Weight Loss Surgery Requirements: What You Need To Know

Three plus-sized women in jeans and white t-shirts are embracing each other while smiling at each other and the camera. (Models)

If weight loss surgery is your next step toward health, understanding the eligibility criteria is essential. This blog post breaks down the qualification process in Canada’s public health care system, from BMI calculations to comprehensive health evaluations by a multidisciplinary team. And if that’s not the right path for you, we’ll offer insight into another option: bariatric surgery at a private weight loss centre.

Eligibility Requirements in the Public Health Care System

Before starting on the path to weight loss surgery, you need to consider your eligibility and understand the assessment process. In Canada, the Canadian Clinical Practice Guidelines for the Management of Obesity directs the qualifications for bariatric surgery, published by Obesity Canada. These guidelines set forth the criteria you must meet to qualify for surgery.

BMI Requirements at Public Health Centres

Body mass index (BMI), a measure of body fat based on height and weight, serves as a primary indicator of obesity severity. In Canada, the general requirement for bariatric surgery is a BMI of 40 or greater. (If you don’t know your BMI, use our BMI calculator to find out.) You may also be eligible if you have a BMI of 35 or greater and one or more weight-related health conditions, such as:

  • Type 2 diabetes
  • High blood pressure
  • Sleep apnea
  • Infertility
  • Osteoarthritis or joint pain
  • High cholesterol or high triglycerides
  • Heart disease
  • Non-alcoholic fatty liver disease
  • Gastroesophageal reflux disease (GERD) or heartburn
  • Polycystic ovarian syndrome (PCOS)

A Comprehensive Assessment

While the public health care system values BMI as an assessment tool, it’s not the only factor determining your eligibility for bariatric surgery. A comprehensive evaluation by a multidisciplinary team of professionals is required to assess your overall health, psychological state, and readiness for surgery. This evaluation typically involves consultations with a bariatric surgeon, dietician, psychologist, and other specialists such as cardiologists or endocrinologists.

The Qualification Process

The process of obtaining weight loss surgery through publicly funded programs in Canada typically involves the following steps:

1. Consultation with a primary care physician: The primary care physician assesses your overall health and refers you to a bariatric surgeon or other relevant specialist.

2. Assessment by a multidisciplinary team: You’ll receive a comprehensive evaluation by the bariatric surgeon and other specialists to determine eligibility and ensure you’re a good candidate for surgery.

3. Approval from the provincial or territorial health authority: This approval is necessary to access coverage by provincial or territorial health plans.

4. Surgery preparation: Once approved, you’ll undergo a series of preoperative appointments to finalize preparations, including dietary modifications, nutritional counselling, and psychosocial counseling.

5. Weight loss surgery and recovery: A qualified surgeon performs the procedure. Postoperative care typically involves recovery, monitoring, and nutritional guidance.

Wait Times for Publicly Funded Bariatric Surgery

When using a public health plan to cover the procedure, wait times for bariatric surgery are the longest of any surgically treatable condition and vary significantly by province or territory.

Patients in most provinces wait 2 to 5 years for weight loss surgery, with most of this time incurred between referral and consultation with a specialist. The wait time between the consultation with a specialist and surgery is typically between 6 to 12 months.

Benefits of Weight Loss Surgery at a Private Centre

Private weight loss centres like SmartShape allow you to cut through the red tape and restrictive eligibility requirements and bypass the lengthy wait time.

More Inclusive Eligibility

Eligibility qualifications vary depending on the type of bariatric surgery chosen. Below are some of the minimum requirements for surgeries offered at SmartShape. Keep in mind that a consultation is required to determine your specific eligibility.

Surgical TypeMinimum AgeBMI RequirementsLifestyle
Gastric Sleeve1835+
30+ with weight-related comorbidities
You do not drink alcohol excessively or use illegal drugs. You are ready to alter your eating and lifestyle habits.
Mini Gastric Bypass1835+You do not drink alcohol excessively or use illegal drugs. You are ready to alter your eating and lifestyle habits.
Lap-Band®1830+, especially if you have type 2 diabetesYou do not drink alcohol excessively or use illegal drugs. You are ready to alter your eating and lifestyle habits.

Where you live does not restrict your access to bariatric surgery at SmartShape. Learn more about the provinces and out-of-town patients we serve in our FAQs.

Reduced Wait Times

A prime advantage of using a private surgical centre for bariatric surgery is the ease of access to care and dramatically shorter wait times.

  • You do not need to have a physician referral to schedule a consultation.
  • You can typically arrange your free consultation within the same week as your initial inquiry.
  • Self-financed procedures can often be scheduled within 4 to 6 weeks of your consultation.

More Surgical Choices

Private centres also allow access to a wider range of procedures. Most patients who use provincial health plans such as OHIP to cover their costs have gastric bypass as their only option. Private surgery at SmartShape opens up alternatives, including gastric sleeve, mini gastric bypass, the LAP-BAND® system, and revision surgery.

Affordable Options

When you consider the cost of obesity versus the long-term health benefits of weight loss surgery—such as an extended, healthier life—the expense is relatively minor.

Most private health insurance plans don’t cover bariatric surgery. However, to make financing more accessible, SmartShape has partnered with several trusted financial service partners. You may also qualify for a federal medical tax credit for medically necessary procedures. Speak with your financial advisor or accountant to learn more.

Take the Next Step

With high-quality care and aftercare support, bariatric surgery can lead you to improved health, well-being, and quality of life.

If you’re ready to take control of your health, SmartShape is here for you every step of the way. We encourage you to call our office today at (888) 278-7952 or request a consultation.