Obesity surgery may also be an option for people with a BMI of 35 to 40 who suffer from obesity-related problems (for example, severe sleep apnea, obesity-related heart disease, or diabetes). For these people, the risk of death from not having the surgery may be greater than the risks from the possible complications from undergoing the procedures.

In early 2011, however, the FDA approved the use of Lap Band restrictive surgery in those with a BMI of 30 or higher who have at least one obesity-related condition, such as diabetes. This change made the surgery an option for more people.

Keep in mind that as in other treatments for obesity, results may vary. In many cases, patients are required to show proof that their attempts at dietary weight loss have been ineffective before surgery will be approved. A psychological evaluation may be required by doctors to determine your potential response to weight loss and change in body image. Most surgeons require patients to demonstrate serious motivation and a clear understanding of the extensive dietary, exercise, and medical guidelines that must be followed for the remainder of their lives after having weight loss surgery. In addition, studies are performed to assess the health of your heart and hormonal systems. Nutritional counseling is also a must before and after surgery.

For patients who remain severely obese after nonsurgical approaches to weight loss have failed, or for patients who have an obesity-related disease, surgery may be an appropriate treatment option. But for most patients, greater efforts toward weight control, such as changes in eating habits, lifestyle changes, and increasing physical activity, are more appropriate. The following questions may help you decide if weight loss surgery is right for you.

• Have you tried to lose weight through conventional methods of weight loss: group classes, one-on-one counseling, calorie-controlled meal plans, food journals, and exercise?
• Are you well-informed about the surgical procedure and the effects of treatment?
• Are you determined to lose weight and improve your health?
• Are you aware of how your life may change after the operation (adjustment to the side effects of the surgery, including dramatically different eating habits)?
• Are you aware of the potential for serious complications from the procedure, the associated dietary restrictions, and the slight chance that the procedure will not help you lose weight?
• Are you committed to life-long medical follow-up?