Bariatric Surgery Candidates
Bariatric Surgery Patient CriteriaAdolescents being considered for bariatric surgery at Lucile Packard Children’s Hospital must:
- Have a Body Mass Index (BMI) ≥ 40 with serious obesity-related complications (comorbidities) or have a BMI ≥ 50 with less serious comorbidities
- Have participated in at least six consecutive months of medically-supervised attempts at weight management
- Have attained physical maturity. This may vary depending on the severity of any comorbidities. Pediatric Weight Clinic physicians will evaluate patients to diagnose and determine the severity of comorbidities.
- Demonstrate commitment to comprehensive medical and psychological evaluation before and after the surgery
- Agree to avoid pregnancy for at least two years after bariatric surgery
- Be capable of and willing to follow postoperative nutritional guidelines and exercise program
- Provide informed consent to surgery. This means the patient understands all of the facts and risks about bariatric surgery and agrees to have the operation.
- Attend four support group sessions per year
Insurance CoverageParents of prospective bariatric surgery patients should check to see if their health insurance covers the procedure. Different carriers have different coverage policies. Please contact us if you have questions about health insurance coverage.
Referral ProcessIf you would like to be considered for bariatric surgery, please ask your health care provider to complete our referral form (PDF). The completed form should be faxed to the Packard Children’s Hospital Referral Center at (650) 721-2884. Health care professionals can call (650) 736-2114 with questions.
Patients who meet the criteria listed above will be further evaluated at our Pediatric Weight Clinic. The clinic will help adolescents explore various weight-loss strategies.
If no other strategy proves to be effective, the Packard Children’s Hospital’s Adolescent Bariatric Board will review the patient’s case. The Board includes bariatric surgery team members and specialists who have been involved in the patient’s care. They:
Review the patient’s nutritional, medical and psychological status
Discuss the expected benefits and risks of the surgery for the patient
Preoperative InformationBefore the surgery, the patient, family, bariatric surgeon and nurse practitioner discuss:
Possible risks of the surgery
Baseline laboratory tests, clinical consultations and diagnostic tests are also performed. The diagnostic tests include:
Obstructive sleep apnea study
Pulmonary function test – Measures the lungs' ability to exchange oxygen and carbon dioxide
Electrocardiogram/echocardiogram to evaluate the heart's electrical activity
Child psychologist assessment
Bone age x-ray to determine if the patient is still growing
Endoscopy – A test that looks at the inside of the digestive system to check for gastroesophageal reflux