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Common eligibility BMI of 40+, or BMI 35–39.9 with significant obesity-related conditions (type 2 diabetes, hypertension, sleep apnoea), which aligns with how overweight for gastric bypass is typically assessed in specialist clinics Previous non-surgical weight loss attempts without lasting results Understanding of lifelong dietary changes and supplementation required Agreement to long-term follow-up Medically fit for general anaesthesia Factors affecting candidacy Smoking: most programmes require stopping 4–8 weeks before surgery Uncontrolled conditions: diabetes, heart disease, or psychiatric disorders may need stabilising first

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The previous guideline advised doctors that patients with Pernicious Anaemia can safely have their injections stopped for a year as they will have sufficient stores of B12 in their liver