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

I am 40-50 lbs overweight and hve bmi of 33.

Doctor Answers 3

Sleeve and acid reflux

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.

Lafayette Bariatric Surgeon
3.0 out of 5 stars 1 review

How much over weight do you have to be to have gastric Sleeve Surgery?

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.   

Can sleeve be done with acid reflux and a BMI of 33?

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. 

Daniel J. Rosen, MD
New York Bariatric Surgeon
5.0 out of 5 stars 3 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.