Why wouldn't someone qualify for surgery if their BMI is over 40?

Thank you for your question. The reason is that a BMI of > 40 is not really associated with good weight loss and the FDA approval was within the 30-40 BMI. The greater the BMI the lesser the good results with balloons and other non-surgical interventions. 

Hi, 
The Orbera balloon is FDA approved for individuals with a BMI between 30 and 40. However, it can certainly be used outside of this range. We routinely provide the Orbera system to patients with BMIs in the low to mid 40 range, as long as they are otherwise excellent candidates. However, I would not recommend Orbera if your BMI is above 50. While you would certainly lose weight, we are unlikely to be able to provide the degree of weight loss that you need, and there is a higher risk of certain complications. Traditional bariatric surgery would be more successful in this range. Alternatively, the Aspire Assist device is an excellent option for our higher BMI patients who are still seeking a minimally invasive weight loss option.