Despite what someone may have told you, weight loss surgery is NOT “cheating”. There are many reasons people consider weight loss surgery and non are better or more worthy than another, since they all attempt to achieve one thing: a better quality-of-life. Some seek an end to decades of effort and stress of ineffective dieting, some desire to get off medications for diseases brought on by or made worse by extra body weight, and some simply want more mobility to enjoy time with their family. So, we feel weight loss surgery is no more “cheating” than using automobiles, air-conditioners, or antibiotics.  Eligibility may be a somewhat evolving and controversial topic. There are traditional guidelines established by the National Institute of Health 30 years ago and based on a very different era of bariatric surgery. These guidelines were made when there were relatively few surgeons practicing weight loss surgery, through large incisions prior to minimally invasive laparoscopic techniques, based on surgical procedures that haven’t been performed in decades. The essential recommendations include that suggestion that patients have a BMI (body mass index) of at least 40, or a BMI as low as 35 if the person has additional medical illnesses or co-morbidities. Over time, some procedures have been felt to be appropriate for BMI as low as 30 if the person has medical issues associated with extra body weight. Unfortunately, what legitimately constitutes these “associated medical issues” has been manipulated over the years by insurance companies, and even surgeons. Weight loss surgery has been shown, as would be expected, to be safe in lower BMI patients; sensibly, it may be better and less risky to operate when the patient weighs less and has less illnesses. We feel the most important elements for eligibility is an interested, participating, educated patient who is aware of the options, techniques, and risks involved in the goal of having a better quality-of-life.