Candidacy · Newnan, GA
Am I a candidate for weight loss surgery?
Medically reviewed by Dr. Roger Eduardo, MD, FASMBS, Board-Certified General Surgeon. Last reviewed August 2026.
Book a consultation →Who qualifies for bariatric surgery?
You may be a candidate for weight loss surgery if your BMI is 35 or higher, or 30 or higher with at least one obesity-related condition such as type 2 diabetes, sleep apnea or high blood pressure. Final candidacy is confirmed after a full medical, nutritional and psychological evaluation.
BMI → what it means for you
| Your BMI | Likely candidacy | Typical next step |
|---|---|---|
| 40+ | Candidate regardless of other conditions | Book a surgical consult |
| 35–39.9 | Candidate with ≥1 obesity-related condition | Bring records of related conditions |
| 30–34.9 | May qualify with serious metabolic disease | Discuss surgery vs. GLP-1 options |
| < 30 | Surgery not typically indicated | Consider medical weight loss |
Thresholds are individualized at consultation.
Qualifying conditions
Obesity-related conditions that strengthen candidacy include:
- ✓Type 2 diabetes or prediabetes
- ✓Obstructive sleep apnea
- ✓High blood pressure (hypertension)
- ✓High cholesterol / metabolic syndrome
- ✓Fatty liver disease (NAFLD)
- ✓Joint disease worsened by weight
- ✓Severe acid reflux / GERD
- ✓PCOS or obesity-related infertility
Who is not a candidate (for now)
Surgery may be deferred until these are addressed:
- ·Untreated substance use disorder
- ·Certain unmanaged psychiatric conditions
- ·Active, untreated eating disorder
- ·Medical conditions making anesthesia unsafe
- ·Inability to commit to lifelong follow-up and vitamins
Many patients who aren't candidates today become candidates after preparation. Dr. Eduardo will tell you exactly what's needed.
The surgeon's evaluation
Your evaluation with Dr. Eduardo
A calculator can estimate eligibility, but only a surgeon can confirm it. At your consultation, Dr. Eduardo reviews your full weight and medical history, examines you, and explains which procedure best fits your profile, sleeve, bypass, SADI-S or, where relevant, revision. You'll also meet the nutrition, psychology and insurance team who support you through every step. There's no obligation; the goal is an informed decision.
Below the surgical range?
Medical weight loss & GLP-1
If your BMI is under 30, or you'd prefer a non-surgical start, our physician-supervised medical weight loss and GLP-1 program may be the right first step, with a clear path to surgery later if needed.
Explore medical weight lossReflux a factor?
Severe heartburn with obesity
If you also have significant acid reflux, that influences which procedure is best, gastric bypass usually resolves reflux. As a foregut surgeon, Dr. Eduardo factors this directly into your recommendation.
About heartburn & reflux surgeryCandidacy FAQ
Candidacy questions
Can't find your answer here? Call us at (470) 742-1832 or book a consultation, we'll answer every question before you commit to anything.
Current ASMBS and IFSO guidelines recommend surgery at a BMI of 35 or higher regardless of other conditions, and consider it at a BMI of 30 to 34.9 with metabolic disease such as type 2 diabetes. These 2022 guidelines replaced the 1991 NIH criteria. Many commercial plans continue to use older coverage thresholds such as a BMI of 40 or higher, or 35 or higher with an obesity-related condition. Traditional Medicare is different: it requires a BMI of 35 or higher, at least one obesity-related condition, and documented prior unsuccessful medical treatment for obesity. Clinical eligibility and insurance coverage are not the same question, and we check both. In practice most candidates have a BMI of 35 or higher, or 30 or higher with an obesity-related condition such as type 2 diabetes, sleep apnea or hypertension. patients with a BMI of 30 or higher and serious metabolic disease may also qualify. Your exact BMI is only one factor, a full evaluation confirms candidacy.
Yes. Type 2 diabetes is one of the strongest qualifying conditions. Many patients with a BMI of 35 or higher and type 2 diabetes are candidates, and gastric bypass in particular has strong published rates of diabetes improvement. Dr. Eduardo will review your full metabolic history at consultation. Individual results vary.
Surgery may not be appropriate for patients with untreated substance use disorder, certain unmanaged psychiatric conditions, active eating disorders, or medical conditions that make anesthesia unsafe, until those are addressed. Candidacy is individualized; some patients become candidates after pre-surgical preparation.
You will likely have tried weight loss on your own, that's common and expected. Some insurance plans also require a documented supervised diet period before approval. Dr. Eduardo's team will tell you exactly what your plan requires and help you complete it. See our insurance page for details.
Dr. Eduardo reviews your weight history, medical conditions, medications and goals, performs an exam, and explains which procedures fit your profile. You'll also meet the team who coordinate nutrition, psychology and insurance. There's no obligation, the goal is an informed decision.
Coverage pre-check
Will my insurance consider bariatric surgery?
Enter your BMI range and any obesity-related conditions. We will show you the usual coverage pathway. Nothing is required to see the result.
Quick pre-check
Will insurance likely cover your surgery?
Coverage comes down to a few criteria. Enter your details for an instant read on where you likely stand. Nothing you type is stored or sent anywhere.
Enter your details above
We will show where you likely stand against the criteria most plans use.
Plans also typically ask for a psychological and nutrition evaluation, a weight history, and sometimes a supervised diet period. We verify your exact plan and handle the prior-authorization paperwork for you.
Educational estimate only, not a coverage guarantee and not medical advice. Commercial criteria vary by insurer and employer, and many plans still use BMI 40 or higher, or 35 or higher with an obesity-related condition. Traditional Medicare is different: it requires a BMI of 35 or higher, at least one obesity-related condition, AND documented prior unsuccessful medical treatment for obesity (NCD 100.1). Clinical eligibility and plan coverage are not the same question. Our team verifies your specific benefits.
Start your journey
Find out if you qualify
Take the 2-minute candidacy quiz, or book a consultation with Dr. Eduardo for a definitive answer.
