Hi, Officially, the Orbera system is only FDA approved for individuals with a BMI between 30 and 40. However, we can safely use this device for people who fall slightly outside of that range. Ultimately, we want to choose the best weight loss option for you, based on your needs, any medical problems, and your goals. Even at a BMI of 45, Orbera may be a good option for you. Or we may decide that you aren't likely to meet all your goals, or you have other health problems that would benefit from a surgical procedure. I would recommend contacting a specialist to discuss all available weight loss options. The field is rapidly advancing and we now have multiple endoscopic and minimally invasive options to explore. Good luck!