Question:
Do you have to be a certain BMI to have the RNY done?

I talked to a nurse today and was told that most Drs wont do a RNY on a person that has a BMI over 50. I have not been to see the surgeon yet but just got the recommendation from my doctor. However I have done alot of research on the RNY and never came across any thing like that. Has anyone else heard or been told this? If so what did you have to do?    — Kelly G. (posted on May 17, 2004)


May 17, 2004
Kelly, Some surgeons recommend the BPD/DS for people with a BMI over 50. My BMI was 64 at the time of my surgery. I had an open BPD/DS and since surgery have lost 205 lbs and pretty much all of my comorbidities (okay, I'll always have bum knees and back). Let me know if I can help at all, okay? Blessings, dina
   — Dina McBride

May 17, 2004
I don't think you mean the RNY. I had the RNY with a BMI of 40.
   — susanje

May 17, 2004
I have seen a few different surgeons about having WLS and my BMI is 61.2. One doctor did offer to do DS but I have already researched RnY and I know this is the surgery for me. The second surgeon was willing to do Lap RnY, and I would prefer my surgery to be open as strange as that sounds. So the surgeon I am going to now is going to do my Open RnY and my surgery date is scheduled for 6/30. If you truly want RnY keep researching surgeons and their surgeries and make your own decision as to what is best for you!! If they don't want to do what you want find another surgeon!! Good Luck in your journey and feel free to email me with any questions.
   — Maggie M.

May 17, 2004
I am having the RNY and even after I loose the 20lbs I need to my BMI will still be 54. I think any surgery if used to its fullest will allow you to get to your goal weight but because of the malabsorption the DS will help you get there quicker or should I say is more helpful to those who need to loose at 200lbs.
   — davesband1

May 17, 2004
Adrian G, I'm glad the DS is the right surgery for you but don't let anyone kid you that a DS loses faster as there just isn't a lot of info to support that. They lose fine but no guarantee it will be faster. I lost 227 lbs in 12-3/4 months and I had an RNY. After PS and losing a few extra lbs I was down 250 lbs by about 15 months. I've had a number of DS people comment that they always heard a DS loses faster but not really the case. Comes down to the surgery and how small the pouch is etc. By the way I am only a 150 cm bypass so it's not like I'm a very distal bypass or short common channel. I know that in the long term the DS is supposedly better for maintaining but I still feel it comes down to how each person embraces their new life. Have I had some struggles in the past few months, yes, but being able to eat the crap that I am struggling with just because I will malabsorb most of it would not help me truly deal with my eating issues and habits. Like I said each person has to find the right surgery for them, but do not base it significantly on facts that just aren't accurate. I belong to a Yahoo board for people over 400 lbs and there are a number of RNY's who have lost 200+ lbs in a year. We also have some DS people and they have done wonderful too.
   — zoedogcbr

May 17, 2004
Kelly, I had a bmi of 58.2 when I had my laproscopic rny done. It has now been 6 1/2 months since my surgery and my bmi is 37.2 (i have lost 21 points off of my bmi !!). So it is possible to have the rny and to lose. My start weight was 339 (I'm 5'4" tall), and I now weight 217lbs. I know my journey is not over, I want to get to 140. I had 150in bypassed, which puts me at distal rny. Don't give up hope, if a doctor is uncomfortable with working on you because of your bmi, then contact another surgeon. You will find that there are plenty who are willing and able to do the work, check their track record out and then come join us on the losing side. By the way, my sister also had rny done 3 mths after me, her bmi was lower than mine, but i still think over 50, and she was also done lap and is doing awesome. If you have any questions you can email me. Lisa postop lap/rny 10-23-03 -122lbs
   — Lisa H.

May 17, 2004
My BMI was like 53 or 54 and I was a perfect candidate. I am now almost 8 months out and my BMI is around 30, so that is not the case, at least not in my situation. Good Luck!!
   — Donna F.

