Key Points Consider weight loss surgery if patients are motivated, have not succeeded using nonsurgical treatments, and have a BMI of > 40 kg / m 2 or a BMI of > 35 kg / m 2 plus a serious complication (eg, diabetes, hypertension, obstructive sleep apnea, high-risk lipid profile) or a BMI of 30 to 34.9 with type 2 diabetes and inadequate glycemic control despite optimal lifestyle and medical therapy.