Age Limit for Gastric Sleeve Surgery

In general, a qualified body mass index (BMI) probably is all you need to skip other qualification requirements of gastric sleeve surgery. But sometimes other factors are also taken into account, especially if you want to have third-party coverage (such as insurance) to pay. One of these factors is age. So, what is the age limit for this bariatric surgery?

Minimum requirements

Sleeve surgery removes part of the stomach, creating a narrow stomach about the size of a banana. With smaller stomach, you’re likely to eat less and feel full more quickly. This will induce a dramatic weight loss after surgery.

This surgery is often successful to help people with obesity and health problems associated with their weight. Although it’s relatively new in bariatric procedure, it has been acquiring in popularity relative to more established bariatric surgeries (e.g. lap-band and bypass). It has been accepted as a reliable option for morbid obesity.

For the right candidates, it is one of effective ways to loss extra weight and keep it off.  The next question, what are requirements to qualify for sleeve surgery?! As mentioned earlier, your BMI is the key for the qualification.

In general, the surgery is indicated for people with BMI of 40 or more. But it’s also possible for obese people with BMI of 30-39.9 if they have obesity-related medical problems (e.g. hypertension, diabetes, or heart disease).

Although sleeve surgery is efficient and covered by insurance, not all overweight people are qualified for the operation. Furthermore, it’s not going without risks. So a number of factors are taken into account for approval.

Besides BMI, the following factors are usually required if you need insurance to pay [1].

  1. You have been obese for 3 years or more.
  2. Have a personal history of unsuccessfully weight loss attempts. So surgery is actually the last option.
  3. To be aware that the surgery is just a tool. Still, a healthy-balanced diet, regular exercise, and other healthy lifestyles are required to keep your weight off in long term. So you need to be willing to have such lifestyle changes after surgery, because this surgery is not a ‘fix and forget’ solution.
  4. And age. Sleeve surgery is not recommended for people of all ages

You should also be ready enough for surgery, sometimes psychological consultation is necessary. The surgery could involve a series of extreme lifestyle changes, making your stressful or causing unexpected reactions.

How old do you have to be for sleeve surgery?

Age has a role to determine whether or not you’re qualified for the operation. The good news, it is not the key criteria for approval.

In general, sleeve surgery is addressed for morbidly obese adults – typically between the ages 18 and 60, some experts say between 18 and 75 years old. But a slightly change in this acceptable age range probably is still qualified for approval as long as your doctor believe that the surgery carries benefits that outweigh risks.

For example, weight loss surgery is sometimes suggested for teens at least 14 years old with 100 pounds (or more) of excess weight to lose [2] — plus, other factors mentioned earlier are required. The following additional factors are also required:

  1. The overall health status, whether the patient is strong and healthy enough to handle the operation.
  2. Having health conditions that could improve with sleeve surgery, such as diabetes, heart problems, and sleep apnea.
  3. Whether the patient has good environment (family members) to provide practical and emotional support.

The same goes for the upper age limit — it’s also possible to take the operation above the age of 65. But what to remember, the operation is riskier for anyone older! So again, it’s important to comprehensively analyze whether the operation will carry benefits that outweigh risks, and the patient is healthy enough to handle the physical stress of the operation. Also, there is no health issue that can make the operation very risky.

So the decision should not be only based on age alone. Even in a few cases, older adult patients might have better results than younger adult patients, according to one study [3]. Instead, (for summary) here probably are the most common reasons of why people are not qualified for gastric sleeve [4]:

  1. BMI is not qualified (not high enough).
  2. There is no enough evidence to confirm their unsuccessfully weight loss (diet) attempts.
  3. If they have certain conditions that cause surgery side effects /complications more likely, making surgery too risky for them.

Conditions that make sleeve surgery become too much of a risk can vary. Here are a few examples that may disqualify you:

  1. Being pregnant, or if you plan pregnancy in the near future.
  2. Your general health. Typically, major surgeries are not recommended when your general health is poor.
  3. Current infection. There is a chance for infection to occur after surgery, and this could be much worse if you have current infection before and during surgery.
  4. Substance abuse such as alcohol.
  5. Having a severe lung disease, cirrhosis, or other very high operative risks.
  6. Mental health issues, such as; a personal history of suicide attempts, having psychiatric disorder (especially if it’s left untreated or uncontrolled), and not willing to follow healthy lifestyles.
  7. Certain medications you’re taking (e.g. if you’re on chronic, long-term treatment with steroid).
  8. If the gastrointestinal tract is not healthy enough to support the operation (e.g. if you have severe esophagitis, peptic ulcers, Crohn’s disease, or Barrett’s esophagus).
  9. Chronic pancreatitis (inflammation of pancreas). It may make malnutrition more likely after surgery.
  10. Portal hypertension might also induce postoperative complications.

If you’re not qualified for sleeve surgery

Since gastric sleeve surgery is often successful to help morbidly obese adults, there are several ways for financing the operation. The most recommended one is with insurance. Although getting insurance approval is not always easy, it will help you a lot to reduce the cost. For more guidance, see also ways to reduce the costs of sleeve surgery!

If you have factors /conditions that don’t meet the requirements for sleeve surgery, you probably are still qualified for endoscopic intragastric balloon, a procedure that leaves ‘one, two, or three’ saline-filled silicone balloons in the stomach for a certain period of time.

Unlike sleeve surgery, gastric balloon is temporary – it’s not purposed for a long-term fix solution. In this procedure, a deflated silicone balloon is inserted and expanded in the stomach. The expanded balloon will make less room for food, resulting in weight loss because you’re likely to eat less and feel full sooner. The balloon could be left in the stomach for weeks or months.

The qualification requirements are less stringent than sleeve surgery. The most popular one, Orbera balloon, usually only requires:

  1. At least 18 years old.
  2. BMI of 30 or higher (United States). In some countries, BMI of 27 or higher.

But for some types of gastric balloon procedure, the qualification requirements could be a bit more stringent. ReShape Balloon, for example, requires additional qualification requirements such as having a comorbidity factor associated with obesity (e.g. sleep apnea, hypertension, or diabetes).

Resources:

  1. https://www.marinahospital.com/faq/who-qualifies-for-gastric-sleeve
  2. https://kidshealth.org/en/teens/gastric-sleeve.html
  3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4491147/
  4. https://www.bariatric-surgery-source.com/gastric-sleeve-qualifications.html