May 17, 2004
I meant 150 cm not inches bypassed...lol. Lisa
   — Lisa H.

May 17, 2004
I had an open rny surgery and I had a BMI of 60. My Surgeon made sure that I had demonstrated good habits for an extended period of time (with weightloss) prior to agreeing to do the surgery. I started with a BMI of 63+. If your not comfortable with what your Surgeon says, find a second opinion. I would also check out the creditials and reputation of your Surgeon. You can't always believe what a doctor tells you, I once had a doctor tell me to lose 50 lbs before I could have a pap, I weighed 245 at the time). I waited 3 yrs before I asked another doctor what I should do, I hadn't lost the weight. That doctor was appalled that I'd been told that and did the exam for me. It just goes to show that some doctors feel more comfortable than others dealing with obesity.
   — Julesbird

May 17, 2004
Welcome to the world of 'know it all' health care professionals. That's simply not true. Every surgeon has different 'cut-off' points where they feel comfortable, but there is no random munber set that doctors won't operate over. WLS surgery is ideal for people with higher BMI's because of all the health problems and restricted movement we encounter at higher weights. My BMI was over 50 when I had surgery.
   — LMCLILLY

May 17, 2004
I had a BMI of 71 when I had lap rny a year ago.
   — lstone86

May 18, 2004
I had my surgery last August with a BMI of 89! Some doctors are just different in what they feel comfortable working with (ie fear of malpractice suits from working with riskier patients) and also in what they require pre-ops to do to qualify for surgery. I didn't have to do the pre-op diet or anything like that. Good luck finding the right doctor for you. You can research them on this site to find one tht meets your needs. Christie, 8 mo post, -185
   — christied

May 18, 2004
From what I understand is that certain Dr.'s choose not to perform the surgery on patients with a higher BMI for various reasons based on their comfort level. The risks are higher for a higher BMI; therefore, some Dr's just don't feel as comfortable. Ofcourse, there are some Docs who choose to operate only on "ideal" candidates in hopes of boosting their success rate; however, I've heard of a few but find that to not be the normal case. There are some surgeon's who will only operate on patients with extreme BMI's because their wait list for the surgery is so long and they are choosing the candidates that are most in need at that time. You may need to look outside your immediate area; however, I'm sure if you research well you will find a Dr. who will perform the most appropriate surgery for you and your needs. Best of luck!! Denise/ RNY 3/20/03 -140 at goal
   — denisel

May 18, 2004
I have talked with Dr Ross Fox with the Surgical Weight Loss Clinic in Tacoma, Wa and that is the surgery I will be having soon. He says that you have to be a certain BMI to have that surgery. I think that if you are 50 or higher the right type of surgery is the RNY. I go in for my H & P with him on Thursday this week and will ask that question for you. I know though, that I will be having that done as that is the fastest way to loose weight. By the way my BMI is 63.
   — Angela C.

May 18, 2004
Absolute bunk! The only time I have heard of a BMI limit limit on the RNY -- or for any surgery-- are those that have an EXTREMLY high BMI. But there are surgeons who specialize in doing WLS on people who have very high BMIs-- they can be hard to find but they are out there. You and your surgeon need to choose the right surgery for you. If that means that you have to change surgeons because he or she does not perform the surgery you need for whatever reason, then so be it. Every type of WLS has its pros and cons, as does every surgeon. There are many different reasons why some surgeons only perform certain surgeries, or only do open surgeries-- it can be personal preference, skill level, training, insurance liability, time constraints--any number of things. I don't think that nurse gave you reliable info.
   — lizinPA

May 18, 2004
Hi Kelly, I have read that to be eligible for gastric bypass according to the insurance companies, you have to have a BMI of 40 with no co-morbidities or 35 with them. Call the doctor's office that you are going to and ask. They will be quick to tell you. All doctors are different and set different standards. Good Luck--Debbie
   — imdebbie




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