It very much depends on your insurance requirements as ShoppGirl mentioned. My insurance required 6 months of monitored weight loss, 3 months of nutrition, lung clearance, heart clearance, nutrition classes, surgical classes, psyche clearance, etc. The whole process took approximately 8 months from my first appointment until the day I had my surgery. I was also able to lose 68 pounds in that time so I was at least productive during that time lol.