Patients who are or have any of the following should not be offered bariatric surgery: BMI < 35 kg/m2 age < 18 y or > 65 y a medical condition that makes surgery too risky clinically significant or unstable mental health concerns an unrealistic postsurgical target weight unrealistic expectations of a surgical treatment not tried or optimized lifestyle or medical treatments a history of poor compliance with lifestyle, medical, or mental health interventions pregnant, lactating, or plan for pregnancy within 2 y of potential surgical treatment9 lack of safe access to abdominal cavity or gastrointestinal tract smokers (All smokers, regardless of their weight status, should quit smoking [for at least 8 weeks before surgery] as a goal of risk-factor management.8 All patients should be encouraged to remain non-smokers and participate in smoking cessation programs.9)

BMI—body mass index.

Data from National Institutes of Health^6–8 and Mechanick et al.⁹