Indications and Contraindications to weight loss surgery 


  • BMI ≥ 40, or more than 100 pounds overweight. 

  • 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. 

  • Inability to achieve a healthy weight loss sustained for a period of time with prior weight loss efforts. 

  • Presence of comorbidities that may resolve or improve with weight loss.  Such as OSA, cardiovascular disease and respiratory difficulties. 


  • Inflammatory disease or condition of the gastrointestinal tract, such as ulcers, severe esophagitis, or Crohn's disease. 

  • Severe heart or lung disease that makes the patient a poor candidate for surgery. 

  • Other diseases making patient a poor candidate for surgery. 

  • Problem that could cause bleeding in the esophagus or stomach. This might include esophageal or gastric varices (a dilated vein). It might also be something such as congenital or acquired intestinal telangiectasia (dilation of a small blood vessel). 

  • Portal hypertension. 

  • Esophagus, stomach, or intestine is not normal (congenital or acquired) 

  • You have or have experienced an intra-operative gastric injury, such as a gastric perforation at or near the location of the intended band placement, pouch creation. 

  • cirrhosis. 

  • chronic pancreatitis. 

  • Pregnant, or want to become pregnant in the next year - 18 months 

  • alcohol or drug addiction. 

  • You have an infection anywhere in your body or one that could contaminate the surgical area. 

  • Unwilling patient to follow the dietary rules that come with the procedure. 

  • allergic to materials in the devices. 

  • You cannot tolerate pain from an implanted device, or presence of a foreign body 

  • autoimmune connective tissue disease. That might be a disease such as systemic lupus erythematosus or scleroderma. The same is true if you have symptoms of one of these diseases. 


  • Prior gastric surgery (nissen, hiatal hernia repair, stomach resection...) 

  • Prior open or laparoscopic bariatric surgery 

  • gastric mass, ulcers 

  • large hiatal hernia 

  • intractable gastro-esophageal disease 

  • achalasia, or other severe dysmotility disorders or strictures of the esophagus 

  • upper GI tract bleeding conditions 

  • Inflammatory diseases of the GI tract 

  • Any medical condition that would not permit endoscopy 

  • cirrhosis