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My doctor actually just sprung this whole thing on me. I wasn't even thinking about it, but he said that I was gaining weight steadily, and that it was alarming that it wasn't stopping. Also, none of the diets he'd put me on in the past worked after about 3 weeks or so, I'd gain it all back, even though I was following everything correctly. So, to answer the first question, my doctor set me up with a consultation that very next week. The whole process took about 3 weeks from consultation to surgery because I'm on my mom's insurance, and she's a federal employee, and I didn't have to do the 6 month diet/psych eval/etc. But I'm sure that other insurances do the same thing, and probably won't make you wait that long.