From the Lap Band website: Indications: The LAP-BAND® System is indicated for weight reduction for patients with obesity, with a Body Mass Index (BMI) of at least 40 kg/m2 or a BMI of at least 30 kg/m2with one or more obesity-related comorbid conditions. Lower than 35 BMI is allowed with comorbidities, but insurance would probably give you a hard time. Many doctors will do the Lap Band with a lower BMI, but the good surgeons want to be sure it is for the right reasons. For me (and many banders with low BMI), it is more about the improvement of health than the weight loss. In my mind, I always think of my health first and think of the weight loss as an amazing side effect. To look at me, most don't understand why I need surgery, but my surgeon, Dr. George Fielding looks at me (and my family) and knows he is giving me my life back. It seems like although Bariatric Surgeons can make plenty of money (so I don't think they expect to get rich approving all those low BMI patients for surgery), for most of them, it is about helping people live a happy and active life. It is up to us the patients to be sure we have our ducks in a row and are doing the surgery for the right reasons. Remember the surgeons are just the guys qualified to install the tool....it's up to us to understand how to use the tool for the most benefit.