BMI Groups and Surgery

Hi Dr. Reed,

Thank you for the email. I have a trans woman who is interested in surgery.
My question is whether or not a BMI of 36 would rule her out.

Thank you for your commitment to the trans community.


Good afternoon Madeline,

“We” think of BMI’s in groups of 5.

20 to 25 normal, but we would not operate on anyone
with a BMI below 22. Their wounds don’t heal well and
patients usually lose about 10 pounds after surgery, then their
BMI could be 18. 25 to 30 is the “overweight” category
and with some caution we will operate on this group.
When someone’s BMI is over 30 (generally speaking)
they are considered obese.

Admittedly some patients with BMI’s over 30 are very muscular,
but the true clue is what is their waistline. Over 40″ again suggests obesity.

If you look at muscle mags of men and women you’ll see all their
waistlines are trim. If someone has had silicone injections or
huge breast implants we can take that into consideration.

In surgery, especially elective, safety first. I am not a meanie but some complications
last a whole life time and that makes 2 people who don’t want to live with that.

I tell prospective patients “you are responsible for what you put in your mouth.”

Have a restful night and the collegiality has begun,

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