I feel like I could have written all of these responses. I am going to be a self pay with a low BMI also. I told my doctor that I could lose 20# on a diet and I could gain 25# back but I can't get 50 off. I know if I could get down 50 that I would keep it off. He tried to talk me in to getting a gastric sleeve but I'm not going that route. Glad to hear these success stories from low BMI patients