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Like most insurance company requirements here, I needed to be a 'failure' at the 6 month diet (the three seminars I went to all said to lose 5-10 lbs. (but don't gain). I lost about 10 pounds during the 6 mo. diet and was approved within 48 hours. I lost another 9 pounds on my own (I didn't have a pre-op diet) in the 3 weeks between approval and my banding. Best wishes in your research and let me know if I can help with anything! -BG (I'm down 80 lbs. today...best thing I've ever done for me!)