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 Am I a candidate for weight loss surgery?

Well, the answer to this question depends on whether you are morbidly obese. This answer may give you the courage you need to take the first step. Below are tools you can use to determine if you are morbidly obese and thus potentially a candidate for weight loss surgery. We also talk about what causes morbid obesity and and its negative effects.

Section Topics:

How do you know if you are Morbidly Obese and Possibly a Candidate for Surgery?

Generally, if you are or have:

  • a BMI that is greater than 40, surgery should be considered.  If it is greater than 35, and is accompanied by serious comorbidity, surgery may be medically necessary.  To find out your BMI, use the BMI calculator below.
  • comorbidities from being overweight? We look for health effects that are known to be caused by, or aggravated by serious obesity.
  • tried dieting, especially medically-supervised dieting, and been unable to achieve a sustained healthy body weight.

BMI Calculator: Select English or Metric measurement, and then fill in your height and weight to calcluate your BMI. The results of the BMI calculations are displayed below. Note that these are approximate values, and are intended to be used only as a rough guide. Below the ideal body weight chart you will find information about morbid obesity.

ft in
Your BMI:
Your BMI:
BMI Weight Status
Below 18.5 Underweight
18.5 – 24.9 Healthy
25.0 – 29.9 Overweight
30.0 – 34.9 Obese
35.0 – 39.9 Severely Obese
40.0 –49.9 Morbidly Obese
50.0 and Above Super Obese

This is not an official medical calculation. For an accurate B.M.I, please visit your doctor.

If your browser does not show the calculator above, try using this body mass index table by the CDC to determine your BMI.

 Ideal Body Weight Chart:

How to Approximate Your Frame Size

  1. Bend your forearm up to a 90 degree angle. Your arm should be parallel to your body.
  2. Keep your fingers straight and turn the inside of your wrist towards the body.
  3. Using your other hand, place your thumb and index finger on the two prominent bones (on either side) of the elbow.
  4. Measure the distance between the bones with a tape measure or calipers.
  5. Compare with the tables listing elbow measurements for medium-framed men or women.
  6. Compare to the chart below. The chart lists elbow measurements for a medium frame - if your elbow measurement for that particular height is less than the number of inches listed, you are a small frame - if your elbow measurement for that particular height is more than the number of inches listed, your are a large frame.
Elbow Measurements For Medium Frame
Height in 1" heels Elbow Height in 1" heels Elbow
Men Breadth Women Breadth
5'2"-5'3" 2 1/2"-2 7/8" 4'10"-4'11" 2 1/4"-2 1/2"
5'4"-5'7" 2 5/8"-2 7/8" 5'0"-5'3" 2 1/4"-2 1/2"
5'8"-5'11" 2  3/4"-3" 5'4"-5'7" 2 3/8"-2 5/8"
6'0"-6'3" 2 3/4"-3 1/8" 5'8"-5'11" 2 3/8"-2 5/8"
6'4" 2 7/8"-3 1/4" 6'0" 2 1/2"-2 3/4"

Quick Reference to Find Your Frame Size.

Keep in mind that this is a far less accurate measurement method.

To calculate your frame type place your thumb and index finger around your wrist. If your finger overlaps the thumb, your frame is a "Small Frame". If they touch, your frame is a "Medium Frame". If they do not touch, your frame is a "Large Frame".

Height and Weight Table for Women

Feet Inches
4' 10" 102-111 109-121 118-131
4' 11" 103-113 111-123 120-134
5' 0" 104-115 113-126 122-137
5' 1" 106-118 115-129 125-140
5' 2" 108-121 118-132 128-143
5' 3" 111-124 121-135 131-147
5' 4" 114-127 124-138 134-151
5' 5" 117-130 127-141 137-155
5' 6" 120-133 130-144 140-159
5' 7" 123-136 133-147 143-163
5' 8" 126-139 136-150 146-167
5' 9" 129-142 139-153 149-170
5' 10" 132-145 142-156 152-173
5' 11" 135-148 145-159 155-176
6' 0" 138-151 148-162 158-179


Weights at ages 25-59 based on lowest mortality. Weight in pounds according to frame (in indoor clothing weighing 3 lbs.; shoes with 1" heels)

Height and Weight Table for Men

Feet Inches
5' 2" 128-134 131-141 138-150
5' 3" 130-136 133-143 140-153
5'' 4" 132-138 135-145 142-156
5' 5" 134-140 137-148 144-160
5' 6" 136-142 139-151 146-164
5' 7" 138-145 142-154 149-168
5' 8" 140-148 145-157 152-172
5' 9" 142-151 148-160 155-176
5' 10" 144-154 151-163 158-180
5' 11" 146-157 154-166 161-184
6' 0" 149-160 157-170 164-188
6' 1" 152-164 160-174 168-192
6' 2" 155-168 164-178 172-197
6' 3" 158-172 167-182 176-202
6' 4" 162-176 171-187 181-207


Weights at ages 25-59 based on lowest mortality. Weight in pounds according to frame (in indoor clothing weighing 5 lbs.; shoes with 1" heels)

Being underweight or overweight are recognized risk factors for many diseases, namely hypertension, diabetes, hyperlipidemias, and perhaps certain types of cancers.

