I have a BMI of 36 and am pre-diabetic. Would I qualify for sleeve gastrectomy, or do I have to have full-fledged diabetes?

Question

I'm 43, 5' 8" tall, and 235 lbs.

Ariel Ortiz, MD, FACS · Answer

You are a great candidate gastric sleeve.  Its best to take action before your pre-diabetes progresses.  The Gastric Sleeve can help resolve metabolic issues quickly, and stop progression.  We also recommend this surgery for patients with lower BMI especially when you already have metabolic issues.

Shawn Garber, MD, FACS, FASMBS · Answer

In order to qualify for a sleeve gastrectomy you need a BMI of 40 with no medical problems or a BMI of 35 with at least one medical problem related to obesity like hypertension, type 2 diabetes, or obstructive sleep apnea.  Pre-diabetes in not considered a medical problem related to obesity.  You do qualify for a gastric balloon recently approved by the FDA in August.  There are two balloons on the market - Reshape and Orbera.  The Reshape is the newer technology with two balloons instead of one and can fill up to 900 cc of your stomach.  You can lose between 25 and 75 pounds with the one year Reshape Balloon program.

Guillermo Alvarez, MD · Answer

Yes you would be a great candidate for weight loss surgery, specifically the gastric sleeve. This procedure will give you excellent weight loss and help you with your pre-diabetic condition as well since this procedure does have an "anti-diabetic" effect. I have some videos that talk about patients like you (low BMI and the sleeve) and have excellent results. I hope you find them useful. Happy Thanksgiving. Dr. Guillermo Alvarez

Pablo Garcia, MD - Account Suspended · Answer

Hello, I hope you are well. Based on the metrics you provided your calculated BMI would be 35.7, which would classify you as Obese type II. You do not need to be properly diagnosed with diabetes in order to be eligible for bariatric surgery. However, you would need to be evaluated in order to determine which procedure would most appropiate for you. In addition, any bariatric procedure would help you with your pre-diabetes, as it would produce weight loss.

Mark Pleatman, MD (retired) · Answer

When Dr. Farber talks about "qualifying" for bariatric surgery, is is probably referring to the rules used by insurance companies to decide if they will pay.  These rules were made many years ago, and many people think they are too conservative.  But they still stand.  On the other hand, that doesn't mean that it's wrong for you to have the surgery if you have the money to pay for it.  I take care of many patients in your situation, and they are happy to be able to get the surgery done.I TOTALLY disagree with Dr. Farber about the gastric balloon.  These, in my view, are gimmicks.  They have to be removed after 6 months.  After that you will most likely regain all your weight.  Insurance companies don't cover it yet, and it costs not much less than it would to get a sleeve gastrectomy.  Don't go for it.

I have a BMI of 36 and am pre-diabetic. Would I qualify for sleeve gastrectomy, or do I have to have full-fledged diabetes?

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