Gastric Sleeve Surgery, or Vertical Sleeve Gastrectomy (VSG), has quickly grown into one of the most reliable weight loss procedures. It has many health benefits to treat morbid obesity, high expected weight loss results and is relatively less invasive.
In order to be a candidate for gastric sleeve, it’s important to understand the qualifications, requirements, benefits, and costs that can impact a patient’s eligibility. Even if you qualify for a gastric sleeve, it doesn’t mean that it is the best weight loss procedure for you.
In order to make an informed decision, make sure you compare the advantages, disadvantages, benefits, and results of all bariatric surgery options before you sign up.
How Do I Qualify For Gastric Sleeve?
To be eligible for gastric sleeve surgery in the US, you need to have a body mass index (BMI) of at least 30 or be at least 100 pounds overweight. Additionally, you must also have health issues that are directly caused by or related to obesity, such as:
- High blood pressure
- Severe sleep apnea
- Type 2 diabetes
- Heart disease
- Certain types of cancer.
Here are the specific requirements for undergoing the operation in the United States vs. Mexico. While qualifying for gastric sleeve procedures in Mexico is less strict, many facilities still uphold safety and quality standards similar to those in the US.
|Qualifications for Gastric Sleeve in the U.S.||Qualifications for Gastric Sleeve Surgery in Mexico|
|Age 18 to 65||Age 16 to 70|
|BMI of 40+ or BMI of 35+ with comorbidities||BMI over 30|
Reasons You Can Be Denied
Safety is the main factor for qualifying for weight loss surgery. Surgeons will only consider patients with low risks who have a high likelihood of achieving long-term success.
Patients may be denied gastric sleeve surgery depending on the requirements of the hospital, surgeon, or insurance provider. Reasons can include but are not limited to:
- BMI is too low
- BMI is too high and may need to lose weight before getting sleeved
- Age is under 18 or over 65
- Health problems that make surgery high-risk
- Addiction problems with substance abuse
- Certain mental health diagnoses or psychiatric conditions
- Not able to follow the pre-op diet
- GERD and Acid Reflux
- Barrett’s Esophagus
Calculate Your BMI
Am I a Candidate for Gastric Sleeve Insurance Coverage?
Insurance typically accepts adults between the ages of 18-65 years old with a body mass index of at least 35. You are more likely to be accepted if you have had an obesity-related comorbidity (or health problem) for at least 5 years. Examples include type II diabetes, hypertension, sleep apnea, asthma, etc.
However, depending on your insurance coverage or out-of-pocket cash pay, health insurance providers will normally only cover the procedure once you have undergone a variety of tests and health requirements:
- A psychological evaluation is typically required to know that you are mentally prepared and able to not only handle the procedure but succeed long-term.
- A physical evaluation is also required in most cases to verify your body is able to handle the surgery to reduce risks of complications arising.
- Significant changes in behavior, lifestyle, and physical health are also required after gastric sleeve surgery.
Gastric Sleeve Qualifications for Insurance Coverage
Every insurance company has individual criteria for patients to be accepted. Even if you qualify for a gastric sleeve procedure through insurance, you may not be accepted based on their requirements prior to surgery.
- BMI is 35 or greater
- One obesity-related health problem – such as diabetes or sleep apnea
- Your medical records for suffering from obesity for at least 5 years
- Tried and failed at least one weight loss program
- Psychological evaluation
- Any treatable diseases are ruled out
- Minimum of participating and passing one supervised weight loss program
Learn more: Does insurance cover gastric sleeve?
What to Do if Not Approved or Eligible in the United States?
If you are not approved for the gastric sleeve in the United States or want to avoid long wait times and tedious tests, medical tourism can offer you alternatives in other countries. One of the best options is to cash-pay for low-cost, high-quality weight loss surgery in Mexico. Mexico is a great alternative to weight loss surgery in the United States because of the surgeon’s experience, quality care, and safety standards that are in place by individual bariatric providers.
