A decision last month by the federal government has paved the way for many Medicare patients who are candidates for weight loss surgery to have that opportunity, without the inconvenience and expense of travelling great distances away from home.

The Centers for Medicare and Medicaid Services concluded that the evidence was "sufficient that continuing the requirement for certification for bariatric surgery facilities would not improve health outcomes for Medicare beneficiaries." Therefore, CMS decided to remove this certification requirement.

This is not to say that bariatric surgery facilities do not have to meet certain requirements, but under the old certification process, the requirements were, in some cases so lofty, that only mostly larger facilities around the country could comply.

This meant that we, as a small facility, had to turn away many patients who were good candidates for bariatric surgery, who were then faced with travelling to either Columbia or facilities in Kansas in order to obtain the procedure. I'm very happy to announce, for patients living near Blue Springs, that is no longer the case. St. Mary's has a very successful program with a proven track record.

Since we started the program last year, at eight months post surgery, the average weight loss for patients at St. Mary's was 46 pounds. Our goal is for patients to lose one to two pounds per week and many are exceeding that goal. However, whether you are on Medicare, or conventional health insurance, there are guidelines for qualification.

While the following guidelines are generally true for all three forms of bariatric surgery: gastric bypass, sleeve gastrostomy and laparoscopic adjustable banding, they are specific to the adjustable LAP-BAND procedure, which is the preferred bariatric procedure at St. Mary's Bariatric Services.

Whether or not you are a good candidate for weight loss surgery will be a decision that you and your doctor will make together. One of the most important measures of eligibility that your doctor will use is your Body Mass Index, a calculation based on your height and weight. Your BMI classifies you as either overweight, obese or morbidly obese and determines if you fall in the range to be considered for lap-band surgery.

The Body Mass Index is a measurement of body fat based on height and weight. The formula for determining your BMI is (weight in pounds) divided by (height in inches squared).

The BMI measurement categorizes weight as follows:

n Healthy weight: BMI between 19 and 25 n Overweight: BMI between 25 and 30 n Obese: BMI over 30 n Severely (morbidly) obese: BMI is 40 or more.

The BMI and age requirements for lap-band surgery are set by the Food and Drug Administration (FDA), the government agency that approves medical devices for marketing in the United States.

Lap-band surgery may be right for you if:

n Your BMI is more than 40; or more than 35 with obesity-related health conditions n You are between the ages of 18 and 65 n You have been unable to lose weight through diet and exercise n You do not have an illness that has caused you to be overweight n You do not drink too much alcohol n You are committed to making changes in your diet and lifestyle n You are willing to continue working with and be monitored by your doctor.

A couple of other notes: a BMI of more than 60 will require weight loss prior to surgery and any weight gain prior to your procedure will postpone surgery. If you are considering weight loss surgery, talk with your doctor and or attend one of the monthly seminars at St. Mary's. You can also view a video on the St. Mary's Bariatric Services website, bariatrickc.com. Call the Bariatric Surgery Navigator at 816-655-5560 for more information.

M. Brook Redd, MD, practices at St. Mary's Medical Center in Blue Springs.