How much do you have to be overweight to have the gastric sleeve and can it be done if you have acid reflux?

Hello,
Thank you for your question and congratulations on seeking proactive solutions to improve your health! For you to qualify to have laparoscopic sleeve gastrectomy surgery, the basic recommendation is determination of your Body Mass Index.  This number is calculated from your Height and weight.   To find your BMI - please refer to a BMI Calculator on any website.  The recommendation for Laparoscopic gastric bypass, Gastric Sleeve is BMI of 40 or greater.  If you are between 35 - 40 you can still qualify but you must have an obesity-related medical condition ( also know as co-morbidity).  These are often specific for most insurance companies, but the typical ones that are considered are:  Type II Diabetes, Hypertension, Obstructive sleep apnea, hypercholesterolemia.     Just to clarify this further the above numbers applies to an individual who is interested in having the cost of surgery covered by insurance. There are folks that fall outside these parameters. These individuals may still qualify for bariatric surgery but insurance will not cover their care. If your BMI is between 30 to 35, you still qualify for Laparoscopic gastric banding and Laparoscopic Sleeve gastrectomy but these procedures are not deemed as medically necessary and therefore you have to pay out of pocket.  The average cost of surgery is from 10k to 14k.  Each individual has specific circumstance that a simple number such as BMI can not represent.  Therefore the most suitable recommendation should come from your bariatric surgeon after a clear understanding of your goals, medical conditions and circumstances.   
A Skype or in person evaluation will allow the surgeon to give you an individualized   recommendation based on your unique situation and health goals.
Kindest regards,
Dr. Moein

Weight and height is not the only parameter to take into account for bariatric surgery. Also it is consider if you have other medical problems associated (glucose intolerance, insulin resistance, diabetes mellitus, high blood pressure, dyslipidemia, etc.), body composition ( body fat percentage above 30% for women). Recent studies have shown that a men with more than 20% of body fat or a women with more than 30% with normal weight have a high degree of metabolic imbalance they are still at high risk of developing metabolic syndrome, diabetes mellitus, insulin resistance, dyslipidemia, cardiometabolic disorders etc. with a higher risk or mortality. So each case has to be asses individually.Acid reflux is not an absolute contraindication for gastric sleeve. Acid reflux has a variety of causes, it could go from habits, type of food you eat, increase intrabdominal pressure, esophageal disfunction, slow gastric emptying or hiatal hernia. This last one can be and has to be corrected during the surgery, the gastric emptying will improve after the sleeve and the intrabdominal pressure will decrease as you loose weight. So each patient is different and it has to be asses individually

Thank you for your question,
People who have a body mass index of 35 to 40 kg/m² are  eligible if they have co-morbidities including diabetes, hypertension or sleep apnea. Non-surgical treatment modalities such as intragastric balloon or gastric botulinum toxin injections should be preferred in patients with a BMI less than 35 kg/m², however a sleeve gastrectomy procedure may be considered in patients with a BMI 30 to 35 kg/m² in the presence of very severe medical conditions.
*Severe reflux disease is diagnosed by endoscopy as well as the complaints of the patient.
Best wishes
Dr HE

Traditionally qualification criteria for weight loss surgery are BMI of 35 with weight-related medical conditions, or a BMI of 40 or more without medical comorbidities. The gastric sleeve can lead to reflux or worsening of reflux symptoms. However, it is important to specify what "acid relfux" one has, because it is a term that can have different meanings to different people.

All the insurances follow the NIH (National Institite of Health) guidelines. That is BMI over 40 or BMI over 35 with Medical comorbidity.
That being said, most Surgeons do not pay attention to how much overweight you think that you are, as that is relativel. But at least you have to be 80 lbs overweight to quality. 
Regardless, at some practices a BMI of 30 and above will get you a consultation with the Surgeon, and then he can decide if you are a good candidate for the surgery, or maybe a less invasive procedure like Gastric Balloon is more appropriate.
In summary, if you have a BMI (Body Mass Index) above 30 then you should consult a Bariatric Surgeon.

