Preoperative weight loss or medical optimization may be required in order for us to safely perform surgery. We generally do not operate on patients over 400 pounds. If you find yourself in this situation, we will still work with you. We are able to help patients over that weight to achieve enough preoperative weight loss to have surgery, and we also maintain close relationships with Boston hospitals where we can refer patients who have more complex needs. If we cannot safely perform surgery at CMC and we refer you to a larger hospital, we will still provide all of your pre- and post-operative care here in Manchester.