Some reasons an operation should be avoided include:

• Heart valve disease and/or angina pectoris
• Active peptic ulcer disease
• Patient is unfit for general anesthesia
• Patient is not prepared to make necessary lifestyle and/or behavior changes
• Active alcoholism or drug abuse
• Hepatic cirrhosis with impaired liver function tests
• Serious psychiatric disability
• Patients in very poor overall health
• Persons desiring the surgery for the wrong reasons (see below)