morbidly obese with poor medical compliance, and "attempted weight loss" has been unsuccessful. So you shall get her weight down by other mean → Gastric bypass

Indication for bariatric surgery:

BMI ≥40 kg/m2. BMI ≥35 kg/m2 with serious comorbidity (eg, T2DM, hypertension, OSA). BMI ≥30 kg/m2 with resistant T2DM or metabolic syndrome.

This lady needs to cut her stomach as well as all the friends and family around her

BMI ≥40 --> Gastric Bypass candidate. BMI ≥35 + comorbidity --> Gastric Bypass candidate.

She has already tried weight loss without success. Plus she is a compliant patient (diet, insulin regimen, and daily glucose monitoring)

Everyone has a story and a struggle, and weight is not dependent just on our effort or workout regimen. Genetics, microbiome, and many other factors play a role. Let's not judge these patients but help them!

• Patient is a middle-aged woman with a BMI of 75, poorly controlled type 2 diabetes and significant limitations in activities of daily living due to obesity who is compliant with her diet and medications and has been unsuccessful at losing weight on her own who would be a candidate for gastric bypass
• Indications for gastric bypass: Patient with multiple failed attempts to lose weight with adequate ability to follow-up and adhere to a plan who also has (1) BMI > 40 or (2) BMI >35 with obesity-related comorbidity (Type 2 diabetes, obstructive sleep apnea, obesity hypoventilation syndrome, debilitating osteoarthritis, cardiomyopathy, coronary artery disease)
• Note: Interestingly, bariatric surgery in patients with comorbid type 2 diabetes has been found to significantly improve and even cure type 2 diabetes in a significant proportion of patients (https://care.diabetesjournals.org/content/34/Supplement_2/S361)

BMI is 75 Kg/m2!!! GAHHH how does it get to that x_x