Authority
Candidate Selection Criteria
The right metabolic or bariatric option depends on a careful, individualized evaluation. The criteria below are based on current ASMBS/IFSO guidance and clinical practice; final candidacy must be determined by a qualified surgical and metabolic team.
Written by MagnaMetabolic Editorial Team Medically reviewed by Ariel Ortiz, MD — Bariatric & Metabolic Surgery Last reviewed: June 7, 2026
Commonly considered factors
- BMI thresholds. ASMBS/IFSO 2022 guidance supports metabolic and bariatric surgery for adults with BMI ≥35 kg/m², and for adults with BMI 30–34.9 kg/m² who have metabolic disease that is not adequately controlled with non-surgical treatment.
- Metabolic comorbidities. Type 2 Diabetes, severe insulin resistance, MASLD/MASH, dyslipidemia, hypertension, obstructive sleep apnea, cardiovascular risk.
- Prior treatment history. Adequate trial of non-surgical interventions, response to GLP-1 medications, history of weight regain after prior bariatric surgery.
- Behavioral and nutritional readiness. Ability to commit to follow-up, dietary changes, and recommended supplementation.
- Medical and surgical history. Prior abdominal surgery, anatomy, anesthesia risk, comorbid conditions.
Procedure-specific considerations
- Sleeve Plus / Sleeve Plus MagDI may be considered in primary candidates seeking enhanced metabolic effect alongside sleeve gastrectomy.
- Sleeve Rescue Plus is considered after a prior sleeve gastrectomy with weight regain, insufficient weight loss, or diabetes recurrence.
- Diabetes Magna Plus is positioned for patients whose primary concern is Type 2 Diabetes within an obesity context.
See also Contraindications and Risks vs Benefits.
Evidence
Scientific References
Selected primary sources informing this page. External links open in a new tab; we do not control or endorse third-party content.
- ASMBSAmerican Society for Metabolic and Bariatric Surgery (ASMBS) and IFSO 2022 indications for metabolic and bariatric surgery.
- ADAAmerican Diabetes Association — Standards of Care in Diabetes (current edition), Section on obesity and metabolic surgery.
- NIDDKNational Institute of Diabetes and Digestive and Kidney Diseases — Bariatric Surgery for Severe Obesity.