My doctor had asked me to lose between 5 to 10% of my body weight during my 6 months (12-24lbs) which would have had me right at the 40bmi my insurance required. Well, I started out doing really well and lost quite a bit the first 3 months. I gained some of that back months 4 and 5 so in the end I only lost 5 lbs total and was nervous I would be denied. However, my doctor said that my insurance was not necessarily looking for a certain amount of weight loss per se but moreso that I had tried a 6 month medically supervised weight management program. I am not sure whether or not this varies by insurance, bmi etc. but mine was approved even with the small amount I lost over the 6 months.