Remember, these are statistical averages and not absolutes. If you are very muscular, the chart will be inaccurate for you, the same applies to the BMI calculator.

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What is Morbid Obesity?

The word "morbid" means causing disease or injury. Morbid Obesity is a serious disease process, in which the accumulation of fatty tissue on the body becomes excessive, and interferes with, or injures the other bodily organs, causing serious and life-threatening health problems, which are called comorbidities.

Morbid Obesity is also called Clinically Severe Obesity, and is recognized by the consensus of medical opinion as a serious problem, a disease process. Generally, the underlying cause is genetic; you inherit the tendency to gain weight, and once the problem is established, there is very little that you can do to lose it.

How do genes affect obesity?

Overweight and obesity are a result of an energy imbalance over a long period of time. The cause of the energy imbalance for each individual may be due to a combination of several factors. But generally, our behavior is out of sink with our body's biological, and our life's environmental factors which together are all responsible for causing us to be overweight and obese.

Many other factors also contribute to obesity and because of this; obesity is a complex health issue to address. But numerous scientific studies have established that there is a very powerful genetic predisposition to Morbid Obesity.

Science shows that genetics plays a role in obesity. It has been shown that children adopted at birth show no correlation of their body weight with that of their adoptive parents, who feed them, and teach them how to eat. They show an 80% correlation of their body weight with their genetic parents, whom they have never even met. However genes do not always predict future health. It all depends on what other factors are in play. Genes and behavior usually both play hand in hand for those of us who are overweight.

Bottom Line: For people who are genetically predisposed to gain weight, preventing obesity is the best course. Predisposed persons may require individualized interventions (including weight loss surgery) and greater support to be successful in maintaining a healthy weight.

It is time to stop blaming yourself. Many obesity researchers believe that people who struggle with their weight are pushing against thousands of years of evolution that has selected for storing energy as fat in times of plenty for use in times of scarcity. Genes are not destiny; in fact obesity can be prevented or can be managed in many cases with a combination of diet, physical activity, and medication. Genetic predisposition will usually mean that fighting obesity will be a struggle and require a lifelong commitment to achieve better health as will any decision to under go weight loss surgery. Treatments such as stomach stapling, and gastric bypass surgery require life long commitments to living healthy.

What should I do about my obesity?

You could go on another diet. Unfortunately, although diets work for a little while, the effects seldom last, and the answer to Morbid Obesity needs to last a lifetime. No diet program, even the drug programs such as the Phen-Fen, or Redux, programs, are sufficiently powerful, or adequately long-lasting, to produce the necessary sustained weight loss in the severely obese. 

You could look at how much your health is at risk, and consider taking some risk to achieve a more lasting solution: surgery to change your body's physiology, and to help you to gain control of your weight.  In our opinion, surgery is the only effective way to achieve lasting weight control, and a healthy body weight.

Health Effects of Morbid Obesity:

Severe obesity damages the body's mechanical, metabolic and physiological functions. These "comorbidities" affect nearly every organ in the body in some way, and produce serious secondary illnesses, which may also be life-threatening. The cumulative effect of these comorbidities can interfere with a normal and productive life, cause endless frustration and can greatly shorten life span, as well.

Heart Disease

Severely obese persons are approximately 6 times as likely to develop heart disease as those who are normal-weighted. Coronary disease is pre-disposed by increased levels of blood fats, and the metabolic effects of obesity. Increased load on the heart leads to early development of congestive heart failure. Severely obese persons are 40 times as likely to suffer sudden death, in many cases due to cardiac rhythm disturbances.

High Blood Pressure

Essential hypertension, the progressive elevation of blood pressure, is much more common in obese persons, and leads to development of heart disease, and damage to the blood vessels throughout the body, causing susceptibility to strokes, kidney damage, and hardening of the arteries.

High Blood Cholesterol

Cholesterol levels are commonly elevated in the severely obese, another factor predisposing to development of heart and blood vessel disease.

Diabetes Mellitus

Overweight persons are 10 times as likely to develop Type II, Adult-Onset, Diabetes. Elevation of the blood sugar leads to damage to tissues throughout the body: Diabetes is the leading cause of adult-onset blindness, a major cause of kidney failure, and the cause of over one half of all amputations. It is the #3 cause of death in the United States.

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Sleep Apnea Syndrome

Sleep apnea, the stoppage of breathing during sleep, is commonly caused in the obese, by compression of the neck, causing loud snoring, interspersed with periods of complete obstruction, during which no air gets in at all. The sleeping person sounds to an observer like he is holding his breath, but he is, himself, usually unaware that the problem is occurring at all, or only notices that he sleeps poorly, and awakens repeatedly during the night. The health effects of this condition may be severe, high blood pressure, cardiac rhythm disturbances, and sudden death. Affected persons awaken exhausted and often fall asleep during the day, sometimes even at the wheel of their car. This condition has a high mortality rate, and is a life-threatening problem.

