I am bipolar and was approved for my sleeve surgery in 2014 and then again for my bypass revision this year. I think they mainly care that you are stable and medication compliant, and that you aren't in crisis or neglecting treatment for mental health issues that would derail your success with WLS. I was able to use my own psychiatrist to do my insurance approval, and I believe he just wrote a letter explaining that I am in treatment and that he didn't have any concerns with me having the surgery. It's up to the insurance company what kind of clearance they will accept, so maybe call them directly to get the requirements. I also discussed potential malabsorption issues with my psychiatrist and came up with a plan for liquid medication immediately following surgery. My biggest obstacle was having a hard time with the liquid lithium that I was prescribed. It made me queasy and sometimes vomit, and so for a few weeks I wasn't getting enough medication. Luckily, it didn't seem to adversely affect my mood but I would recommend talking to your doctor about these sorts of things and having a plan for getting your medications to work.