Bariatric surgery is an effective treatment for obesity; however, it may not be appropriate for certain patients due to medical or behavioral risks. Surgery is generally not recommended in the following situations:
- Age below 10 years or above 65 years.
- Patients with viral hepatitis, such as Hepatitis B or Hepatitis C, due to the potential risk of viral reactivation and the possibility of liver function deterioration or cirrhosis, which in severe cases may require liver transplantation.
- Patients with kidney failure, those who have undergone kidney transplantation, or individuals with impaired kidney function, particularly when accompanied by proteinuria and elevated kidney function tests.
- Cannabis users (even without addiction), as cannabis smoking may increase the risk of gastric mucosal injury and potential gastric leakage related to acid irritation.
- Tramadol users (even without addiction) because of the significantly increased risk of serious postoperative complications.
- Patients with ventriculoperitoneal shunts used to treat increased intracranial pressure, as bariatric surgery may increase the risk of infection involving the shunt system.
- Individuals who are unwilling or unable to adhere to the required postoperative dietary and medical regimen.
- Patients with severe gastroesophageal reflux disease who strongly prefer sleeve gastrectomy and refuse gastric bypass, especially those with a strong preference for high-sugar diets.
- Patients with lower body weight, particularly those with a Body Mass Index (BMI) below 30 without significant obesity-related comorbidities.
- Patients with elephantiasis or lymphatic obstruction disorders.
- Patients with uncontrolled psychiatric disorders who are not under regular psychiatric care.