Criteria for Bariatric Surgery

Metabolic and bariatric surgery (MBS) can be effective for the right patient, but it isn’t for everyone. Lucile Packard Children’s Hospital Stanford’s Pediatric Metabolic and Bariatric Surgery team has a comprehensive list of criteria to determine whether our services are the best path forward for your child. Patients should consider MBS only if they are able to commit to long-term follow-up care and lifelong dietary, exercise, and medical guidelines.

Metabolic and bariatric surgery requirements

Patients who join our program preparing for MBS will be expected to:

  • Be evaluated by our surgeons, dietitians, and psychologists.
  • Be seen in our   Pediatric Weight Clinic or be established in an affiliated obesity medicine program.
  • Attend at least three preoperative dietitian-led group teaching sessions.
  • Be committed to returning to clinic at least six times in the year following surgery as well as yearly thereafter.
  • Have a Body Mass Index (BMI) above 140% of the 95th percentile or, in the case of patients with complications from their obesity, a BMI above 120% of the 95th percentile.
  • Agree to avoid pregnancy for at least one year after MBS.
  • Be able and willing to follow nutritional guidelines and exercise program, the Stanford 360 both before and after the surgery.
  • Assent to surgery, and the parent or guardian must provide informed consent for surgery, including understanding all the facts and risks of MBS, and be able to agree to have the operation.

In cases of developmental delay, the ethics committee will help identify the best approach to the patient’s care when assent may not be possible.

Metabolic and bariatric surgery evaluation process

If you would like to be considered for metabolic and bariatric surgery, please ask your health care provider to complete our referral form (PDF). The completed form should be faxed to the Stanford Medicine Children’s Health Referral Center at (650) 721-2884. Health care professionals can call (650) 723-6439 with questions. Patients will first be seen by one of our pediatric bariatric surgeons and then, through collaborative decision-making, choose a pathway to effective treatment of obesity that will include lifestyle modifications in addition to MBS and medications when indicated. Our program is run in both English and Spanish with language concordant care for all patients.

The Stanford Medicine Children’s Health Pediatric Bariatric Board will review each patient’s case once they have completed all of the preoperative testing, evaluation and education to determine when surgery should be offered. The board includes psychologists, dieticians, nurses, advanced care providers, pediatric bariatric surgeons, obesity medicine specialized pediatricians and our administrative team.