Hello
Thank you so much for your question. According with your BMI you can be a great candidate for bariatric surgery; but there are other factor to take into consideration before making a decision; The sleeve gastrectomy, wich reduces the size of the stomach is probably an excellent option because  the 70% to 80% of the stomach is removed and the part that produce Ghrelin witch is a hormone that makes you feel hungry.
To qualify for weight loss surgery, the American Society for Metabolic and Bariatric Surgery recommends you meet one of the following:
1- BMI ≥ 40, or more than 100 pounds overweight.
2- BMI ≥35 and at least one or more obesity-related co-morbidities such as type II diabetes (T2DM), hypertension, sleep apnea and other respiratory disorders, non-alcoholic fatty liver disease, osteoarthritis, lipid abnormalities, gastrointestinal disorders, or heart disease.
3- Inability to achieve a healthy weight loss sustained for a period of time with prior weight loss efforts.
Have a consultation with a bariatric surgeon this will allow you to discuss about the different procedures in details. Many factors should be considered when deciding for a bariatric surgery, is needed to check your current health status with lab work and in a consultation you can accomplish this.  Don't be discourage and continue searching the best option to improve your health.
My Best Wishes

As a board-certified bariatric surgeon with extensive experience, I can provide you with the information you need regarding gastric sleeve surgery. At our clinic, we offer a specialized procedure called the "Dr. K's Skinny Mini Sleeve" for individuals with a BMI of 25 or higher. This means that you don't have to be severely overweight to benefit from this surgery. We understand that weight management is a complex issue, and we're here to help a broader range of patients achieve their weight loss goals.
Regarding acid reflux, it's a valid concern, and we address this as well. Many individuals with acid reflux may also have a hiatal hernia, which can contribute to their symptoms. The good news is that we can perform the gastric sleeve surgery even if you have acid reflux and a hiatal hernia. During our thorough pre-operative assessment, we conduct an endoscopy to determine if you have a hiatal hernia and, if so, the best course of action to address it. This ensures that we can address any underlying issues to enhance the success of your surgery.
Every patient is unique, and their medical history, weight loss goals, and health conditions can vary significantly. To determine the most suitable weight loss procedure for you, we recommend scheduling a complementary consultation. During this consultation, we will review your medical history and discuss your weight loss journey, helping us make an informed decision about the best approach for you. You can reach out to us at 786-801-3883 to schedule your consultation, and we also offer phone consultations for your convenience.
Our commitment is to provide personalized care and tailored solutions to help you achieve your weight loss goals, ensuring that you receive the most appropriate treatment to meet your specific needs and circumstances.

To have a gastric sleeve aka sleeve gastrectomy, you need to be above a BMI of 40 or a BMI greater or equal to 35 with one of more health conditions attributable to obesity. Those are the guidelines issues by the National Institute of Health and supported by American Society of Metabolic and Bariatric Surgery, however in rare situations exceptions may be made (if for example poorly controlled diabetes is one of the medical complications), so you should consult with a bariatric surgeon of your choice to find out if you could be a candidate. Acid Reflux disease, in general, is considered to be a relative, but not absolute contraindication to the gastric sleeve procedure, depending on the severity and etiology of the disease and again you may have to consult with a bariatric surgeon to see if you would be an appropriate candidate.

Gastric sleeve can worsen acid reflux disease. A careful evaluation of your symptoms should be done before surgery along with proper diagnostic studies (upper GI series and/or upper GI endoscopy). Only then can a proper decision be made.As stated below, a BMI of 33 does not usually fall w/i the range covered by health insurance. Patients with a BMI of 30-34 are candidates for surgery. Just don't expect your insurance company to cover the cost.

You are a candidate for a sleeve gastrectomy as you suffer from obesity. That insurance won't cover the procedure is a shame for you, and my hope is that type of discrimination to withhold care from those individuals whose disease isn't quite bad enough (yet) will eventually be addressed. As as for the reflux, most patients who have reflux and get a sleeve report improvement in their symptoms, though some need to stay on anti-acid medication.  A small subset of sleeve patients will see worsening of pre-existing reflux disease or new onset reflux where it wasn't present prior to surgery. Addressing a hiatal hernia, when present, even if small, can have a big impact, either way.  In my practice,I don't treat the presence of reflux as a reason to steer a patient away from a sleeve gastrectomy as the right procedure for them.