Hello,
Most insurance companies require that you be roughly 100lbs overweight (BMI=40) in order to qualify for surgery. If you are at least 75lbs overweight (BMI>35), you may qualify if you have a serious co-morbidity like hypertension, diabetes, heart disease, or obstructive sleep apnea. Your BMI is roughly 36.5.

Better than 75% of obese patients have some form of obstructive sleep apnea. In your case, if your doctor does not give you a diagnosis of diabetes, it may be worthwhile to have a sleep study done, to see if you have sleep apnea. Depending on your insurance, a diagnosis of sleep apnea will qualify you for bariatric surgery.

The other issue that you bring up is the alcohol abuse. Most bariatric programs (and all reputable ones) require that patients completely obtstain from alcohol, both before surgery,and for at least a year afterwards. I require it for two reasons: 1- because alcohol contains a ton of sugar and is a great way to keep from losing weight, and 2 - because patients that abuse alcohol are much more likely to vomit, develop ulcers, and run into dangerous complications after surgery.

The history of bipolar disease should not be a big obstacle, in and of itself, to getting the operation done. As long as you are well-regulated on medication and your psychiatrist feels it would be safe for you to have an operation, then bariatric surgery would be ok.

I think you could be a good candidate for surgery, if you can demonstrate to yourself that you are properly motivated. Your ability to completely eliminate alcohol from your life will be a good indicator of your potential for success down the road. I would just caution you to avoid the mental pitfall that you can "cut back" on alcohol and still do fine. Patients that convince themselves of that falsehood almost invariably end up with problems down the road, either in the form of serious complications from surgery or significant weight gain (or both).

Good luck,
Dr Dan