For me it was about 4 months. The process was criteria based, I had 3 months of scheduled appointments with the doctor/nurse and I had to have 2 visits with the nutritionist and one after surgery. I had to get a letter of medical necessity from my PCP, and psych evaluation, and I had to lose like 20lbs, and that might be different from others. I also had to take a nutrition class. There may be a few more things but I'm thinking off top right now. I'm 2 weeks post op.