- BMI ≥ 40, or ≥ 35 with a weight-related condition.
- With poorly controlled type 2 diabetes, some centres consider BMI 30-35.
- Age 18 or older; ETZ uses 18 to 70 as a starting point.
- A GP or specialist referral is required for coverage.
- Motivation for lasting lifestyle change is assessed.
What are the criteria for bariatric surgery in the Netherlands?
The starting point is your BMI: weight in kilograms divided by height in metres squared. With a BMI of 40 or higher you qualify even without related conditions, because according to Vitalys surgery then always brings health gains. With a BMI between 35 and 40 you need a condition linked to your weight.
Vitalys lists examples such as high blood pressure, joint problems, high cholesterol, sleep apnoea, diabetes, asthma, COPD, incontinence, fatty liver and a wish to become pregnant. With a BMI between 30 and 35 and type 2 diabetes that stays poorly controlled despite maximum treatment, surgery may also be considered.
Proof that you tried without surgery
Centres want to see that you have tried to lose weight without an operation, for example with a dietitian or a combined lifestyle programme (GLI). Bring documentation to your GP and the centre: referrals, programmes you followed and your weight history. Missing documentation is a common reason for delay.
When do you not (yet) qualify?
Vitalys mentions two common reasons: psychological problems that have not yet been treated or are still being treated, and dependence on alcohol or drugs, now or recently. Pregnancy, a BMI below the threshold without a related condition, or too little motivation to change your lifestyle can also lead to a negative advice.
A negative advice is usually not the end. You receive the reason in writing with advice on what to do to qualify later, such as first working with a dietitian or treating psychological problems. Under 18, a separate guideline for children with obesity applies.
What counts in your favour and what works against you
Advantages
| Advantage | Explanation |
|---|---|
| BMI ≥ 40 | always an indication, even without conditions |
| Type 2 diabetes or sleep apnoea | counts from BMI 35 |
| Documented attempts | strengthens your application |
| Stopped smoking | lower risk; required by many centres |
Points of attention
| Point of attention | Explanation |
|---|---|
| Untreated psychological problems | treat first |
| Alcohol or drug dependence | reason for postponement |
| No referral | no coverage |
| BMI 35-40 without a condition | not enough for an indication |
Cost and insurance (2026)
If you meet the criteria and have a referral, the whole pathway falls under the basic package.
| Item | Amount or arrangement |
|---|---|
| With indication and referral | €385 deductible 2026 |
| Without indication, self-pay | about €7,000-€11,000 |
| Screening when declined | can count towards the deductible |
Eligibility criteria: key figures
| Feature | Value |
|---|---|
| BMI threshold without a condition | 40 |
| BMI threshold with a condition | 35 |
| Poorly controlled type 2 diabetes (Vitalys) | from 30 |
| Minimum age | 18 |
| Starting point ETZ | 18 to 70 |
BMI 35 and 40 by height
| Height | BMI 35 at | BMI 40 at |
|---|---|---|
| 1.60 m | 90 kg | 102 kg |
| 1.70 m | 101 kg | 116 kg |
| 1.80 m | 113 kg | 130 kg |
| 1.90 m | 126 kg | 144 kg |
Step by step
- Calculate your BMI. Use the BMI check on the English home page.
- List conditions. Which weight-related conditions do you have?
- Documentation. Collect proof of earlier attempts.
- GP. Ask explicitly for a referral to a bariatric centre.
- Screening. The team checks every criterion.
Read next
- Insurance coverage once you qualify — what you pay
- Types of surgery you can qualify for — all options
- Gastric bypass criteria in practice — the most common choice
- Gastric sleeve criteria in practice — when a sleeve fits
What to bring to your GP appointment
Bring your weight and height, a list of your conditions and medicines, and proof of earlier attempts to lose weight, such as dietitian letters or lifestyle programme certificates. Records from abroad help too, ideally translated into Dutch or English.
Ask explicitly for a referral to a bariatric centre, preferably one that your insurer has contracted this year. A general referral to internal medicine often costs weeks of extra waiting time.
Frequently asked questions about eligibility
A BMI of 40 or higher, or 35 or higher with a weight-related condition such as type 2 diabetes, sleep apnoea or high blood pressure.
Usually not. Vitalys makes an exception for type 2 diabetes that remains poorly controlled despite maximum treatment. Otherwise a lifestyle programme, medication or a gastric balloon are options.
Yes, for coverage you always need a referral from your GP (huisarts) or a specialist. Without a referral you can only go to a clinic as a self-paying patient.
Not nationally, but centres use a starting point; the Elisabeth-TweeSteden Hospital mentions 18 to 70. Above that age the team weighs risks more heavily.
You must show you have tried without surgery. After the information session, centres often ask you not to gain weight before the operation and, if possible, to lose a little.
Yes, for example with untreated psychological problems or alcohol or drug dependence. You receive an explanation and advice on how you could qualify later.
Vitalys lists a wish to become pregnant among the conditions that count above BMI 35. After surgery, pregnancy is discouraged during the first year.
Smoking is not a formal exclusion, but you must stop. It increases the risk of complications, thrombosis and reflux. Vitalys works with a covered stop-smoking programme.
That is revision surgery. You are screened again and the team decides whether a second operation makes sense.
Your GP and the centre will measure your weight and height themselves. Bring any records of earlier treatment abroad, translated if possible, to support your application.
Call +31 6 38048347 (Mon–Fri 09:00–17:00) or email info@maagverkleining-info.nl. This page is also available in Dutch.
Sources
- Vitalys (Rijnstate): criteria and FAQ
- Richtlijn Chirurgische behandeling van obesitas, NVvH
- Elisabeth-TweeSteden Hospital: obesity centre
- Ziekenhuis Rivierenland: patient information
Search terms leading here: who qualifies for weight loss surgery Netherlands, bariatric surgery criteria Netherlands, BMI for gastric bypass Netherlands.
Author: Gijs Bodenstaff. Last reviewed: September 2026.