CBE Preoperative Education & Patient Selection 1 — Questions and Answers
Question 1: According to NIH guidelines, what is the minimum BMI required for bariatric surgery eligibility in a patient without obesity-related comorbidities?
- 30
- 35
- 40 (Correct answer)
- 45
Correct answer: 40
NIH guidelines require a BMI ≥40 in the absence of comorbidities, or ≥35 when serious obesity-related comorbidities are present.
Question 2: Which of the following is considered an absolute contraindication to bariatric surgery?
- Controlled type 2 diabetes
- Active untreated substance use disorder (Correct answer)
- BMI of 42 with hypertension
- History of depression treated with medication
Correct answer: Active untreated substance use disorder
Active untreated substance use disorder is an absolute contraindication because it significantly impairs a patient's ability to follow postoperative behavioral and dietary requirements.
Question 3: What is the most common minimum duration of supervised medical weight management required by insurance plans before bariatric surgery approval?
- 1 month
- 3 months
- 6 months (Correct answer)
- 12 months
Correct answer: 6 months
Most insurance plans require at least 6 months of documented supervised medical weight management before approving bariatric surgery.
Question 4: A patient has a BMI of 36 with well-controlled type 2 diabetes. According to NIH guidelines, are they a candidate for bariatric surgery?
- No, because BMI must be at least 40
- Yes, because they have a qualifying obesity-related comorbidity (Correct answer)
- No, because their diabetes must be uncontrolled to qualify
- Yes, but only for non-surgical weight loss procedures
Correct answer: Yes, because they have a qualifying obesity-related comorbidity
NIH guidelines permit bariatric surgery at BMI ≥35 when a serious obesity-related comorbidity such as type 2 diabetes is present.
Question 5: Which psychological factor most commonly disqualifies a patient from bariatric surgery candidacy?
- Mild situational anxiety
- Active binge eating disorder with purging behaviors (Correct answer)
- History of depression treated with medication
- Social isolation without active mental illness
Correct answer: Active binge eating disorder with purging behaviors
Active binge eating disorder with purging is an untreated eating disorder that poses significant risk for poor postoperative adherence and outcomes.
Question 6: What is the primary purpose of the preoperative multidisciplinary evaluation in bariatric programs?
- To reduce hospital billing costs
- To ensure the patient is an appropriate and safe surgical candidate (Correct answer)
- To fulfill insurance documentation requirements only
- To schedule the surgery date and operating room time
Correct answer: To ensure the patient is an appropriate and safe surgical candidate
The multidisciplinary evaluation assesses medical, psychological, nutritional, and social factors to determine if the patient can safely undergo and benefit from bariatric surgery.
Question 7: Which element should be a core component of preoperative bariatric patient education?
- Detailed demonstration of surgical technique
- Setting realistic expectations about weight loss outcomes (Correct answer)
- Comparison of individual surgeon success rates
- Hospital billing procedures and payment plans
Correct answer: Setting realistic expectations about weight loss outcomes
Setting realistic expectations is essential to prevent postoperative disappointment and to promote long-term adherence to required lifestyle modifications.
CBE Preoperative Education & Patient Selection 1
According to NIH guidelines, what is the minimum BMI required for bariatric surgery eligibility in a patient without obesity-related comorbidities?