes about 20-30 minutes for your doctor to perform.

Here’s how the simple outpatient procedure to place the soft gastric balloon works:

  • You will be given a mild sedative to help you relax.
  • Your doctor will insert the deflated gastric balloon through your mouth and into your stomach.
  • Your doctor will then fill the balloon with a safe saline solution until it is about the size of a grapefruit.

Most people are able to go home the same day. The gastric balloon will stay in place for six months, during which time you’ll see the most dramatic weight loss. You’ll work closely with your doctor, dietitian and other specialists to develop healthier eating and lifestyle habits. After six months, your doctor will remove the balloon in a similar, non-surgical procedure. For the next months, you will continue to work through your weight loss coaching program to make sure you have developed and are maintaining healthy habits to carry you through to maximum weight loss.


Watch an Online Seminar

Our online seminar will provide you with valuable information to help make the decision that is best for you. Start your journey below. If you have questions, please contact our Bariatric Coordinator at (913) 498-7367.

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