Do I Qualify for Weight Loss Surgery Quiz
Questions: 15 · 10 minutes
1. When you picture life after surgery, which expectation is closest to yours?
I expect surgery to do most of the work without major long-term changes
I know some changes are needed, but I am unclear about their extent or permanence
I understand the broad commitments but still have specific questions
I expect surgery to be one tool alongside lifelong nutrition, activity, supplements, and follow-up
2. Which statement best fits pregnancy or near-term pregnancy plans for you?
Pregnancy is not relevant to me, or I am not planning it in the near term
I may want pregnancy relatively soon but have not discussed surgical timing
I am actively trying to become pregnant or may be pregnant
I am currently pregnant or in a medically supervised postpartum recovery period
3. How voluntary does the decision to explore surgery feel?
It feels like my decision, and I can freely choose whether to proceed
Other people have strong opinions, but I can still decide for myself
Pressure from family, a partner, work, or a clinician makes it difficult to identify what I want
I feel coerced, threatened, or unsafe saying no
4. What does your surgical, medication, and anesthesia history suggest should be reviewed?
I know my history and am not aware of a special concern
I am missing details or need help assembling my medication and procedure history
I use a medicine or have had a procedure that a surgical team will need to plan around
I have had a serious anesthesia reaction, major surgical complication, or known condition affecting anesthesia
5. What is your current experience with conditions that may be related to weight, such as type 2 diabetes, high blood pressure, sleep apnea, or fatty liver disease?
I have multiple diagnosed conditions, or one is substantially affecting my health
I have one diagnosed condition that requires monitoring or treatment
I have symptoms or concerns, but they have not been fully evaluated
I am not aware of any such condition
6. During a stressful month, how are alcohol, non-prescribed drugs, or misused medications most likely to feature?
Use may increase a little, but it does not interfere with responsibilities or safety
I do not use them, or my use stays within limits agreed with my clinician
Use can become hard to control or interfere with my plans
Use has led to blackouts, withdrawal concerns, overdose, unsafe driving, or another serious consequence
7. Over the past few years, what has happened when you used non-surgical approaches to manage your weight?
I have not yet tried a structured approach or worked with a clinician on this
I have made an independent attempt, but not a sustained structured one
I have tried several structured approaches, with limited or short-lived results
I have made sustained, clinician-supported efforts without achieving a durable result
8. Suppose your program asks you to follow staged eating guidance and take prescribed supplements every day. What would be most realistic?
I could follow the plan consistently and ask for help when obstacles arise
I would need a few reminders or practical adjustments
Cost, routines, food access, or another barrier would often disrupt the plan
I currently could not maintain the plan or obtain the required supplements
9. If recovery temporarily limits lifting, driving, work, or caregiving, what support could you use?
I have dependable help and a realistic recovery plan
I have some help but need to confirm dates or responsibilities
Support is uncertain, and important duties may be difficult to cover
I expect to manage essential duties alone despite restrictions
10. Your clinic schedules repeated appointments, laboratory tests, and long-term follow-up. How workable is that for you?
It is workable with my current transport, time, finances, and access
One manageable obstacle would need planning
Several obstacles could cause missed appointments or tests
I currently lack a realistic way to attend essential follow-up
11. How would you describe your current medical stability before a possible operation?
My known conditions are stable and routinely monitored
I have a condition or symptom that needs a routine review or updated test
A condition is not well controlled, or I am awaiting an important assessment
I have an active serious condition, severe unexplained symptoms, or a recent major medical event
12. Which best describes your current nicotine exposure, including cigarettes, vaping, or nicotine pouches?
I do not currently use nicotine
I stopped recently or use nicotine only on rare occasions
I use nicotine some days
I use nicotine daily or find stopping especially difficult
13. What guidance have you received from a healthcare professional about bariatric or metabolic surgery?
It has not come up, and I have not asked for an assessment
A clinician has suggested discussing weight-treatment options generally
A clinician has said surgery may be reasonable to explore
A clinician has referred me for, or specifically recommended, a bariatric assessment
14. Imagine a typical week. How much does your weight or a related health issue limit mobility, sleep, work, self-care, or other important activities?
It regularly limits several important activities or makes one activity very difficult
It repeatedly limits at least one important activity
It causes occasional difficulty but little ongoing limitation
I notice little or no limitation in these areas
15. Which range contains your most recently calculated body mass index (BMI)?
Below 30
30.0-34.9 without a diagnosed weight-related condition
30.0-34.9 with type 2 diabetes or another diagnosed weight-related condition
35 or higher