The way i got approved was i switched doctors and she sent me to get blood work after our first visit (i didn't mention i was thinking about the surgery) when the results came back there was nothing there that would need the surgery but my bmi was pretty high (im 5'11" 330 age 28 @ the time) and i told her I've tried dieting and working out and that didn't work and she asked me if I ever thought about surgery and that's how we got the ball rolling