Lap band guidelines updated: BMI of 30-35 with obesity-related health conditions

Written by Community Bariatric Services on 5/24/2013 9:00:00 AM

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Dr. Keith McEwen, Community bariatric surgeon, uses your body mass index (BMI) as part of the guidelines to see if you are a good candidate for LAP-BAND® surgery. In 2001, the LAP-BAND was FDA approved. At that time, patient criteria included men and women 18 years or older with a BMI of at least 40, or a BMI between 35-40 in combination with a related health condition such as type 2 diabetes, high blood pressure, heart disease or sleep apnea. Ten years later (Feb. 2011), the FDA lowered the lap band surgery prerequisite BMI to 30 for adults who also have an obesity-related health condition.

Lap band is the only bariatric surgery option with a BMI prerequisite of 30; other surgery options require a higher BMI. “I think this change by the FDA reflects the lap band quality and the high safety record. The outcomes of this surgery have been very good and the behavior modification that follows supports a lifetime of healthier living,” says Dr. McEwen. So, is body mass index a good calculation? It’s an easy and inexpensive calculation of height and weight, but BMI does vary by sex, race and age. While the BMI score has been proven to be a reliable indicator of body fatness for most people, there are exceptions:

  • Women tend to have more fat than men at the same BMI.
  • Older adults have more fat than younger adults at the same BMI.
  • Athletes may have a high BMI because their muscle ratio to fat is higher.

BMI is not a direct measure of body fat, but does correlate to some direct measures of body fat. Someone may have a high BMI, but that score by itself is not definitive of a health risk. Waist circumference has also been identified by the Heart, Lung and Blood Institute as a good predictor of health risk. In a nine-year study of nearly 250,000 men and women (reported in the American Journal of Epidemiology, 2008) researchers looked at adults based on a normal BMI. They found that waist size correlated with risk of death in both men and women:

  • Men with a waist size of 40 inches or greater had a 23% increased risk for death.
  • Women with a waist size of 34.5 inches or greater had a 22% increased risk of death.

Bariatric physicians may also evaluate excess weight using other methods. One common calculation is checking to see if your weight is twice your ideal weight or if you are a woman and 80 pounds overweight or a man and 100 pounds overweight. Bariatric doctors may also measure body fatness using calipers to measure skinfold thickness, or they may request an underwater weight. Bioelectrical impedance, dual-energy x-ray absorptiometry (DXA) and isotope dilution are also used to evaluate weight, but all of these techniques are more complex and require extensive training by the healthcare professional. 

Remember, obesity is only one factor related to developing a health risk for a chronic disease condition. Your physician will need to determine if a health condition causes your weight condition or vice versa. Start by giving a good health history to your doctor.

Does your BMI qualify you for lap band surgery?

If you would like to learn more about the LAP-BAND AP® System and other surgical weight loss options, we invite you to attend a free class presented by Dr. McEwen and his bariatric clinic team. The next class is June 19, 2013 in Noblesville, Indiana. Prefer to stay at home? Watch an online presentation by Dr. McEwen instead. Register today and start your journey!

Register for a free class to learn more about weight loss surgery options in IndianaRegister to view a free online video to learn more about weight loss surgery options in Indiana


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