In 2011, the International Diabetes Federation issued a position statement suggesting "Under some circumstances people with a BMI 30–35 should be eligible for surgery."[6] When determining eligibility for bariatric surgery for extremely obese patients, psychiatric screening is critical; it is also critical for determining postoperative success. Patients with a body-mass index of 40 kg/m2 or greater have a 5-fold risk of depression, and half of bariatric-surgery candidates are depressed.[7]