I fall into this category. I met the WLS about one month ago and he suggested that I lose at least 50 lbs before we set a date. I have met with the dietician and am now on track to losing pre-surgery weight. My BMI is 61 and I feel horrible most of the time...so figured that it can only get better from now forward. I live in a tiny rural town in NW Kansas and have to travel 90 miles one way to see Dr, Nut...etc. Good luck to everyone out there!