1. If you have tried and failed with dieting.
2. If your Body Mass Index (BMI) is 40 or greater. Click here to calculate your BMI.
3. If your BMI is between 35 and 40 and you have any three of the following health problems:
   • Diabetes Mellitus
   • Elevated Lipids
   • Hypertension
   • Depression
   • Heart Disease
   • Degenerative Joint Disease
   • Sleep Apnea
   • Gastroesophogeal Reflux Disease
   • Stress Incontinence
   • Asthma
   • If you are more than 100 lbs over "ideal" weight see chart
   • If you are 60 or younger
   • If you have an absence of severe psychological, emotional, or medical illness which would make surgery unnecessarily risky
   • If you have been drug or alcohol dependent, you must be well into an effective treatment program with one year of sobriety

We strongly encourage patients who are considering surgery to attend at least one of our support group meetings prior to surgery.

"Co-Morbidities"

• Heart Disease - Severely obese persons are approximately 6 times as likely to develop heart disease as those who are normal-weighted. Severely obese persons are 40 times as likely to suffer sudden death, in many cases due to cardiac rhythm disturbances.
• High Blood Pressure - Hypertension is much more common in obese persons and leads to the development of heart disease, damage to the blood vessels through out the body, causing susceptibility to strokes, kidney damage, and hardening of the arteries.
• High Blood Cholesterol - Cholesterol levels are commonly elevated in the severely obese - another factor predisposing to development of heart and blood vessel disease
• Diabetes Mellitus - Overweight persons are 10 times as likely to develop Type II, Adult-Onset Diabetes. Elevation of the blood sugar leads to damage to tissues throughout the body. Diabetes is the #3 cause of death in the United States.
• Sleep Apnea Syndrome - Sleep Apnea - the stoppage of breathing during sleep - is commonly caused in the obese, by compression of the neck, causing loud snoring, interspersed with periods of complete obstruction, during which no air gets in at all. Visit SleepHelp USA for more information about Sleep Apnea.
• Obesity Hyperventilation Syndrome - This condition occurs primarily in the severely obese of over 350 lbs. It is characterized by episodes of drowsiness, or narcosis, occurring during awake hours, and is caused by abnormalities of breathing and accumulation of toxic levels of carbon dioxide in the blood.
• Respiratory Insufficiency - Obese persons find that exercise causes them to be out of breath very quickly. This condition prevents normal physical activities and can be completely disabling.
• Heartburn - Reflux Disease and Reflux Nocturnal Aspiration - Acid belongs in the stomach, and seldom causes any problem when it stays there. When it escapes into the esophagus, through a weak or overloaded valve at the top of the stomach, the result is called "heartburn", or "acid indigestion". Often this occurs at night, especially after a large meal, and if one is asleep when the acid regurgitates, it may actually be inhaled, causing violent coughing and gasping.
• Asthma and Bronchitis - Obesity does not itself cause asthma or bronchitis, directly. However, it does interfere with breathing, aggravating any attack of asthma, and gastroesophageal reflux, which may cause severe bronchitis.
• Gallbladder Disease - Gallbladder disease occurs several times as frequently in the obese, in part due to repeated efforts of dieting, which predispose to this problem.
• Stress Urinary Incontinence - A large, heavy abdomen, and relaxation of the pelvic muscles, may cause the valve on the urinary bladder to weaken, leading to leakage of urine with coughing, sneezing, or laughing.
• Degenerative Disease of the Lumbo-Sacral Spine- The entire weight of the upper body falls on the base of the spine, and overweight causes it to wear out, or fail. The consequence may be accelerated arthritis of the spine, or "slipped disk".
• Degenerative Arthritis of Weight-Bearing Joints - The hips, knees, ankles, and feet have to bear most of the weight of the body. These joints tend to wear out more quickly, or to develop degenerative arthritis much earlier or more frequently, than in a normal weighted person.
• Venous Stasis Disease - The veins of the lower legs carry blood back to the heart, and they are equipped with an elaborate system of delicate one-way valves, to allow them to carry blood "uphill". The pressure of a large abdomen may increase the load on these valves, eventually causing damage or destruction. The blood pressure in the lower legs then increases, causing swelling, thickening of the skin, and sometimes ulceration of the skin.
• Emotional/Psychological Disease - Seriously overweight persons face constant challenges to their emotions; repeated failure with dieting, disapproval from family and friends, sneers and remarks from strangers. They often experience discrimination at work, and cannot enjoy theater seats, or ride in a bus or airliner. There is no wonder, that anxiety and depression might accompany years of suffering from the effects of a genetic condition - one which skinny people all believe should be controlled easily by will power.
• Social Effects - Seriously obese persons suffer inability to qualify for many types of employment, and discrimination in employment opportunities, as well. They tend to have higher rates of unemployment, and lower socioeconomic status. Many severely obese persons find it preferable to avoid social interactions or public places, choosing to limit their own freedom, rather than suffer embarrassment.