Why Choose Gastric Sleeve Surgery
Gastric sleeve surgery is one of the most popular and common weight-loss surgeries performed today. It has many benefits and is fast-acting, but there are also side effects and limitations to consider. The patient should be informed about the lifestyle changes they will need to make before and after surgery. They should also be aware of how their eating habits will be affected.
Gastric Sleeve removes a large portion of the stomach (up to 80-85%) to create significant restriction. This banana-shaped sleeve will cause patients to feel full from just a tiny amount of food. Also, the reduced stomach size decreases your hunger hormones and fills the stomach up faster with smaller food portions.
The gastric sleeve costs vary from $4,395 to $24,000, depending on the country you are interested in undergoing surgery. Click here to find out if you pre-qualify in 2 minutes or less.
Bariatric Surgery in Adolescents
Unless it is a serious medical necessity approved by a pediatric endocrinologist, gastric sleeve surgery is currently not recommended for individuals under the age of 18. With certain age groups, there are overall risks that can cause problems for those who are considering the surgery.
Average Weight Loss Gastric Sleeve Surgery
The weight loss after gastric sleeve surgery varies from patient to patient. The average expected excess weight loss (%EWL) for gastric sleeve surgery with proper nutrition, diet, and exercise is:
- 3 months: 30% excess weight loss
- 6 months: 50% excess weight loss
- 12 months: 70% excess weight loss
- 18 months: 75% excess weight loss
Learn more: Gastric Sleeve Weight Loss Timeline
Benefits of Gastric Sleeve Surgery
Gastric sleeve surgery is a great alternative to other bariatric procedures like gastric bypass because it doesn’t cause malabsorption. This means it doesn’t drastically reduce calorie intake, which can be a problem for patients with lower BMI.
- Improve, reduce, and even cure obesity-related comorbidities – type II diabetes, hypertension, sleep apnea, arthritis, high blood pressure, cholesterol, fatty liver, depression, acid reflux (GERD), etc.
- An average of 65% expected excess weight loss in 1 year
- Low-risk because of no malabsorption or changes to the anatomy
- Resets metabolic thermostat – resets the body setpoint
Who is not eligible for Gastric Sleeve?
One of the side effects of laparoscopic sleeve gastrectomy is the worsening symptoms of acid reflux. After a vertical sleeve gastrectomy, the pyloric valve, where food passes from the stomach into the intestines, stays intact. This reduces acid production and intra-abdominal pressure (IAP). The smaller-sleeved stomach fills up faster, increasing intragastric pressure and causing a backflow of food in the esophagus.
Patients who have severe GERD or acid reflux may consider gastric bypass instead of a sleeve. More effective anti-reflux procedures, like RNY gastric bypass, circumvent the pyloric valve which will eliminate the risk of GERD.
While gastric sleeve surgery can aggravate pre-existing gastroesophageal reflux disease, there are options that can still make the sleeve a viable option for patients. Acid reflux can be caused by a hiatal hernia (HH) which will be repaired by Mexico Bariatric Center® surgical teams during the procedure for the patient’s safety. Losing extra fatty (adipose) tissues in the abdomen after surgery can also relieve reflux issues in obese patients after surgery.
The surgeon can also perform a Nissen Fundoplication surgery during the operation to relieve reflux issues after surgery. This involves wrapping the upper stomach around the esophagus to avoid a hernia bulging through the stomach diaphragm.
Things to Consider
There are some other aspects that the bariatric surgeon will need to consider to advise you as to whether the operation will be successful or not. The patient must be willing to change their habits to accommodate a healthy diet and to provide themselves with a chance at success.
Sleeve patients must be of sound mind and be psychologically in a position to handle the situation at hand. There is a great deal that goes along with dealing with the surgery and the physical changes that will come.
Those who are being considered for the surgery will need to be counseled regarding the way to handle their diet and exercise plan after the surgery.