Obesity Hypoventilation Syndrome

This condition occurs primarily in the very severely obese, over 350 lbs. It is characterized by episodes of drowsiness, or narcosis, occurring during awake hours, and is caused by abnormalities of breathing and accumulation of toxic levels of carbon dioxide in the blood. It is often associated with sleep apnea, and may be hard to distinguish from it.

Respiratory Insufficiency

Obese persons find that exercise causes them to be out of breath very quickly. The lungs are decreased in size, and the chest wall is very heavy and difficult to lift. At the same time, the demand for oxygen is greater, with any physical activity. This condition prevents normal physical activities and exercise, often interferes with usual daily activities, such as shopping, yard-work or stair climbing, and can be completely disabling.

Heartburn - Reflux Disease and Reflux Nocturnal Aspiration

Acid belongs in the stomach, and seldom causes any problem when it stays there. When it escapes into the esophagus, through a weak or overloaded valve at the top of the stomach, the result is called "heartburn", or "acid indigestion". The real problem is not with digestion, but with the burning of the esophagus by the powerful stomach acid. When one belches, the acid may bubble up into the back of the throat, causing a fiery feeling there as well. Often this occurs at night, especially after a large or late meal, and if one is asleep when the acid regurgitates, it may actually be inhaled, causing a searing of the airway, and violent coughing and gasping.

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This condition is dangerous, because of the possibility of pneumonia or lung injury. The esophagus may become , or scarred and constricted, causing trouble with swallowing. Approximately 10 - 15% of patients with even mild sporadic symptoms of heartburn will develop a condition called Barrett's esophagus, which is a pre-malignant change in the lining membrane of the esophagus, a cause of esophageal cancer.

Asthma and Bronchitis

Obesity does not itself cause asthma, or bronchitis, directly. However, it does interfere with breathing, aggravating any attack of asthma, and gastroesophageal reflux, caused by obesity, may seriously aggravate asthma, and may cause severe bronchitis.

Gallbladder Disease

Gallbladder disease occurs several times as frequently in the obese, in part due to repeated efforts at dieting, which predispose to this problem. When stones form in the gallbladder, and cause abdominal pain or jaundice, the gallbladder must be removed.

Stress Urinary Incontinence

A large heavy abdomen, and relaxation of the pelvic muscles, especially associated with the effects of childbirth, may cause the valve on the urinary bladder to be weakened, leading to leakage of urine with coughing, sneezing, or laughing. This condition is strongly associated with being overweight, and is usually relieved by weight loss.

Degenerative Disease of Lumbo-Sacral Spine

The entire weight of the upper body falls on the base of the spine, and overweight causes it to wear out, or to fail. The consequence may be accelerated arthritis of the spine, or "slipped disk", when the cartilage between the vertebrae squeezes out. Either of these conditions can cause irritation or compression of the nerve roots, and lead to sciatica, a dull, intense pain down the outside of the leg.

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Degenerative Arthritis of Weight-Bearing Joints

The hips, knees, ankles and feet have to bear most of the weight of the body. These joints tend to wear out more quickly, or to develop degenerative arthritis much earlier and more frequently, than in the normal-weighted person. Eventually, joint replacement surgery may be needed, to relieve the severe pain. Unfortunately, the obese person faces a disadvantage there too, joint replacement has much poorer results in the obese. Many orthopedic surgeons refuse to perform the surgery in severely overweight patients

Venous Stasis Disease

The veins of the lower legs carry blood back to the heart, and they are equipped with an elaborate system of delicate one-way valves, to allow them to carry blood "uphill". The pressure of a large abdomen may increase the load on these valves, eventually causing damage or destruction. The blood pressure in the lower legs then increases, causing swelling, thickening of the skin, and sometimes ulceration of the skin.

Emotional/Psychological Disease

Seriously overweight persons face constant challenges to their emotions: repeated failure with dieting, disapproval from family and friends, sneers and remarks from strangers. They often experience discrimination at work, and cannot enjoy theatre seats, or a ride in a bus or airliner. There is no wonder, that anxiety and depression might accompany years of suffering from the effects of a genetic condition, one which skinny people all believe should be controlled easily by will power.

Social Effects

Seriously obese persons suffer inability to qualify for many types of employment, and discrimination in employment opportunities, as well. They tend to have higher rates of unemployment, and a lower socioeconomic status. Ignorant persons often make rude and disparaging comments, and there is a general societal belief that obesity is a consequence of a lack of self-discipline, or moral weakness. Many severely obese persons find it preferable to avoid social interactions or public places, choosing to limit their own freedom, rather than suffer embarassment.

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Disclaimer: California Thin is an independent service offered by BCCI, Inc. It is meant to be an educational site that offers patients information to help them investigate weight loss surgery. Although the site has been reviewed for accuracy, BCCI, Inc. cannot be held liable for inaccurate data or conclusions drawn from the site. Neither information obtained from this site nor e-mailed correspondence from BCCI, Inc. constitutes a doctor/patient relationship. This web site cannot be considered a doctor's opinion for your situation and is not a substitute for medical evaluation and counsel. Any health care providers listed here are private, independent practitioners.
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