I am a relative newcomer in the midst of research. My concern is the insurance requirement that you prove you have been unsuccessful on physician-monitored weight loss programs. I cannot do that. I have never been on a physician-monitored diet (I am not qualified for various medications - Xenical, Meridia for example, due to health issues.) I went on South Beach about two years ago and lost 30 pounds - all gained back, of course. I lost 40 pounds on WW twenty years ago. So does this mean I will have to go on a physician-monitored diet, lose weight, and then gain it all back before I can be approved???? I have also read that perhaps one is required to go on the post-surgery diet before surgery. Let's say I do that and lose some weight. Will they then come back to me and say obviously I can lose on the diet without the surgery?? This is the only requirement I am concerned about meeting. My BMI is 51 and I have several co-morbities. Jeez ... the reason I need the surgery is I have been unable to diet! Any guidance deeply appreciated. Thanks.